<HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: HG4 --><Div align="center"><!-- WP Style End: HG4 --> CHAPTER 58-18B <!-- WP Paired Style Off: HG4 --><!-- WP Style End: HG4 --> </Div> <br> <!-- WP Paired Style On: HG4C --><Div align="center"><!-- WP Style End: HG4C --> REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE <!-- WP Paired Style Off: HG4C --><!-- WP Style End: HG4C --> </Div> <br> <p> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-1">58-18B-1</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Definition of terms. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-2">58-18B-2</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Chapter applicable to small employer benefit plans. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-3">58-18B-3</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Regulations on premium rates. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-3.1">58-18B-3.1</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Base rate increase to be filed with director--Approval or disapproval. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-4">58-18B-4</A>, 58-18B-5. <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-6">58-18B-6</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Disclosure in solicitation and sales materials. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-7">58-18B-7</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Information and documentation required--Disclosure. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-8">58-18B-8</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Suspension of rate requirements. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-9">58-18B-9</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Application of chapter. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-10">58-18B-10</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-11">58-18B-11</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Health maintenance organization considered separate carrier. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-12">58-18B-12</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Ceding arrangements resulting in less than fifty percent of obligation or risk retained by carrier prohibited. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-13">58-18B-13</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Transition period when acquiring additional class of business. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-14">58-18B-14</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Rate changes only for small employer business. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-15">58-18B-15</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Provisions for premium rates. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-16">58-18B-16</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-17">58-18B-17</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Limit on premium rates. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-18">58-18B-18</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Promulgation of rules for rating practices. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-19">58-18B-19</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-20">58-18B-20</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Small employer carrier to issue plan to any small employer--Criteria--Exceptions--Two percent earned premium threshold. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-21">58-18B-21</A>, 58-18B-22. <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-23">58-18B-23</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Uniform application of requirements used to determine eligibility of employers. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-24">58-18B-24</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Application of minimum participation and minimum employer contribution requirements. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-25">58-18B-25</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Considerations in applying minimum participation requirements--Premium discounts. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-26">58-18B-26</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Increase in minimum requirements for employee participation or employer contribution prohibited after acceptance for coverage. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-27">58-18B-27</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Modification to exclude certain diseases prohibited. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-27.1">58-18B-27.1</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-28">58-18B-28</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Requirements lifted from small employer carrier in financially impaired condition. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-29">58-18B-29</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-30">58-18B-30</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-31">58-18B-31</A>, 58-18B-32. <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-33">58-18B-33</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-34">58-18B-34</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-35">58-18B-35</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Director to promulgate rules regulating sale of multiple employer trusts and welfare arrangements--Scope of rules. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-36">58-18B-36</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Rules governing implementation and administration of this chapter. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-37">58-18B-37</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Marketing health benefit plans--Denial of coverage to employer. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-38">58-18B-38</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Prohibited activities of small employer carriers or insurance producers. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <hr> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-39">58-18B-39</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Information regarding restricted network provision of carrier. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-40">58-18B-40</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Agent compensation based on characteristics of small employer prohibited--Commission on sale of health insurance plan through exchange. