Making Changes?

It’s as easy as 1, 2, 3.

Individual Forms

If you have an existing account with NMHIA please let us know of any change on your group plan or individual policy. Print the forms and fax or mail them to us. Please contact your agent for assistance.

Our fax number is: 505-988-3461

Our mailing address is:
P.O. Box 5095
Santa Fe, NM 87502

For current NMHIA Employer Group members the following forms can be downloaded and printed. You will need Acrobat Reader software which is found and downloaded from the internet free of charge.

Electronic Funds Transfer Form (EFT) - This form is for NMHIA individuals who want their monthly premium payment withdrawn from their personal bank account. Premium payments are withdrawn on the 1st business day of every month. This form can be printed and either faxed or mailed to our office.

Individual Change Request Form - This form can be printed and either faxed or mailed to our office for the following changes:

Address changes
Name changes
Dependent additions or deletions
Cancellation of coverage