South Dakota Codified Laws
Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance
Section 58-18B-23 - Uniform application of requirements used to determine eligibility of employers.

58-18B-23. Uniform application of requirements used to determine eligibility of employers.
Except as provided in §58-18B-26, requirements used by a small employer carrier in determining whether to provide coverage to a small employer, including requirements for minimum participation of eligible employees and minimum employer contributions, shall be applied uniformly among all small employers with the same number of eligible employees applying for coverage or receiving coverage from the small employer carrier. An association of small employer plans may require, as a condition of obtaining or continuing coverage, membership in the association.

Source: SL 1995, ch 281, §17.

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Structure South Dakota Codified Laws

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.