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-41">58-18B-41</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Compensation of insurance producer based on percentage of premium. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-42">58-18B-42</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-43">58-18B-43</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Status of insurance producer's employment may not be affected by health status, claims experience, occupation, or location of small employer placed with carrier. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-44">58-18B-44</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Carrier or agent not to induce or encourage employer to exclude employee from coverage. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-45">58-18B-45</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Reasons for denial of coverage to be in writing. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-46">58-18B-46</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Rules for additional standards for fair marketing and broad availability of benefit plans to small employers--Penalties. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-47">58-18B-47</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Third-party administrator treated as small employer carrier. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-48">58-18B-48</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Chapter not applicable to certain group health insurance plans. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-49">58-18B-49</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Establishing risk adjusters. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-50">58-18B-50</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Minimum inpatient care coverage following delivery. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-51">58-18B-51</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Shorter hospital stay permitted--Follow-up visit within forty-eight hours required. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-52">58-18B-52</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Notice to employees--Disclosures. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-53">58-18B-53</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Health insurance policies to provide coverage for biologically-based mental illnesses. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-54">58-18B-54</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Application--Exemptions. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-55">58-18B-55</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Supplemental or short term individual health benefit plans exempt from provisions of chapter--Conditions. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-56">58-18B-56</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-57">58-18B-57</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Diabetes coverage not required of certain plans. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-58">58-18B-58</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Health benefit plans to provide coverage for prostate cancer screening. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-59">58-18B-59</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Repealed. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <br> <!-- WP Paired Style On: B --><!-- WP Style End: B --> <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=58-18B-60">58-18B-60</A> <!-- WP Style Open: IN -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: IN --> Coverage for treatment of hearing impairment for persons under age nineteen. <!-- WP Paired Style Off: B --><!-- WP Style End: B --> <p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075456Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075456SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075456CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075456Normal-000000 { margin-top: 0; margin-bottom: 0; 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font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075456SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075456SCL-000005 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075456Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-1"><span class="s2075456SENU">58-18B-1</span></a><span xml:space="preserve" class="s2075456SENU">. </span><span class="s2075456CL">Definition of terms.</span></p><p dir="ltr" class="s2075456Normal-000000"><span class="s2075456DefaultParagraphFont">Terms used in this chapter mean:</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(1)    "Actuarial certification," a written statement by a member of the American Academy of Actuaries or other individual approved by the director that a small employer carrier is in compliance with the provisions of this chapter, based upon the person's examination, including a review of the appropriate records and of the actuarial assumptions and methods used by the carrier in establishing premium rates for applicable health benefit plans;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(2)    "Base premium rate," the lowest premium rate charged or which could have been charged for each class of business for a rating period under a rating system for that class of business, by the small employer carrier to small employers with similar case characteristics for health benefit plans with the same or similar coverage;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(3)    "Carrier," any person who provides health insurance in this state. In this chapter, carrier includes a licensed insurance company, a prepaid hospital or medical service plan, a health maintenance organization, a multiple employer welfare arrangement, or any person providing a plan of health insurance subject to state insurance regulation;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(4)    "Case characteristics," demographic or other relevant characteristics of a small employer, as determined by a small employer carrier, which are considered by the carrier for the determination of premium rates. Claim experience, health status, and duration of coverage since issue are not case characteristics in this chapter;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(5)    "Class of business," all