South Dakota Codified Laws
Chapter 17A - Medicare Supplement Policies
Section 58-17A-1 - Definition of terms.

58-17A-1.Definition of terms.
Terms used in this chapter mean:
(1)"Applicant," in the case of an individual medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits; and in the case of a group medicare supplement policy or subscriber contract, the proposed certificate holder;
(2)"Certificate," any certificate issued under a group medicare supplement policy, which policy has been delivered or issued for delivery in this state;
(3)"Certificate form," the form on which the certificate is delivered or issued for delivery by the issuer;
(4)"Issuer," includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state medicare supplement policies or certificates;
(5)"Medicare," the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965 and as amended through December31, 1991;
(6)"Medicare supplement policy," a group or individual policy of health insurance or a subscriber contract of nonprofit hospital, medical and surgical service plans, or health maintenance organizations, which is advertised, marketed, or designed primarily as a supplement to reimbursements under medicare for the hospital, medical or surgical expenses of persons eligible for medicare. The term does not include insurance policies or health care benefit plans, including group conversion policies, provided to medicare eligible persons which policies are not marketed or held to be medicare supplement policies or benefit plans, nor does it apply to a policy or contract of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations. The term does not include a policy issued pursuant to a contract under Section 1876 of the federal Social Security Act, 42 U.S.C. §1395 et seq., or a policy issued under a demonstration project specified in 42 U.S. C. §1395ss(g)(i). The term does not include any medicare advantage plan established under Medicare Part C, any outpatient prescription drug plan established under Medicare Part D, or any health care prepayment plan that provides benefits pursuant to an agreement under §1833(a)(1)(A) of the Social Security Act;
(7)"Policy form," the form on which the policy is delivered or issued for delivery by the issuer.

Source: SL 1982, ch 360, §1; SL 1989, ch 431, §1; SL 1990, ch 396, §1; SL 1992, ch 347, §1; SL 1996, ch 293, §1; SL 2005, ch 267, §1.

Structure South Dakota Codified Laws

South Dakota Codified Laws

Title 58 - Insurance

Chapter 17A - Medicare Supplement Policies

Section 58-17A-1 - Definition of terms.

Section 58-17A-2 - Regulations to establish specific standards for policy provisions.

Section 58-17A-3 - Preexisting conditions--Policy provisions.

Section 58-17A-3.1 - Preexisting conditions provision prohibited in replacement policy--Exception.

Section 58-17A-4 - Reasonable benefits required--Regulations to establish minimum standard from loss ratios--Policies issued through mail or mass media advertising.

Section 58-17A-5 - Outline of coverage delivered at time of application for insurance.

Section 58-17A-6 - Informational brochures.

Section 58-17A-7 - Health insurance policies--Requirements for information regarding medicare coverage.

Section 58-17A-8 - Notice of right to return and right to premium refund printed in medicare supplement policies and certificates--Payment of refund.

Section 58-17A-8.1 - Issuance of policies by insurance company, nonprofit hospital service plan, medical service corporation, or fraternal benefit society--Delivery receipts--Certificates of mailing--Term of retention.

Section 58-17A-9 - Regulations subject to Administrative Procedures Act.

Section 58-17A-10 - Filing requirements--Master policy--Rates, rating schedules, and supporting documentation--Riders or amendments to delete outpatient prescription drug benefits.

Section 58-17A-11 - Premiums to be adjusted to produce a loss ratio conforming with minimum standards--Form of adjustments.

Section 58-17A-13 - Review of advertisements of issuers providing medicare supplement insurance.

Section 58-17A-14 - Requirements for replacement of policy.

Section 58-17A-15 - Sale of second policy prohibited except as replacement--Liability of issuer.

Section 58-17A-16 - Additional penalties for violation of title.

Section 58-17A-17 - Conditional or discriminatory policy or certificate prohibited.