The alliance requires:

1. A. a completed application;
2. B. the employer’s federal EID and New Mexico gross receipts tax ID numbers; or, for a new business that has not yet obtained tax ID numbers, a current valid business license;
3. C. a waiver of coverage, in the form specified by the alliance, signed by each eligible employee who does not desire coverage. If the employee has other coverage, the name of the carrier, as well as the subscriber and group names must be specified; and

4. D. for groups that file New Mexico department of labor employer’s quarterly wage and contribution report (schedule A - SUTA), the employer’s most recent SUTA.

   (1) The employer must identify on the SUTA form each employee who is not eligible for coverage and must specify the reason that the employee is ineligible, e.g., on medicare, working less 20 hours per week, etc. For each employee who is not eligible, the employer must specify the employee’s date of hire and hours per week worked.

   (2) If an employer submits a SUTA but desires to enroll employees who are not identified on that report, the employer must submit the following applicable documentation for each such employee:

   (a) for any new employees not yet identified on the most recent SUTA, W-4 forms;

   (b) for each working owner, dependent or partner not identified on the SUTA, an affidavit, signed under oath, that the individual is working in the business at least 20 hours per week on a regular basis.

5. E. If the employer group is required to file a SUTA but has not yet done so because it is a new business (i.e., established within three months prior to the date of application), the employer shall submit an affidavit, signed under oath, that the employer is actively engaged in an ongoing business and reasonably expects to average between two and 50 employees for the next two years, together with a list of current employees. Each individual enrolling as an employee must submit a witnessed affidavit that the individual is working in the business at least 20 hours per week on a regular basis.

6. F. If the employer group is not required to file a SUTA, the employer must submit a witnessed affidavit that the employer is actively engaged in an ongoing business, and is working in the business at least 20 hours per week on a regular basis, together with the relevant portion of its latest complete federal income tax filing, as specified below, in order to allow the alliance to verify the existence of the business and validate actively working requirements through documented earned income/loss. The following forms, as applicable to the employer’s business, are required. NOTE: If wages are reported on any of these forms, the employer must submit either a SUTA or a W-2 form.

   (1) 1120 corporate return.

   (2) 1120S corporate return.

   (3) 1065 and Schedule K-1 for each eligible partner who elects coverage.

   (4) Schedule C for business income profit or loss report for sole-proprietors.

   (5) Schedule E for real estate or rental income.

   (6) Schedule F for farm income.

[13.10.11.23 NMAC - N, 6-1-01; A, 3-31-08]