<html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><title></title><meta name="Generator" content="PowerTools for Open XML" /><style>p.s03838ffb-8600-4098-b011-7baf3aaa870fP0 { margin-top: 0; margin-bottom: 0; margin-left: 0; margin-right: 0; text-indent: 0.00in; text-align: justify; background: white; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; } span.s03838ffb-8600-4098-b011-7baf3aaa870fC0 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s03838ffb-8600-4098-b011-7baf3aaa870fC0-000000 { color: #0000FF; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s03838ffb-8600-4098-b011-7baf3aaa870fC0-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s03838ffb-8600-4098-b011-7baf3aaa870fC0-000002 { color: #0000FF; font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s03838ffb-8600-4098-b011-7baf3aaa870f000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">    </span><a href="https://sdlegislature.gov/Rules?Rule=20:06:21:104"><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000000">20:06:21:104</span></a><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000001">.  Applicability.</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> The requirements of §§ </span><a href="https://sdlegislature.gov/Rules?Rule=20:06:21:87"><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000002">20:06:21:87</span></a><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> to </span><a href="https://sdlegislature.gov/Rules?Rule=20:06:21:103"><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000002">20:06:21:103</span></a><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">, inclusive, apply to a benefit trigger request made after December 31, 2010, under a long-term care insurance policy.</span></p><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870f000003"> </span></p><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">    As used for purposes of independent review, a benefit trigger is a contractual provision in the insured's</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">long-term care insurance conditioning the payment of benefits on a determination of the insured's ability to</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">perform activities of daily living and on cognitive impairment. For purposes of a tax-qualified long term</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">care insurance contract as defined in Section 7702B of the Internal Revenue Code of 1986, as amended, a</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">benefit trigger shall include a determination by a licensed health care practitioner that an insured is a</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">chronically ill individual.</span></p><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870f000003"> </span></p><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">    </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000001">Source:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> 36 SDR 209, effective July 1, 2010; 44 SDR 184, effective June 25, 2018.</span></p><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">    </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000001">General Authority:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17B-4"><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000002">58-17B-4</span></a><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">.</span></p><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">    </span><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000001">Law Implemented:</span><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0"> SDCL </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17B-4"><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0-000002">58-17B-4</span></a><span style="white-space: pre-wrap;" class="s03838ffb-8600-4098-b011-7baf3aaa870fC0">.</span></p><p dir="ltr" class="s03838ffb-8600-4098-b011-7baf3aaa870fP0"><span style="white-space: pre-wrap;" xml:space="preserve" class="s03838ffb-8600-4098-b011-7baf3aaa870f000003"> </span></p></div></body></html>