South Dakota Codified Laws
Chapter 17E - Discount Medical Plans
Section 58-17E-40 - Prohibited conduct.

58-17E-40. Prohibited conduct.
No discount medical plan organization may:
(1)Except as otherwise provided in this chapter or as a disclaimer of any relationship between discount medical plan benefits and insurance, or as a description of an insurance product connected with a discount medical plan, use the term, insurance, in any advertisement, marketing material, brochure, or discount medical plan cards;
(2)Use in any advertisement, marketing material, brochure, or discount medical plan card, the terms, health plan, coverage, co-pay, co-payments, deductible, preexisting conditions, guaranteed issue, premium, PPO, preferred provider organization, or other term in a manner that could reasonably mislead an individual into believing that the discount medical plan is health insurance;
(3)Use language in any advertisement, marketing material, brochure, or discount medical plan card with respect to being licensed or registered by the Division of Insurance in a manner that could reasonably mislead an individual into believing that the discount medical plan is insurance or has been endorsed by the state;
(4)Make misleading, deceptive, or fraudulent representations regarding the discount or range of discounts offered by the discount medical plan or the access to any range of discounts offered by the discount medical plan;
(5)Have restrictions on access to discount medical plan providers, including, except for hospital services, waiting periods and notification periods; or
(6)Pay providers any fees for medical or ancillary services or collect or accept money from a member to pay a provider for medical or ancillary services provided under the discount medical plan, unless the discount medical plan organization has an active certificate of authority to act as a third party administrator in accordance with chapter 58-29D.

Source: SL 2006, ch 257, ยง39.

Structure South Dakota Codified Laws

South Dakota Codified Laws

Title 58 - Insurance

Chapter 17E - Discount Medical Plans

Section 58-17E-1 - Affiliate defined.

Section 58-17E-2 - Discount medical plan defined.

Section 58-17E-3 - Discount prescription drug plan defined.

Section 58-17E-4 - Discount medical plan organization defined.

Section 58-17E-5 - Definitions.

Section 58-17E-6 - Application of chapter.

Section 58-17E-7 - Registration exception and compliance requirements for otherwise registered health carriers.

Section 58-17E-8 - Notification of director required where discount medical plan organization loses registration or is subject to disciplinary proceeding in another state.

Section 58-17E-9 - Registration of discount medical plan organization.

Section 58-17E-10 - Review of application.

Section 58-17E-11 - Internet website to be established.

Section 58-17E-12 - Duration of registration--Renewal applications.

Section 58-17E-13 - Renewal of registration.

Section 58-17E-14 - Nonrenewal, suspension, or revocation of registration.

Section 58-17E-15 - Notice of grounds for nonrenewal, suspension, or revocation--Hearing.

Section 58-17E-16 - Winding up of affairs.

Section 58-17E-17 - Duration of suspension--Conditions for reinstatement.

Section 58-17E-18 - Consent orders.

Section 58-17E-19 - Registration exception for providers giving discounts to own patients.

Section 58-17E-20 - Surety bond.

Section 58-17E-21 - Deposit in lieu of surety bond.

Section 58-17E-22 - Surety bonds and deposits not subject to levy by claimants.

Section 58-17E-23 - Examination or investigation of discount medical organization--Expenses.

Section 58-17E-24 - Pro rata reimbursement of charges upon cancellation of membership.

Section 58-17E-25 - Written materials on member benefits.

Section 58-17E-26 - Services to be provided in accordance with written agreement.

Section 58-17E-27 - Contents of provider agreement.

Section 58-17E-28 - Contents of provider network agreement.

Section 58-17E-29 - Agreements with entity contracting with provider network.

Section 58-17E-30 - Copies of agreements to be maintained.

Section 58-17E-31 - Internet website requirements.

Section 58-17E-32 - Application of provider agreement requirements.

Section 58-17E-33 - Marketing of product--Agreement.

Section 58-17E-34 - Contents of marketing agreement.

Section 58-17E-35 - Liability for conduct of marketer.

Section 58-17E-36 - Approval of advertisements and marketing materials.

Section 58-17E-37 - Submission of advertising and marketing materials to director.

Section 58-17E-38 - Advertisements to be truthful and not misleading.

Section 58-17E-39 - Disclosure that product is not insurance--Advertisements--Rules--Revocation of registration--Agents.

Section 58-17E-40 - Prohibited conduct.

Section 58-17E-41 - Signature on contract required prior to receipt of consideration--Disclosure of information--Exception.

Section 58-17E-42 - Disclosures required for telephone contacts.

Section 58-17E-43 - Member to be provided written copy of terms of plan.

Section 58-17E-44 - Contents of written materials.

Section 58-17E-45 - Consumer's right to return plan or program--Refund.

Section 58-17E-46 - Notice to director of change in plan.

Section 58-17E-47 - Construction with trade practices statute.