<html> <head> <title>Rule 20:06:46:04 Condition of enrollment or continued enrollment may not require additional premium for similarly situated individuals.</title> <META NAME="Keywords" Content="Administrative Rules 20:06:46:04"> <META NAME="Description" Content="Administrative Rules 20:06:46:04 Condition of enrollment or continued enrollment may not require additional premium for similarly situated individuals."> <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>20:06:46:04.&nbsp;&nbsp;Condition of enrollment or continued enrollment may not require additional premium for similarly situated individuals</b>. A carrier subject to this chapter may not require an individual, as a condition of enrollment or continued enrollment under the plan, to pay a premium or contribution rate that is greater than the premium or contribution rate for a similarly situated individual enrolled in the plan based on any health factor that relates to the individual or a dependent of the individual. In determining an individual's premium or contribution rate, discounts, rebates, payments-in-kind, and any other premium differential mechanisms shall be taken into account.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Nothing in this section restricts the aggregate amount that a carrier subject to this chapter may charge an employer for coverage under a plan, except that a carrier subject to this chapter may not quote or charge an employer a different premium than that quoted or charged an individual in a group of similarly situated individuals based on a health factor unless permitted under SDCL chapter <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B">58-18B.</A></p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 29 SDR 48, effective October 10, 2002.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18-79">58-18-79.</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=58-18-79">58-18-79.</A></p> </div> </body> </html>