or a distinct grouping of small employers as shown on the records of the small employer carrier;</span></p><p dir="ltr" class="s2075456Normal-000002"><span class="s2075456DefaultParagraphFont">(a)    A distinct grouping may only be established by a small employer carrier on the basis that the applicable health benefit plans:</span></p><p dir="ltr" class="s2075456Normal-000003"><span class="s2075456DefaultParagraphFont">(i)    Are marketed and sold through individuals and organizations which are not participating in the marketing or sale of other distinct groupings of small employers for such small employer carrier;</span></p><p dir="ltr" class="s2075456Normal-000003"><span class="s2075456DefaultParagraphFont">(ii)    Have been acquired from another small employer carrier as a distinct grouping of plans;</span></p><p dir="ltr" class="s2075456Normal-000003"><span class="s2075456DefaultParagraphFont">(iii)    Are provided through an association with membership of not less than twenty-five small employers which has been formed for purposes other than obtaining insurance; or</span></p><p dir="ltr" class="s2075456Normal-000003"><span class="s2075456DefaultParagraphFont">(iv)    Are in a class of business that meets the requirements for exception to the restrictions related to premium rates provided in subsection 58-18B-3(1)(a);</span></p><p dir="ltr" class="s2075456Normal-000002"><span class="s2075456DefaultParagraphFont">(b)    A small employer carrier may establish no more than two additional groupings under each of the subparagraphs in subsection (a) on the basis of underwriting criteria which are expected to produce substantial variation in the health care costs;</span></p><p dir="ltr" class="s2075456Normal-000002"><span class="s2075456DefaultParagraphFont">(c)    The director may approve the establishment of additional distinct groupings upon application to, and a finding by, the director that such action would enhance the efficiency and fairness of the small employer insurance marketplace;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(6)    "Director," the director of the Division of Insurance;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(7)    "Division," the Division of Insurance of the Department of Labor and Regulation;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(8)    "Index rate," the arithmetic average of the applicable base premium rate and the corresponding highest premium rate for each class of business for small employers with similar case characteristics;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(9)    "New business premium rate," the premium rate charged or offered by a small employer carrier to small employers with similar case characteristics for newly issued health benefit plans with the same or similar coverage for each class of business for a rating period;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(10)    "Rating period," the calendar period for which premium rates established by a small employer carrier are assumed to be in effect, as determined by the small employer carrier;</span></p><p dir="ltr" class="s2075456Normal-000001"><span xml:space="preserve" class="s2075456000004"> </span></p></div><div><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(11)    "Small employer," any person, firm, corporation, partnership, or association actively engaged in business which on an average of its working days during the preceding year, employed no more than fifty and no less than two employees and who employs at least two employees on the first day of the plan year. In determining the number of employees, companies which are affiliated companies or which are eligible to file a combined tax return for purposes of state taxation are considered to be one employer;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(12)    "Small employer carrier," any carrier which offers health benefit plans covering the employees of a small employer;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(13)    "Affiliate" or "affiliated," any person who, directly or indirectly, through one or more intermediaries, controls or is controlled by, or is under common control with, any other specified person;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(14)    "Dependent," except as otherwise required by this title, any spouse, any unmarried child under the age of nineteen years, any unmarried child who is a full-time student under the age of twenty-three and who is financially dependent upon the parent, and any unmarried child of any age who is medically certified as disabled and dependent upon the parent;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(15)    "Eligible employee," any employee who works on a permanent basis and has a normal work week of thirty or more hours. The term includes any sole proprietor, any partner, and any independent contractor, if the sole proprietor, partner, or independent contractor is included as an employee under a health benefit plan of a small employer, but does not include any employee who works less than thirty hours or on a temporary or substitute basis;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(16)    "Employee," has the meaning given such term under Section 3(6) of Title I of the Employee Retirement Income Security Act of 1974 (ERISA) as amended to January 1, 2001;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(17)    "Health benefit plan," any hospital or medical policy or certificate, hospital or medical service plan, or health maintenance organization subscriber contract. The term does not include specified disease, hospital indemnity, fixed indemnity, accident-only, credit, dental, vision, prescription drug, medicare supplement, long-term care, or disability income insurance, coverage issued as a supplement to liability insurance, worker's compensation or similar insurance, or automobile medical payment insurance;</span></p><p dir="ltr" class="s2075456Normal-000001"><span class="s2075456DefaultParagraphFont">(18)    "Restricted network provision," any provision of a health benefit plan that conditions the payment of benefits, in whole or in part, on the use of health care providers that have entered into a contractual arrangement with the carrier to provide health care services to covered individuals.