58-17E-9. Registration of discount medical plan organization.
Any discount medical plan organization that is not offered directly by a health carrier as provided by this chapter, shall register in a format as prescribed by the director and shall file reports and conduct business under the same standards as required of utilization review organizations in accordance with provisions of §§58-17H-36 and 58-17H-37. No health carrier may offer or provide coverage through a person not registered but required to be registered pursuant to §§58-17E-9, 58-17E-39, 58-17E-41, and 58-17E-45, inclusive. Any plan or program that is registered pursuant to §58-17F-16 is not required to maintain a separate registration pursuant to §§58-17E-9, 58-17E-39, 58-17E-41, and 58-17E-45, inclusive. Any plan or program of discounted goods or services that is offered by a health carrier in conjunction with a health benefit plan, as defined in §§58-18-42 and 58-17-66(9), a medicare supplement policy as defined in §58-17A-1, or other insurance product that is offered by an authorized insurer and that is subject to the jurisdiction of the director is not required to be registered pursuant to §§58-17E-9, 58-17E-39, 58-17E-41, and 58-17E-45, inclusive. (SL 2012, ch 239, §1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed.")
Source: SL 2005, ch 269, §1; SDCL §58-17C-104; SL 2006, ch 257, §44; SL 2011, ch 219, §98.
Structure South Dakota Codified Laws
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-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-40 - Prohibited conduct.
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.