South Dakota Codified Laws
Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance
Section 58-18B-11 - Health maintenance organization considered separate carrier.

South Dakota Codified Laws

Title 58 - Insurance

Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance

Section 58-18B-1 - Definition of terms.

Section 58-18B-2 - Chapter applicable to small employer benefit plans.

Section 58-18B-3 - Regulations on premium rates.

Section 58-18B-3.1 - Base rate increase to be filed with director--Approval or disapproval.

Section 58-18B-6 - Disclosure in solicitation and sales materials.

Section 58-18B-7 - Information and documentation required--Disclosure.

Section 58-18B-8 - Suspension of rate requirements.

Section 58-18B-9 - Application of chapter.

Section 58-18B-11 - Health maintenance organization considered separate carrier.

Section 58-18B-12 - Ceding arrangements resulting in less than fifty percent of obligation or risk retained by carrier prohibited.

Section 58-18B-13 - Transition period when acquiring additional class of business.

Section 58-18B-14 - Rate changes only for small employer business.

Section 58-18B-15 - Provisions for premium rates.

Section 58-18B-17 - Limit on premium rates.

Section 58-18B-18 - Promulgation of rules for rating practices.

Section 58-18B-20 - Small employer carrier to issue plan to any small employer--Criteria--Exceptions--Two percent earned premium threshold.

Section 58-18B-23 - Uniform application of requirements used to determine eligibility of employers.

Section 58-18B-24 - Application of minimum participation and minimum employer contribution requirements.

Section 58-18B-25 - Considerations in applying minimum participation requirements--Premium discounts.

Section 58-18B-26 - Increase in minimum requirements for employee participation or employer contribution prohibited after acceptance for coverage.

Section 58-18B-27 - Modification to exclude certain diseases prohibited.

Section 58-18B-27.1 - 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 58-18B-28 - Requirements lifted from small employer carrier in financially impaired condition.

Section 58-18B-35 - Director to promulgate rules regulating sale of multiple employer trusts and welfare arrangements--Scope of rules.

Section 58-18B-36 - Rules governing implementation and administration of this chapter.

Section 58-18B-37 - Marketing health benefit plans--Denial of coverage to employer.

Section 58-18B-38 - Prohibited activities of small employer carriers or insurance producers.

Section 58-18B-39 - Information regarding restricted network provision of carrier.

Section 58-18B-40 - Agent compensation based on characteristics of small employer prohibited--Commission on sale of health insurance plan through exchange.

Section 58-18B-41 - Compensation of insurance producer based on percentage of premium.

Section 58-18B-43 - Status of insurance producer's employment may not be affected by health status, claims experience, occupation, or location of small employer placed with carrier.

Section 58-18B-44 - Carrier or agent not to induce or encourage employer to exclude employee from coverage.

Section 58-18B-45 - Reasons for denial of coverage to be in writing.

Section 58-18B-46 - Rules for additional standards for fair marketing and broad availability of benefit plans to small employers--Penalties.

Section 58-18B-47 - Third-party administrator treated as small employer carrier.

Section 58-18B-48 - Chapter not applicable to certain group health insurance plans.

Section 58-18B-49 - Establishing risk adjusters.

Section 58-18B-50 - Minimum inpatient care coverage following delivery.

Section 58-18B-51 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.

Section 58-18B-52 - Notice to employees--Disclosures.

Section 58-18B-53 - Health insurance policies to provide coverage for biologically-based mental illnesses.

Section 58-18B-54 - Application--Exemptions.

Section 58-18B-55 - Supplemental or short term individual health benefit plans exempt from provisions of chapter--Conditions.

Section 58-18B-56 - Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.

Section 58-18B-57 - Diabetes coverage not required of certain plans.

Section 58-18B-58 - Health benefit plans to provide coverage for prostate cancer screening.

Section 58-18B-60 - Coverage for treatment of hearing impairment for persons under age nineteen.