South Dakota Codified Laws
Chapter 18 - Group And Blanket Health Insurance Policies
Section 58-18-9 - Summary statement of coverage for delivery to member of insured group.

South Dakota Codified Laws

Title 58 - Insurance

Chapter 18 - Group And Blanket Health Insurance Policies

Section 58-18-1 - "Group health insurance" defined.

Section 58-18-2 - Employee group insurance authorized--"Employees" defined.

Section 58-18-3 - Employer association group health insurance authorized--Employees defined.

Section 58-18-4 - Industry fund group insurance authorized--"Employees" defined.

Section 58-18-4.1 - Restrictions on issuance of group health insurance policy to association.

Section 58-18-4.2 - Required duration of participation by employer member in association plan.

Section 58-18-4.3 - Association plan covering state residents to comply with state law.

Section 58-18-4.4 - Requirements for insurer offering fully insured health benefit plan through association.

Section 58-18-5 - Issuance to person or organization to which group life insurance policy may be issued.

Section 58-18-6 - Issuance to cover similar group subject to discretion of director.

Section 58-18-6.1 - Coverage of proprietors, partners and executive corporate officer employees.

Section 58-18-7 - Continuation without evidence of insurability--Application.

Section 58-18-7.1 - Coverage for inpatient treatment of alcoholism to be offered in group policies--Treatment within state included.

Section 58-18-7.2 - Benefits provided under alcoholism coverage--Maximum treatment periods permitted.

Section 58-18-7.3 - Policies not within alcoholism coverage requirement.

Section 58-18-7.4 - Coverage upon application by employee or beneficiary with right to convert following notice of termination.

Section 58-18-7.5 - Continuation of coverage upon leaving employment or termination of coverage by insurer--Duration.

Section 58-18-7.11 - Continuation or conversion policy not required under certain circumstances.

Section 58-18-7.12 - Conditions for continuation.

Section 58-18-7.13 - Premium for conversion policy and continuation policy.

Section 58-18-7.14 - Notification of continuation and conversion rights.

Section 58-18-7.15 - Group insurance coverage in lieu of converted individual policies.

Section 58-18-7.17 - Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.

Section 58-18-7.18 - Continuation coverage to be same as that available to similarly situated beneficiaries--Option to decrease benefits.

Section 58-18-7.19 - Probationary period for continuation or conversion coverage prohibited.

Section 58-18-7.20 - Construction with chapter 58-18C.

Section 58-18-7.21 - Continued coverage--Insurer's use of experience for rating purposes not limited--Options unavailable in market not required.

Section 58-18-8 - Representations by applicant not warranties--Written statement required to avoid insurance or reduce benefits.

Section 58-18-9 - Summary statement of coverage for delivery to member of insured group.

Section 58-18-10 - Additions to group originally insured.

Section 58-18-11 - Direct payment for hospital, medical, or surgical services--Option of insurer.

Section 58-18-11.1 - Reduction of benefits because of increase in statutory disability benefits prohibited.

Section 58-18-12 - "Blanket health insurance" defined.

Section 58-18-13 - Blanket health insurance for passengers on common carrier.

Section 58-18-14 - Blanket health insurance for employees, dependents, or guests with reference to hazardous activities.

Section 58-18-15 - Blanket health insurance for institutions of learning, camps, or sponsors.

Section 58-18-16 - Blanket health insurance for religious, charitable, recreational, educational, or civic organizations.

Section 58-18-17 - Blanket health insurance for sports team or sponsors.

Section 58-18-18 - Blanket health insurance for volunteer group or agency.

Section 58-18-19 - Blanket health insurance for other risks approved by director.

Section 58-18-20 - Authority to issue blanket health insurance--Filing of copy of form--Required provisions.

Section 58-18-21 - Policy and application constitute entire contract--Statements by policyholder not warranties--Written statement required for use in defense of claim.

Section 58-18-22 - Sickness or injury--Provision for notice to insurer.

Section 58-18-23 - Forms for filing proof of loss--Failure of insurer to furnish, submission of written proof.

Section 58-18-24 - Claim for loss of time--Time for furnishing proof of loss--Notice of continuance of disability.

Section 58-18-25 - Time for payment of benefits.

Section 58-18-26 - Physical examination of insured--Autopsy in death claims.

Section 58-18-27 - Time for commencement of action to recover under policy.

Section 58-18-28 - Individual application and certificate not required under blanket policy.

Section 58-18-29 - Persons to whom benefits payable under blanket health policy.

Section 58-18-30 - Chapter inapplicable to prior policies.