</span></p><p dir="ltr" class="s2075456Normal"><span xml:space="preserve" class="s2075456000004"> </span></p><p dir="ltr" class="s2075456Normal"><span class="s2075456SCL">Source:</span><span xml:space="preserve" class="s2075456SCL-000005"> SL 1991, ch 402, § 1; SL 1995, ch 281, § 1; SL 1997, ch 289, § 14; SL 2001, ch 279, § 1; SL 2003, ch 272 (Ex. Ord. 03-1), § 27; SL 2011, ch 1 (Ex. Ord. </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=11-1"><span class="s2075456SCL-000005">11-1</span></a><span class="s2075456SCL-000005">), § 162, eff. Apr. 12, 2011.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075457Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075457SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075457CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075457Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075457DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075457Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s2075457Normal-000002 { text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075457000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075457SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075457SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075457Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-2"><span class="s2075457SENU">58-18B-2</span></a><span xml:space="preserve" class="s2075457SENU">. </span><span class="s2075457CL">Chapter applicable to small employer benefit plans.</span></p><p dir="ltr" class="s2075457Normal-000000"><span class="s2075457DefaultParagraphFont">This chapter is applicable to any health benefit plan which provides coverage to two or more employees of a small employer and policies which meet the following criteria:</span></p><p dir="ltr" class="s2075457Normal-000001"><span class="s2075457DefaultParagraphFont">(1)    Any portion of the premium or benefits is paid by or on behalf of the small employer; or</span></p><p dir="ltr" class="s2075457Normal-000001"><span class="s2075457DefaultParagraphFont">(2)    The health benefit plan is treated by the employer or any of the eligible employees or dependents as part of a plan or program for the purposes of section 125 or section 106 of the United States Internal Revenue Code as of January 1, 1995.</span></p><p dir="ltr" class="s2075457Normal-000002"><span xml:space="preserve" class="s2075457DefaultParagraphFont">This chapter does not apply to any employer plan with only one employee. Any employer plan with only one employee, even if the employer pays a portion or all of the premium, may be sold as individual policies subject to the provisions of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17"><span class="s2075457DefaultParagraphFont">58-17</span></a><span xml:space="preserve" class="s2075457DefaultParagraphFont">. If a plan covering one employee is sold as an individual plan and new employees are added which brings the number of employees to at least two but not more than fifty, then the individual carrier may nonrenew the coverage or accept those new employees and bring the plan into compliance with the applicable provisions of chapters </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18"><span class="s2075457DefaultParagraphFont">58-18</span></a><span xml:space="preserve" class="s2075457DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B"><span class="s2075457DefaultParagraphFont">58-18B</span></a><span class="s2075457DefaultParagraphFont">.</span></p><p dir="ltr" class="s2075457Normal"><span xml:space="preserve" class="s2075457000003"> </span></p><p dir="ltr" class="s2075457Normal"><span class="s2075457SCL">Source:</span><span xml:space="preserve" class="s2075457SCL-000004"> SL 1991, ch 402, § 2; SL 1995, ch 281, § 2; SL 1996, ch 298; SL 1998, ch 292, § 1.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075458Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075458SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075458CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075458Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075458DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075458Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s2075458Normal-000002 { margin-left: 1.14in; text-indent: -0.44in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075458DefaultParagraphFont-000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075458Normal-000004 { text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075458000005 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075458SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075458SCL-000006 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075458Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-3"><span class="s2075458SENU">58-18B-3</span></a><span xml:space="preserve" class="s2075458SENU">. </span><span class="s2075458CL">Regulations on premium rates.</span></p><p dir="ltr" class="s2075458Normal-000000"><span class="s2075458DefaultParagraphFont">Premium rates for health benefit plans subject to this chapter are subject to the following provisions:</span></p><p dir="ltr" class="s2075458Normal-000001"><span class="s2075458DefaultParagraphFont">(1)    The index rate for a rating period for any class of business may not exceed the index rate for any other class of business by more than twenty percent unless:</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(a)    The class of business is one for which the carrier does not reject, and never has rejected, small employers included within the definition of employers eligible for the class of business or otherwise eligible employees and dependents who enroll on a timely basis, based upon their claim experience or health status;</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(b)    The carrier does not involuntarily transfer, and never has involuntarily transferred, a health benefit plan into or out of the class of business; or</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(c)    The class of business is currently available for purchase;</span></p><p dir="ltr" class="s2075458Normal-000001"><span class="s2075458DefaultParagraphFont">(2)    For a class of business, the premium rates charged during a rating period to small employers with similar case characteristics for the same or similar coverage, or the rates which could be charged to such employers under the rating system for that class of business, may not vary from the index rate by more than twenty</span><span class="s2075458DefaultParagraphFont-000003">-</span><span