CHAPTER 3-6E
STATE EMPLOYEES' HEALTH AND LIFE INSURANCE
3-6E-1 Benefits plan for employees--Self-funded or group health insurance--Flexible benefit plan.
3-6E-2 Self-funded plan.
3-6E-3 Reinsurance.
3-6E-4 Enrollment of all eligible employees--Exception.
3-6E-5 Effective date of enrollment.
3-6E-6 Coverage of eligible dependents.
3-6E-7 Repealed
3-6E-8 State contributions to health plan--Crediting and disbursement.
3-6E-9 Employee contributions to benefits plan--Crediting and disbursement.
3-6E-10 Funds transferred to trust fund--Disbursements.
3-6E-11 Certificate of benefits.
3-6E-12 Persons to whom benefits payable.
3-6E-13 Promulgation of rules regarding benefits plan.
3-6E-14 State employee workers' compensation program--Crediting receipts and disbursement.
3-6E-15 State Cement Plant former employee workers' compensation claims.
3-6E-16 State contribution of workers' compensation premium--Crediting and disbursement.
3-6E-17 State employee workers' compensation program fund.
3-6E-18 Promulgation of rules regarding workers' compensation program.
3-6E-19 State Cement Plant former employee life insurance benefits.
3-6E-1. Benefits plan for employees--Self-funded or group health insurance--Flexible benefit plan.
The bureau may establish a benefits plan for plan-eligible employees of the state. The plan may either be self-funded or established as a group health insurance program. The plan may provide for group health coverage against the financial cost of hospital, surgical, pharmacy, and medical treatment and care, and any other coverage or benefits the human resources commissioner determines is appropriate and desirable. The human resources commissioner may include a flexible benefit plan which allows an employee to choose the employee's own benefits or levels of coverage.
Source: SL 2012, ch 23, § 63; SL 2019, ch 21, § 45.
3-6E-2. Self-funded plan.
The human resources commissioner may provide all, or any part of, the benefits under the plan or plans provided pursuant to this chapter by means of a plan which is self-funded in whole or in part.
Source: SL 2012, ch 23, § 64; SL 2019, ch 21, § 46.
3-6E-3. Reinsurance.
The human resources commissioner may authorize the purchase of reinsurance to cover against losses incurred by the plan.
Source: SL 2012, ch 23, § 65; SL 2019, ch 21, § 47.
3-6E-4. Enrollment of all eligible employees--Exception.
Each plan-eligible employee shall be enrolled in the plan unless the employee is covered by another group health plan or is covered by Medicare and the employee provides notice to the plan administrator.
Source: SL 2012, ch 23, § 66; SL 2019, ch 21, § 48; SL 2020, ch 18, § 1, eff. Mar. 2, 2020.
3-6E-5. Effective date of enrollment.
Each plan-eligible employee shall be enrolled in the plan on the effective dates established by the human resources commissioner.
Source: SL 2012, ch 23, § 67; SL 2019, ch 21, § 49.
3-6E-6. Coverage of eligible dependents.
A plan-eligible employee may elect to have any of the employee's eligible dependents covered by the plan. The election shall be made at the time the employee becomes enrolled in the plan, or at another time as the human resources commissioner allows.
Source: SL 2012, ch 23, § 68; SL 2019, ch 21, § 50.
3-6E-8. State contributions to health plan--Crediting and disbursement.
The State of South Dakota shall either make a monthly contribution to the system or otherwise provide for the amount necessary to make payment to the system for the full single rate monthly health insurance premium or contribution for the plan with the lowest actuarial value for each plan-eligible employee. This amount shall be transmitted to the account of the state employees' benefits plan in the Office of the State Treasurer. The state treasurer, after making a record of the receipts, shall credit the plan with an amount equal to that remitted or otherwise provided. Costs beyond this amount for other plans offered by the state shall be paid by the employee through premiums. After the contribution has been assigned to the plan, the bureau shall disburse the contribution in accordance with this chapter and the rules promulgated pursuant to chapter 1-26 by the human resources commissioner.
Source: SL 2012, ch 23, § 70; SL 2019, ch 21, § 52; SL 2021, ch 22, § 3.
3-6E-9. Employee contributions to benefits plan--Crediting and disbursement.
The State of South Dakota shall deduct on each payroll of a member for each payroll period the amount of the contribution or premium, including any administrative expense. The state shall make deductions from salaries of plan-eligible employees and shall transmit monthly the amount specified to be deducted to the state treasurer. The state treasurer, after making a record of receipts, shall credit the benefits plan with an amount equal to that remitted by the state. After the credit has been assigned to the benefits plan, the human resources commissioner shall disburse credit in accordance with this chapter and the rules promulgated pursuant to chapter 1-26 by the human resources commissioner.
