58-18A-58. Contracts and coverages included within definition of plan.
For the purposes of this chapter, the term, plan, includes:
(1)Group and nongroup insurance contracts and subscriber contracts;
(2)Uninsured arrangements of group or group-type coverage;
(3)Group and nongroup coverage through closed panel plans;
(4)Group-type contracts;
(5)The medical care components of long-term care contracts, such as skilled nursing care;
(6)The medical benefits coverage in automobile no fault and traditional automobile fault type contracts;
(7)Medicare or other governmental benefits, as permitted by law, except for the medical assistance program. That part of the definition of plan may be limited to the hospital, medical, and surgical benefits of the governmental program; and
(8)Group and nongroup insurance contracts and subscriber contracts that pay or reimburse for the cost of dental care.
Source: SL 2006, ch 259, §6; SL 2007, ch 290, §1; SL 2015, ch 253, §1.
Structure South Dakota Codified Laws
Chapter 18A - Coordination Of Benefits Of Health Plans
Section 58-18A-53 - Definitions.
Section 58-18A-54 - Allowable expenses defined.
Section 58-18A-55 - Expenses that are not allowable.
Section 58-18A-56 - Exclusion of certain expenses.
Section 58-18A-58 - Contracts and coverages included within definition of plan.
Section 58-18A-59 - Contracts and coverages not included within definition of plan.
Section 58-18A-60 - Application date.
Section 58-18A-61 - Promulgation of rules concerning coordination of health plan benefits.
Section 58-18A-62 - Prohibited grounds for reduction of benefits.
Section 58-18A-63 - Restriction on excess or secondary benefits provisions.
Section 58-18A-64 - Closed panel plans.
Section 58-18A-65 - Prohibition on reduction of benefits for coverage not qualifying as plan.
Section 58-18A-66 - Order of benefit payments.
Section 58-18A-67 - Coordination of benefits only available to secondary plans.
Section 58-18A-68 - Order of benefits determined under §§ 58-18A-69 to 58-18A-74.
Section 58-18A-69 - Plan covering person other than as dependent.
Section 58-18A-70 - Plan covering dependent child.
Section 58-18A-71 - Plan covering person as active employee.
Section 58-18A-72 - Coverage under COBRA or right of continuation.
Section 58-18A-73 - Plan covering person for longer period of time.
Section 58-18A-74 - Sharing of allowable expenses equally.
Section 58-18A-75 - Calculation of amount to be paid by secondary plan.
Section 58-18A-76 - Plan providing benefits as services.
Section 58-18A-77 - Coordination of benefits of complying and noncomplying plans.
Section 58-18A-79 - Subrogation distinguished.
Section 58-18A-80 - Paying of claim where plans disagree on order of benefits.
Section 58-18A-81 - Time for bringing existing contract into compliance with statutory requirements.
Section 58-18A-82 - Proceedings not subject to statutory requirements.
Section 58-18A-83 - Duties, rights accrued, and offenses committed prior to July 1, 2007.