58-18B-36. Rules governing implementation and administration of this chapter.
The director shall promulgate rules pursuant to chapter 1-26 to provide for the implementation and administration of this chapter. The rules shall cover:
(1)Terms of renewability;
(2)Initial and subsequent conditions of eligibility;
(3)Probationary periods;
(4)Benefit limitations, exceptions and reductions;
(5)Requirements for replacement;
(6)Participation and contribution requirements;
(7)Definition of terms;
(8)Marketing practices;
(9)Reporting and disclosure practices or requirements;
(10)Compensation arrangements between insurers or other entities and their agents, representatives, or producers;
(11)Guaranteed acceptance of small groups by small group carriers;
(12)Continuation and conversion rights; and
(13)Group discontinuance and replacement.
The director may promulgate rules pursuant to chapter 1-26 that specify prohibited policy or certificate provisions not otherwise specifically authorized by statute which, in the opinion of the director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a policy or certificate. If any federal standards are in place which would require additional steps to meet those standards beyond what is required by this chapter, the director may promulgate rules to require the offering of health insurance plans, in addition to those specifically required by §58-18B-20, the underwriting criteria that may be utilized for such health insurance plans, and other requirements related to the availability of health insurance to individuals in this state in order to minimally meet the federal standards.
Source: SL 1995, ch 281, §31; SL 1997, ch 289, §21; SL 1998, ch 289, §19.
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.