South Dakota Codified Laws
Chapter 17A - Medicare Supplement Policies
Section 58-17A-2 - Regulations to establish specific standards for policy provisions.

58-17A-2. Regulations to establish specific standards for policy provisions.
The director shall promulgate rules pursuant to chapter 1-26 to establish specific standards and requirements for medicare supplement policies and certificates. The standards and requirements shall be in addition to and in accordance with applicable laws of this state and may cover, but are not limited to:
(1)Terms of renewability;
(2)Initial and subsequent conditions of eligibility;
(3)Nonduplication of coverage;
(4)Probationary periods;
(5)Benefit limitations, exceptions, and reductions;
(6)Elimination periods;
(7)Requirements for replacement;
(8)Recurrent conditions;
(9)Definitions of terms;
(10)Filing requirements for forms and rates and rate schedules;
(11)Marketing practices;
(12)Reporting practices;
(13)Compensation arrangements between insurers or other entities and their agents, representatives, or producers;
(14)Suitability and appropriateness of policy sold;
(15)Data on application forms;
(16)Continuation and conversion rights;
(17)Loss ratio requirements and refund and credit calculations;
(18)Suspension and reinstitution of coverage; and
(19)Refund of premium for duplication and suspension and reinstitution of coverage.
The director may promulgate rules pursuant to chapter 1-26 that specify prohibited policy or certificate provisions not otherwise specifically authorized by statute which, in the opinion of the director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a medicare supplement policy or certificate. The director may also promulgate rules assuring public access to rate and form information, establishing procedures for rate and form approvals or disapprovals, and establishing a uniform methodology for calculating and reporting loss ratios.
The director shall promulgate rules pursuant to chapter 1-26 to establish minimum standards for benefits and claims payment under medicare supplement policies and certificates and to establish procedures for rate hearings.

Source: SL 1982, ch 360, §2; SL 1989, ch 431, §2; SL 1990, ch 396, §2; SL 1992, ch 347, §2.

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.