Rule 20:06:39:63 Coverage issued outside open enrollment.
issued outside open enrollment. A health insurance issuer may issue
a health plan to any individual applying for coverage outside of an insurance
Exchange and outside of an open enrollment period. For health plans offered
outside the exchange and outside an open enrollment the following apply:
(1) For those that are uninsured
the issuer may require a waiting period of not more than 90 days from the date
of application until coverage is effective;
(2) For uninsured applicants only
a bronze level plan or, if eligible, a catastrophic plan may be issued with an
effective date consistent with open enrollment standards;
(3) For those with creditable
coverage within 63 days of the date of application, only coverage in the same
metal level as the applicant's prior coverage may be issued. This section
applies to all applications received after March 31, 2014, in the individual
market outside the Exchange that are not received during an open enrollment
period. For purposes of this section an uninsured does not include a person who
lapsed or voluntarily terminated coverage in the past 12 months prior to
39 SDR 203, effective June 10, 2013.
Authority: SDCL 58-17-87.
Implemented: SDCL 58-17-87.
Back to 20:06:39