Section 58-18-31 - Continuation of coverage for child with intellectual or physical disability--Proof of dependency.

Section 58-18-31.1 - Dependent coverage termination--Age--Full-time student.

Section 58-18-32 - Family coverage to include newborn and newly adopted children.

Section 58-18-33 - Premature birth, congenital defects, and birth abnormalities covered--Applicability.

Section 58-18-34 - Notice of birth or adoption required for continued coverage.

Section 58-18-35 - Notice required for rate increase by group health insurance company.

Section 58-18-36 - Grandfathered plans required to cover low-dose mammography--Extent of coverage.

Section 58-18-36.1 - Policies required to cover occult breast cancer screening.

Section 58-18-37 - Freedom of choice for pharmacy services.

Section 58-18-38 - Annual period of enrollment for licensed pharmacies--Actual notice of enrollment period not required.

Section 58-18-39 - Provisions denying choice for pharmacy services as void.

Section 58-18-40 - Enforcement of provisions permitting choice for pharmacy services.

Section 58-18-41 - Coverage for phenylketonuria.

Section 58-18-42 - "Health benefit plan" defined.

Section 58-18-43 - "Late enrollee" defined.

Section 58-18-44 - "Creditable coverage" defined.

Section 58-18-45 - Preexisting conditions--Limitation of waiting periods.

Section 58-18-45.1 - (Text of section effective until the first plan year, policy year, or renewal date on or after January 1, 2019) Anesthesia and hospitalization for dental care to be provided certain covered persons.

Section 58-18-46 - Renewability of health benefit plans--Employer's election--Exceptions.

Section 58-18-47 - Nonrenewal of health benefit plans by an employer carrier.

Section 58-18-48 - Acceptance of new employees for coverage under employer's existing health benefit plan.

Section 58-18-49 - Carrier's offer of coverage to employer--Coverage of all eligible employees.

Section 58-18-51.1 - Application of §§ 58-18-42 to 58-18-49, inclusive.

Section 58-18-52 - Formation of voluntary health insurance purchasing organizations.

Section 58-18-52.1 - Political subdivisions permitted to join with health insurance purchasing organizations.

Section 58-18-53 - Membership of voluntary health insurance purchasing organizations.

Section 58-18-54 - Purchasing organization's responsibility for negotiating terms and conditions.

Section 58-18-55 - Purchasing organization's notice of premium charge.

Section 58-18-56 - Additional chapters applicable to purchasing organization.

Section 58-18-57 - Approval of purchasing organization by Division of Insurance.

Section 58-18-58 - Premiums held in trust by purchasing organization.

Section 58-18-59 - Rates for group health insurance issued to purchasing organizations.

Section 58-18-60 - Reasonable participation requirements for group members of purchasing organizations.

Section 58-18-61 - Purchasing organizations exempt from antitrust provisions.

Section 58-18-62 - Promulgation of rules for purchasing organizations.

Section 58-18-63 - Minimum loss ratio for employer health benefit plans--Application of section.

Section 58-18-76 - Minimum inpatient care coverage following delivery.

Section 58-18-77 - Shorter hospital stay permitted--Follow-up within forty-eight hours required.

Section 58-18-78 - Notice to employees or members--Disclosures.

Section 58-18-79 - Promulgation of rules to minimally meet federal standards--Additional rules--Scope.

Section 58-18-80 - Health insurance policies to provide coverage for biologically-based mental illnesses.

Section 58-18-81 - Application--Exemptions.

Section 58-18-82 - Carrier to provide annual report--Time frame--Information.

Section 58-18-83 - Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.

Section 58-18-84 - Diabetes coverage not required of certain plans and policies.

Section 58-18-85 - Policies to provide coverage for prostate cancer screening.

Section 58-18-86 - Plans subject to § 58-18-45--Exceptions.

Section 58-18-87 - Director to promulgate rules governing use of genetic information.

Section 58-18-88 - Authorization of self-funded multiple employer trust sponsored by association--Conditions.

Section 58-18-88.1 - Request for waiver by association formed in another state.

Section 58-18-89 - Promulgation of rules pertaining to multiple employer trusts.

Section 58-18-90 - Multiple employer trust not insurance company or association or subject to specified provisions--Exception.

Section 58-18-91 - Suspension or revocation of authorization of multiple employer trust--Action in lieu of suspension or revocation.

Section 58-18-92 - Payment of premium taxes.

Section 58-18-93 - Agent licensing requirements.

Section 58-18-94 - Application of provisions regarding multiple employer trusts--Inclusion of large and small employers.

Section 58-18-95 - Coverage for treatment of hearing impairment for persons under age nineteen.