Source: SL 2012, ch 23, § 71; SL 2019, ch 21, § 53.
3-6E-10. Funds transferred to trust fund--Disbursements.
Any funds transmitted to the Office of the State Treasurer as designated transfers to the state employees' benefits plan shall be placed in the trust fund established by this chapter and entitled the state employees' benefits plan fund. Disbursements from the fund shall be made by warrants drawn by the state auditor upon itemized vouchers duly approved by the human resources commissioner.
Source: SL 2012, ch 23, § 72; SL 2019, ch 21, § 54.
3-6E-11. Certificate of benefits.
The bureau shall make available upon request, to each member, a certificate setting forth the benefits to which the member and the member's dependents are entitled under this chapter, to whom the benefits are payable, to whom claims shall be submitted, and a summary of the provisions of the plan's benefits as they affect the member and the member's dependents.
Source: SL 2012, ch 23, § 73; SL 2019, ch 21, § 55.
3-6E-12. Persons to whom benefits payable.
Any benefits payable under the plan may be paid either directly to the attending physician, dentist, hospital, medical, or dental group, or other person, corporation, limited liability company, association, or firm furnishing the service upon which the claim is based, or to the member upon presentation of receipted bills for such service.
Source: SL 2012, ch 23, § 74; SL 2019, ch 21, § 56.
3-6E-13. Promulgation of rules regarding benefits plan.
The human resources commissioner is responsible for the administration of this chapter and shall promulgate rules required for the effective administration of the provisions of this chapter pursuant to chapter 1-26. The rules may be promulgated in the following areas:
(1) To establish what benefits will be offered pursuant to this chapter;
(2) Participation in the plan by employees, retired employees, and dependents;
(3) Procedures for election of coverage;
(4) Effective dates of coverage if not specified by statute;
(5) Termination of coverage;
(6) Changes in dependent coverage;
(7) Collection of premiums and contributions;
(8) To coordinate the benefits plan with the health insurance plan authorized in this chapter; and
(9) Other provisions as required to meet federal law.
Source: SL 2012, ch 23, § 75; SL 2019, ch 21, § 57.
3-6E-14. State employee workers' compensation program--Crediting receipts and disbursement.
The State of South Dakota shall provide for the amount necessary to make payment to the state employee workers' compensation program for the claims of employees of the state arising under title 62. This amount shall be transmitted to the account of the state employee workers' compensation program in the Office of the State Treasurer. The state treasurer, after making a record of the receipts, shall credit the state employee workers' compensation program with an amount equal to that remitted or otherwise provided. After the contribution has been assigned to the state employee workers' compensation program, the bureau shall disburse the funds according to the provisions of title 62 and the rules promulgated by the human resources commissioner pursuant to chapter 1-26.
Source: SL 2012, ch 23, § 76; SL 2019, ch 21, § 58.
3-6E-15. State Cement Plant former employee workers' compensation claims.
Responsibility for the administration and payment of workers' compensation claims of former employees of the South Dakota State Cement Plant Commission is hereby transferred to the state employee workers' compensation program.
Source: SL 2012, ch 23, § 77; SL 2019, ch 21, § 59.
3-6E-16. State contribution of workers' compensation premium--Crediting and disbursement.
The state shall contribute on each payroll for an employee for each payroll period the amount of the state employee workers' compensation program premium, including any administrative expense. The state shall transmit monthly the amount specified to be paid to the state treasurer. The state treasurer, after making a record of receipts, shall credit the state employee workers' compensation program with an amount equal to that remitted by the state. The credit shall be assigned to the state employee workers' compensation program. The human resources commissioner shall disburse the funds according to title 62 and the rules promulgated by the Department of Labor and Regulation and the commissioner pursuant to chapter 1-26.
Source: SL 2012, ch 23, § 78; SL 2019, ch 21, § 60.
3-6E-17. State employee workers' compensation program fund.
Any funds transmitted to the Office of the State Treasurer as designated transfers to the state employee workers' compensation program shall be placed in the trust fund established by this section and entitled the state employee workers' compensation program fund. Disbursements from this fund shall be made by warrants drawn by the state auditor.
Source: SL 2012, ch 23, § 79; SL 2019, ch 21, § 61.
3-6E-18. Promulgation of rules regarding workers' compensation program.
The human resources commissioner may promulgate rules, pursuant to chapter 1-26, with respect to the adjustment, administration, and management of the state employee workers' compensation program.
Source: SL 2012, ch 23, § 80; SL 2019, ch 21, § 62.
3-6E-19. State Cement Plant former employee life insurance benefits.
Responsibility for the administration and payment of life insurance plan benefits of former employees of the South Dakota State Cement Plant Commission is hereby transferred to the bureau.
Source: SL 2012, ch 23, § 81; SL 2019, ch 21, § 63.