class="s2075458DefaultParagraphFont">five percent of the index rate;</span></p><p dir="ltr" class="s2075458Normal-000001"><span class="s2075458DefaultParagraphFont">(3)    The percentage increase in the premium rate charged to a small employer for a new rating period may not exceed the sum of the following:</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(a)    The percentage change in the new business premium rate measured from the first day of the prior rating period to the first day of the new rating period. In the case of a class of business for which the small employer carrier is not issuing new policies, the carrier shall use the percentage change in the base premium rate;</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(b)    An adjustment, not to exceed fifteen percent annually and adjusted pro rata for rating periods of less than one year, due to the claim experience, health status or duration of coverage of the employees or dependents of the small employer as determined from the carrier's rate manual for the class of business; and</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(c)    Any adjustment due to change in coverage or change in the case characteristics of the small employer as determined from the carrier's rate manual for the class of business;</span></p><p dir="ltr" class="s2075458Normal-000001"><span class="s2075458DefaultParagraphFont">(4)    For health benefit plans issued prior to July 1, 1991, a premium rate for a rating period may exceed the ranges described in subdivision (1) or (2) of this section for a period of five years from July 1, 1991. In that case, the percentage increase in the premium rate charged to a small employer in such a class of business for a new rating period may not exceed the sum of the following:</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(a)    The percentage change in the new business premium rate measured from the first day of the prior rating period to the first day of the new rating period. In the case of a class of business for which the small employer carrier is not issuing new policies, the carrier shall use the percentage change in the base premium rate; and</span></p><p dir="ltr" class="s2075458Normal-000002"><span class="s2075458DefaultParagraphFont">(b)    Any adjustment due to change in coverage or change in the case characteristics of the small employer as determined from the carrier's rate manual for the class of business.</span></p><p dir="ltr" class="s2075458Normal-000004"><span class="s2075458DefaultParagraphFont">This section does not affect the use by a small employer carrier of legitimate rating factors other than claim experience, health status or duration of coverage in the determination of premium rates. Small employer carriers shall apply rating factors, including case characteristics, consistently with respect to all small employers in a class of business.</span></p><p dir="ltr" class="s2075458Normal-000004"><span class="s2075458DefaultParagraphFont">A small employer carrier may not involuntarily transfer a small employer into or out of a class of business. A small employer carrier may not offer to transfer a small employer into or out of a class of business unless the offer is made to transfer all small employers in the class of business without regard to case characteristics, claim experience, health status, or duration since issue.</span></p><p dir="ltr" class="s2075458Normal"><span xml:space="preserve" class="s2075458000005"> </span></p><p dir="ltr" class="s2075458Normal"><span class="s2075458SCL">Source:</span><span xml:space="preserve" class="s2075458SCL-000006"> SL 1991, ch 402, § 3.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s50221dff723a4cbd9df00c3b07979dccNormal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s50221dff723a4cbd9df00c3b07979dccSENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s50221dff723a4cbd9df00c3b07979dccCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s50221dff723a4cbd9df00c3b07979dccNormal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s50221dff723a4cbd9df00c3b07979dccDefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s50221dff723a4cbd9df00c3b07979dcc000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s50221dff723a4cbd9df00c3b07979dccSCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s50221dff723a4cbd9df00c3b07979dccSCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s50221dff723a4cbd9df00c3b07979dccDefaultParagraphFont-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-18B-3.1 - Base rate increase to be filed with director--Approval or disapproval."><meta property="og:description" content="SDLRC Codified Law 58-18B-3.1 - Base rate increase to be filed with director--Approval or disapproval."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-18B-3.1"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s50221dff723a4cbd9df00c3b07979dccNormal"><a href="https://sdlegislature.gov/Statutes?Statute=58-18B-3.1" rel="noopener"><span class="s50221dff723a4cbd9df00c3b07979dccSENU">58-18B-3.1</span></a><span xml:space="preserve" class="s50221dff723a4cbd9df00c3b07979dccSENU">. </span><span class="s50221dff723a4cbd9df00c3b07979dccCL">Base rate increase to be filed with director--Approval or disapproval.</span></p><p dir="ltr" class="s50221dff723a4cbd9df00c3b07979dccNormal-000000"><span class="s50221dff723a4cbd9df00c3b07979dccDefaultParagraphFont">No small employer carrier may increase its small employer base rates unless the small employer carrier has filed the base rate increase with the director for review at least thirty days prior to the implementation of the rate increase. The base rates are deemed approved at the expiration of thirty days after the filing thereof unless disapproved by the director within thirty days after the date of filing. The filing of the base rate increase shall include documentation sufficient to actuarially justify the increase and a history of the earned premiums and incurred claims on the policy forms applicable to the rate increase. The base rates shall be reasonable in relation to the benefits.</span></p><p dir="ltr" class="s50221dff723a4cbd9df00c3b07979dccNormal"><span xml:space="preserve" class="s50221dff723a4cbd9df00c3b07979dcc000001"> </span></p><p dir="ltr" class="s50221dff723a4cbd9df00c3b07979dccNormal"><span class="s50221dff723a4cbd9df00c3b07979dccSCL">Source:</span><span xml:space="preserve" class="s50221dff723a4cbd9df00c3b07979dccSCL-000002"> SL 2011, ch 216, § 18.