20:06:55:22.  Individual plans -- Annual limits. With respect to policy years beginning prior to January 1, 2014, a health plan may establish, for any individual, an annual limit on the dollar amount of benefits that are essential health benefits provided the limit is no less than the following:

          (1)  For a plan year beginning after September 22, 2010, but before September 23, 2011, $750,000;

          (2)  For a plan year beginning after September 22, 2011, but before September 23, 2012, $1,250,000;

          (3)  For plan years beginning after September 22, 2012, but before January 1, 2014, $2,000,000.

          In determining whether an individual has received benefits that meet or exceed the allowable annual limits as required by this section the plan or issuer may only take into account essential health benefits.

          For plan years beginning after December 31, 2013, no annual dollar limit is permitted for essential health benefits.

          Source: 37 SDR 63, effective September 23, 2010; 37 SDR 111, effective December 7, 2010; 39 SDR 203, effective June 10, 2013.

          General Authority: SDCL 58-17-87.

          Law Implemented: SDCL 58-17-87.