20:06:55:19.  Group plans -- Special enrollment. An individual enrolling in a group health plan pursuant to § 20:06:55:18 must be treated as if the individual were a special enrollee pursuant to §§ 20:06:40:05 and 20:06:40:05.01. The individual eligible for special enrollment must be offered all the benefit packages available to similarly situated individuals who did not lose coverage by reason of reaching a lifetime limit on the dollar value of all benefits. Any difference in benefits or cost-sharing constitutes a different benefit package. The individual may not be required to pay more for coverage than similarly situated individuals who did not lose coverage by reason of reaching a lifetime limit on the dollar value of all benefits.

          Source: 37 SDR 63, effective September 23, 2010; 37 SDR 111, effective December 7, 2010.

          General Authority: SDCL 58-18-79.

          Law Implemented: SDCL 58-18-79.