20:06:21:10. Converted policy from group defined. For the purposes of §§ 20:06:21:09 to 21:06:21:17, inclusive, a converted policy from group is an individual policy of long-term care insurance providing benefits identical to or benefits determined by the director to be substantially equivalent to or in excess of those provided under the group policy from which conversion is made.
If the group policy from which conversion is made restricts provision of benefits and services to, or contains incentives to use, certain providers or facilities, the director, in determining the substantial equivalence of benefits, shall take into consideration the differences between managed care and nonmanaged care plans, including provider system arrangements; service availability; benefit levels; and administrative complexity.
Source: 22 SDR 97, effective December 18, 1995.
General Authority: SDCL 58-17B-4.
Law Implemented: SDCL 58-17B-5.1.
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