58-18B-48. Chapter not applicable to certain group health insurance plans.
Unless the carrier otherwise subjects itself to this chapter, this chapter does not apply to any bona fide association insurance plan or to the insurance carrier underwriting the group plan if the bona fide association meets the following criteria:
(1)The association has been actively in existence for at least five years;
(2)The association has been formed and maintained in good faith for purposes other than obtaining insurance;
(3)The association does not condition membership in the association on any health status- related factor relating to an individual, including an employee of an employer or a dependent of an employee;
(4)Health insurance coverage offered through the association is available to all members regardless of any health status-related factor relating to such members or individual eligible for coverage through a member;
(5)The association does not make health insurance coverage offered through the association available other than in connection with a member of the association;
(6)The association and any plan issued through the association are complying with any applicable provisions of Title 47 and §§58-18-42 to 58-18-62, inclusive.
Source: SL 1995, ch 281, §43; SL 1997, ch 289, §23.
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.