South Dakota Codified Laws
Chapter 17B - Standards For Long-Term Care Insurance
Section 58-17B-7 - Requirements for long-term care insurance policies--Post-confinement, post-acute care, or recuperative benefits.

58-17B-7. Requirements for long-term care insurance policies--Post-confinement, post-acute care, or recuperative benefits.
No long-term care insurance policy may be delivered or issued for delivery in this state if the policy:
(1)Conditions eligibility for any benefits on a prior hospitalization requirement;
(2)Conditions eligibility for benefits provided in an institutional care setting on the receipt of a higher level of institutional care; or
(3)Conditions eligibility for any benefits other than waiver of premium, post-confinement, post-acute care or recuperative benefits on a prior institutionalization requirement.
Post-confinement, post-acute care, or recuperative benefits do not include home health care, adult day care, or any other benefit based on treatment or services received.
A long-term care insurance policy, continuing post-confinement, post-acute care, or recuperative benefits, shall clearly label, in a separate paragraph of the policy or certificate entitled "Limitations or Conditions on Eligibility for Benefits," such limitations or conditions, including any required number of days of confinement.
A long-term care insurance policy or rider which conditions eligibility of non-institutional benefits on the prior receipt of institutional care may not require a prior institutional stay of more than thirty days, except waiver of premium which may not require a prior institutional stay of more than ninety days.

Source: SL 1989, ch 440, ยง7; SL 1991, ch 401.

Structure South Dakota Codified Laws

South Dakota Codified Laws

Title 58 - Insurance

Chapter 17B - Standards For Long-Term Care Insurance

Section 58-17B-1 - Scope.

Section 58-17B-2 - Definition of terms.

Section 58-17B-3 - Minimum requirements for individual policy.

Section 58-17B-4 - Adoption of rules--Standards for disclosure.

Section 58-17B-5 - Grounds for termination and certain provisions prohibited.

Section 58-17B-5.1 - Replacement of policy--Waiver of time periods.

Section 58-17B-6 - Defining "preexisting conditions"--Requirements--Exclusions for loss or confinement--Extending limitation periods.

Section 58-17B-7 - Requirements for long-term care insurance policies--Post-confinement, post-acute care, or recuperative benefits.

Section 58-17B-8 - Adoption of rules to establish loss ratio standards.

Section 58-17B-9 - Policyholder's right to return--Notice.

Section 58-17B-10 - Delivery of outline of coverage--Contents.

Section 58-17B-11 - Contents of certificate.

Section 58-17B-12 - Compliance with chapter prerequisite to advertisement, marketing, offer.

Section 58-17B-13 - Endorsement required--Cost-of-living adjustment not required.

Section 58-17B-13.1 - Establishment of standards and requirements for cost-of-living adjustment.

Section 58-17B-14 - Coverage offered to resident under group policy issued in other state--Requirements.

Section 58-17B-15 - Rules in accordance with chapter 1-26.

Section 58-17B-16 - Temporary absence from nursing home or assisted living facility--Effect on benefits for long-term care charges and other requirements--Application.