<html> <head> <title>Rule 67:46:14:03 Insurance -- Exceptions.</title> <META NAME="Keywords" Content="Administrative Rules 67:46:14:03"> <META NAME="Description" Content="Administrative Rules 67:46:14:03 Insurance -- Exceptions."> <meta name=Generator content="Microsoft Office HTML Filter 2.0"> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Originator content="Microsoft Word 10"> <style> <!-- --> </style> </head> <body lang=EN-US> <div> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>67:46:14:03.&nbsp;&nbsp;Insurance -- Exceptions.</b> The provisions of subdivisions 67:46:14:02(3) and (4) do not apply if any of the following circumstances exist:</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (1)&nbsp;&nbsp;The child had coverage under a group health plan and the coverage was dropped for good cause;</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (2)&nbsp;&nbsp;The child had health insurance coverage or was covered under a group health plan but access to care was not available under the policy; or</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; (3)&nbsp;&nbsp;The child has health insurance coverage or is covered under a group health plan but access to care is not available under the policy.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 26 SDR 168, effective July 1, 2000.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=28-6-1">28-6-1.</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Example:</b> If a child's absent parent is located in another state and covers the child through the parent's employer's health maintenance organization and the child cannot get treatment in South Dakota under the policy, the coverage is considered to be inaccessible to the child.</p> </div> </body> </html>