58-18B-2. Chapter applicable to small employer benefit plans.
This chapter is applicable to any health benefit plan which provides coverage to two or more employees of a small employer and policies which meet the following criteria:
(1)Any portion of the premium or benefits is paid by or on behalf of the small employer; or
(2)The health benefit plan is treated by the employer or any of the eligible employees or dependents as part of a plan or program for the purposes of section 125 or section 106 of the United States Internal Revenue Code as of January 1, 1995.
This chapter does not apply to any employer plan with only one employee. Any employer plan with only one employee, even if the employer pays a portion or all of the premium, may be sold as individual policies subject to the provisions of chapter 58-17. If a plan covering one employee is sold as an individual plan and new employees are added which brings the number of employees to at least two but not more than fifty, then the individual carrier may nonrenew the coverage or accept those new employees and bring the plan into compliance with the applicable provisions of chapters 58-18 and 58-18B.
Source: SL 1991, ch 402, §2; SL 1995, ch 281, §2; SL 1996, ch 298; SL 1998, ch 292, §1.
Structure South Dakota Codified Laws
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-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-23 - Uniform application of requirements used to determine eligibility of employers.
Section 58-18B-27 - Modification to exclude certain diseases prohibited.
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-41 - Compensation of insurance producer based on percentage of premium.
Section 58-18B-45 - Reasons for denial of coverage to be in writing.
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-52 - Notice to employees--Disclosures.
Section 58-18B-54 - Application--Exemptions.
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.