20:06:39:64.  Enrollment in catastrophic plans. A health plan is a catastrophic plan if it meets the following conditions:

          (1)  Meets all applicable requirements for health insurance coverage in the individual market and is offered only in the individual market;

          (2)  Does not provide a bronze, silver, gold, or platinum level of coverage described in § 20:06:56:11;

          (3)  Provides coverage of the essential health benefits under § 20:06:56:03 once the annual limitation on cost sharing is reached;

          (4)  Provides coverage for at least three primary care visits per year before reaching the deductible; and

          (5)  Covers only individuals who meet either of the following conditions:

              (a)  Have not attained the age of 30 prior to the first day of the plan year;

              (b)  Have received a certificate of exemption for the reasons identified in section 1302(e)(2)(B)(i) or (ii) of PPACA as defined in § 20:06:55:32.

          A catastrophic plan may not impose any cost-sharing requirements, such as a copayment, coinsurance, or deductible, for preventive services, in accordance with § 20:06:56:03. For other than self-only coverage, each individual enrolled must meet the requirements.

          Source: 39 SDR 203, effective June 10, 2013.

          General Authority: SDCL 58-17-87.

          Law Implemented: SDCL 58-17-87.