58-29D-13. Insurer responsibility for procedures and administration of its programs--Review and audit of administrator.
If an insurer utilizes the services of an administrator, the insurer shall be responsible for determining the benefits, premium rates, underwriting criteria and claims payment procedures applicable to such coverage and for securing reinsurance, if any. The rules pertaining to these matters shall be provided, in writing, by the insurer to the administrator. The responsibilities of the administrator as to any of these matters shall be set forth in the written agreement between the administrator and the insurer. It is the sole responsibility of the insurer to provide for competent administration of its programs.
In cases where an administrator administers benefits for more than one hundred certificate holders on behalf of an insurer, the insurer shall, at least semiannually, conduct a review of the operations of the administrator. At least one such review shall be an on-site audit of the operations of the administrator.
Source: SL 1992, ch 352, ยง13.
Structure South Dakota Codified Laws
Chapter 29D - Regulation Of Life And Health Administrators
Section 58-29D-1 - Definition of terms.
Section 58-29D-2 - Administrator defined--Exceptions.
Section 58-29D-3 - Insurer defined.
Section 58-29D-4 - Written agreement between administrator and insurer.
Section 58-29D-5 - Provisions of written agreement.
Section 58-29D-6 - Termination of written agreement--Suspension of underwriting authority--Dispute.
Section 58-29D-8 - Recordkeeping by administrator.
Section 58-29D-9 - Director's access to administrator's records--Confidentiality.
Section 58-29D-10 - Insurer's ownership of administrator's records.
Section 58-29D-11 - Transfer of records to new administrator.
Section 58-29D-12 - Advertising--Approval of insurer.
Section 58-29D-14 - Fiduciary capacity of administrator--Accounting of underwriting transactions.
Section 58-29D-15 - Records of deposits and withdrawals from fiduciary account.
Section 58-29D-16 - Provisions in written agreement as to withdrawals from fiduciary account.
Section 58-29D-18 - Compensation of administrator.
Section 58-29D-20 - Delivery of written communications from insurer.
Section 58-29D-21 - Administrator's license or registration required.
Section 58-29D-22 - Application by administrator--Contents--Fee.
Section 58-29D-22.1 - Annual financial statement--Contents of application--Required audit.
Section 58-29D-23 - Inspection of applicant's contracts.
Section 58-29D-24 - Denial of license.
Section 58-29D-25 - Validity of license.
Section 58-29D-26 - Conditions not requiring license.
Section 58-29D-27 - Servicer of certain employee benefit plans--Exempt from licensure--Requirements.
Section 58-29D-28 - Notice of administrator's change in circumstance.
Section 58-29D-29 - Waiver of application requirements.
Section 58-29D-30 - Annual renewal of administrator--Fee--Lapse of license or registration.
Section 58-29D-31 - Grounds for denial, suspension, or revocation of license or registration.
Section 58-29D-32 - Immediate suspension of license--No notice required.
Section 58-29D-33 - Money penalty in lieu of suspension or revocation.