</span></p><p dir="ltr" class="s50221dff723a4cbd9df00c3b07979dccNormal"><span xml:space="preserve" class="s50221dff723a4cbd9df00c3b07979dcc000001"> </span></p><p dir="ltr" class="s50221dff723a4cbd9df00c3b07979dccNormal"><span xml:space="preserve" class="s50221dff723a4cbd9df00c3b07979dccDefaultParagraphFont-000003">Commission Note: </span><span class="s50221dff723a4cbd9df00c3b07979dccDefaultParagraphFont">SL 2011, ch 216, § 19 provides: "The provisions of this Act are repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed."</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-4 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-4 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-4"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-4, 58-18B-5. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1994, ch 383, &#167;&#167;&nbsp;12, 13<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075461Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075461SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075461CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075461Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075461DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075461Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075461000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075461SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075461SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075461Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-6"><span class="s2075461SENU">58-18B-6</span></a><span xml:space="preserve" class="s2075461SENU">. </span><span class="s2075461CL">Disclosure in solicitation and sales materials.</span></p><p dir="ltr" class="s2075461Normal-000000"><span class="s2075461DefaultParagraphFont">Each small employer carrier shall make reasonable disclosure in solicitation and sales materials provided to small employers of the following:</span></p><p dir="ltr" class="s2075461Normal-000001"><span class="s2075461DefaultParagraphFont">(1)    The extent to which premium rates for a specific small employer are established or adjusted due to the claim experience, health status or duration of coverage of the employees or dependents of the small employer;</span></p><p dir="ltr" class="s2075461Normal-000001"><span class="s2075461DefaultParagraphFont">(2)    The provisions concerning the carrier's right to change premium rates and the factors, including case characteristics, which affect changes in premium rates;</span></p><p dir="ltr" class="s2075461Normal-000001"><span class="s2075461DefaultParagraphFont">(3)    A description of the class of business in which the small employer is or will be included, including the applicable grouping of plans; and</span></p><p dir="ltr" class="s2075461Normal-000001"><span class="s2075461DefaultParagraphFont">(4)    The provisions relating to renewability of coverage.</span></p><p dir="ltr" class="s2075461Normal"><span xml:space="preserve" class="s2075461000002"> </span></p><p dir="ltr" class="s2075461Normal"><span class="s2075461SCL">Source:</span><span xml:space="preserve" class="s2075461SCL-000003"> SL 1991, ch 402, § 6.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075462Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075462SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075462CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075462Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075462DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075462Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075462000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075462SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075462SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075462Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-7"><span class="s2075462SENU">58-18B-7</span></a><span xml:space="preserve" class="s2075462SENU">. </span><span class="s2075462CL">Information and documentation required--Disclosure.</span></p><p dir="ltr" class="s2075462Normal-000000"><span class="s2075462DefaultParagraphFont">Each small employer carrier shall maintain at the carrier's principal place of business a complete and detailed description of the carrier's rating practices and renewal underwriting practices, including information and documentation which demonstrate that the carrier's rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles.</span></p><p dir="ltr" class="s2075462Normal-000001"><span class="s2075462DefaultParagraphFont">A small employer carrier shall make the information and documentation required by this section available to the director upon request. Except in cases of violations of this chapter, the information shall be considered proprietary and trade secret information and is not subject to disclosure by the director to persons outside of the division except as agreed to by the carrier or by order of a court, or if requested by a law enforcement officer or another state insurance agency.</span></p><p dir="ltr" class="s2075462Normal"><span xml:space="preserve" class="s2075462000002"> </span></p><p dir="ltr" class="s2075462Normal"><span class="s2075462SCL">Source:</span><span xml:space="preserve" class="s2075462SCL-000003"> SL 1991, ch 402, § 7; SL 1995, ch 281, § 12; SL 2009, ch 262, § 2.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075463Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075463SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075463CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075463Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075463DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075463000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075463SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075463SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075463Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-8"><span class="s2075463SENU">58-18B-8</span></a><span xml:space="preserve" class="s2075463SENU">. </span><span class="s2075463CL">Suspension of rate requirements.