20:06:55:20.  Group plans -- Applicability. Sections 20:06:55:15 to 20:06:55:19, inclusive, apply for plan years beginning after September 22, 2010, and apply to any employer based health plan, including health benefit plans subject to the provisions of SDCL 58-18-42 but do not apply to excepted benefits.

          For plan or policy years beginning prior to January 1, 2014, a group health insurance policy is exempt from the annual limit requirements if the policy is approved for a waiver from such requirements by the U.S. Department of Health and Human Services but such exemption only applies for the specified period of time that the waiver from the U.S. Department of Health and Human Services is applicable.

          At the time a policy receives a waiver from the U.S. Department of Health and Human Services, the health carrier shall notify prospective applicants and affected policyholders and the commissioner in each state where prospective applicants and any affected insured are known to reside.

          At the time the waiver expires or is otherwise no longer in effect, the health carrier shall notify affected policyholders and the commissioner in each state where any affected insured is known to reside.

          Source: 37 SDR 63, effective September 23, 2010; 37 SDR 111, effective December 7, 2010.

          General Authority: SDCL 58-18-79.

          Law Implemented: SDCL 58-18-43, 58-18-44, 58-18-45, 58-18-48, 58-18-51.1, 58-18-79.