</span></p><p dir="ltr" class="s2075463Normal-000000"><span xml:space="preserve" class="s2075463DefaultParagraphFont">The director may suspend all or any part of the premium rate requirements of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-3"><span class="s2075463DefaultParagraphFont">58-18B-3</span></a><span xml:space="preserve" class="s2075463DefaultParagraphFont"> applicable to one or more small employers for one or more rating periods upon a filing by the small employer carrier and a finding by the director that either the suspension is reasonable in light of the financial condition of the carrier or that the suspension would enhance the efficiency and fairness of the marketplace for small employer health insurance.</span></p><p dir="ltr" class="s2075463Normal"><span xml:space="preserve" class="s2075463000001"> </span></p><p dir="ltr" class="s2075463Normal"><span class="s2075463SCL">Source:</span><span xml:space="preserve" class="s2075463SCL-000002"> SL 1991, ch 402, § 8.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075464Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075464SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075464CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075464Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075464DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075464000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075464SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075464SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075464Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-9"><span class="s2075464SENU">58-18B-9</span></a><span xml:space="preserve" class="s2075464SENU">. </span><span class="s2075464CL">Application of chapter.</span></p><p dir="ltr" class="s2075464Normal-000000"><span class="s2075464DefaultParagraphFont">The provisions of this chapter apply to each health benefit plan for a small employer that is delivered, issued for delivery, renewed or continued in this state after July 1, 1992. The date a plan is continued is the first rating period which commences after July 1, 1992.</span></p><p dir="ltr" class="s2075464Normal"><span xml:space="preserve" class="s2075464000001"> </span></p><p dir="ltr" class="s2075464Normal"><span class="s2075464SCL">Source:</span><span xml:space="preserve" class="s2075464SCL-000002"> SL 1991, ch 402, § 9.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-10 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-10 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-10"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-10. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2002, ch 237, &#167;&nbsp;1<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075466Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075466SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075466CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075466Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075466DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075466000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075466SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075466SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075466Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-11"><span class="s2075466SENU">58-18B-11</span></a><span xml:space="preserve" class="s2075466SENU">. </span><span class="s2075466CL">Health maintenance organization considered separate carrier.</span></p><p dir="ltr" class="s2075466Normal-000000"><span xml:space="preserve" class="s2075466DefaultParagraphFont">An affiliated carrier that is a health maintenance organization having a certificate of authority under chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41"><span class="s2075466DefaultParagraphFont">58-41</span></a><span xml:space="preserve" class="s2075466DefaultParagraphFont"> may be considered to be a separate carrier for the purposes of this chapter.</span></p><p dir="ltr" class="s2075466Normal"><span xml:space="preserve" class="s2075466000001"> </span></p><p dir="ltr" class="s2075466Normal"><span class="s2075466SCL">Source:</span><span xml:space="preserve" class="s2075466SCL-000002"> SL 1995, ch 281, § 4.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075467Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075467SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075467CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075467Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075467DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075467000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075467SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075467SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075467Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-12"><span class="s2075467SENU">58-18B-12</span></a><span xml:space="preserve" class="s2075467SENU">. </span><span class="s2075467CL">Ceding arrangements resulting in less than fifty percent of obligation or risk retained by carrier prohibited.</span></p><p dir="ltr" class="s2075467Normal-000000"><span class="s2075467DefaultParagraphFont">Unless otherwise authorized by the director, no small employer carrier may enter into one or more ceding arrangements with respect to health benefit plans delivered or issued for delivery to small employers in the state if the arrangements would result in less than fifty percent of the insurance obligation or risk for such health benefit plans being retained by the ceding carrier.</span></p><p dir="ltr" class="s2075467Normal"><span xml:space="preserve" class="s2075467000001"> </span></p><p dir="ltr" class="s2075467Normal"><span class="s2075467SCL">Source:</span><span xml:space="preserve" class="s2075467SCL-000002"> SL 1995, ch 281, § 5.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075468Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075468SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075468CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075468Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075468DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075468000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075468SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075468SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075468Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-13"><span class="s2075468SENU">58-18B-13</span></a><span xml:space="preserve" class="s2075468SENU">. </span><span class="s2075468CL">Transition period when acquiring additional class of business.</span></p><p dir="ltr" class="s2075468Normal-000000"><span xml:space="preserve" class="s2075468DefaultParagraphFont">The director may promulgate rules pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075468DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2075468DefaultParagraphFont"> to provide for a period of transition in order for a small employer carrier to come into compliance with subdivision 58-18B-1(5) when the carrier acquires an additional class of business from another small employer carrier.</span></p><p dir="ltr" class="s2075468Normal"><span xml:space="preserve" class="s2075468000001"> </span></p><p dir="ltr" class="s2075468Normal"><span class="s2075468SCL">Source:</span><span xml:space="preserve" class="s2075468SCL-000002"> SL 1995, ch 281, § 6.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075469Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075469SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075469CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075469Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075469DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075469000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075469SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075469SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075469Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-14"><span class="s2075469SENU">58-18B-14</span></a><span xml:space="preserve" class="s2075469SENU">. </span><span class="s2075469CL">Rate changes only for small employer business.</span></p><p dir="ltr" class="s2075469Normal-000000"><span class="s2075469DefaultParagraphFont">Unless otherwise specified, nothing in this chapter requires a carrier to change any of its rates or rating methodologies for any business other than the small employer business subject to the provisions of this chapter.</span></p><p dir="ltr" class="s2075469Normal"><span xml:space="preserve" class="s2075469000001"> </span></p><p dir="ltr" class="s2075469Normal"><span class="s2075469SCL">Source:</span><span xml:space="preserve" class="s2075469SCL-000002"> SL 1995, ch 281, § 7.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075470Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075470SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075470CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075470Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075470DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075470Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075470000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075470SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075470SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075470Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-15"><span class="s2075470SENU">58-18B-15</span></a><span xml:space="preserve" class="s2075470SENU">. </span><span class="s2075470CL">Provisions for premium rates.</span></p><p dir="ltr" class="s2075470Normal-000000"><span class="s2075470DefaultParagraphFont">Premium rates for health benefit plans subject to this chapter are subject to the following provisions:</span></p><p dir="ltr" class="s2075470Normal-000001"><span class="s2075470DefaultParagraphFont">(1)    Adjustments in rates for claim experience, health status, and duration of coverage may not be charged to individual employees or dependents. Any such adjustments shall be applied uniformly to the rates charged for all employees and dependents of the small employer;</span></p><p dir="ltr" class="s2075470Normal-000001"><span class="s2075470DefaultParagraphFont">(2)    A small employer carrier may utilize industry as a case characteristic in establishing premium rates, if the highest rate factor associated with any industry classification does not exceed the lowest rate factor associated with any industry classification by more than fifteen percent;</span></p><p dir="ltr" class="s2075470Normal-000001"><span class="s2075470DefaultParagraphFont">(3)    Small employer carriers shall apply rating factors, including case characteristics, consistently with respect to all small employers in a class of business;</span></p><p dir="ltr" class="s2075470Normal-000001"><span class="s2075470DefaultParagraphFont">(4)    For the purposes of this section, a health benefit plan that utilizes a restricted provider network is not considered similar coverage to a health benefit plan that does not utilize such a network, if utilization of the restricted provider network results in substantial differences in claims costs; and</span></p><p dir="ltr" class="s2075470Normal-000001"><span class="s2075470DefaultParagraphFont">(5)    No small employer carrier may use case characteristics, other than age, gender, industry, family composition, and group size without prior approval of the director.</span></p><p dir="ltr" class="s2075470Normal"><span xml:space="preserve" class="s2075470000002"> </span></p><p dir="ltr" class="s2075470Normal"><span class="s2075470SCL">Source:</span><span xml:space="preserve" class="s2075470SCL-000003"> SL 1995, ch 281, § 8.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-16 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-16 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-16"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-16. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2004, ch 305, &#167;&nbsp;1<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075472Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075472SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075472CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075472Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075472DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075472000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075472SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075472SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075472Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-17"><span class="s2075472SENU">58-18B-17</span></a><span xml:space="preserve" class="s2075472SENU">. </span><span class="s2075472CL">Limit on premium rates.</span></p><p dir="ltr" class="s2075472Normal-000000"><span class="s2075472DefaultParagraphFont">The premium rates for an individual covered in a small employer plan may not exceed the premium rate for any other individual covered under the same small employer carrier because of age alone by a factor of 3:1. A small employer carrier may not require any individual to pay any premium or contribution that is greater than that for a similarly situated individual enrolled in the plan. Nothing in this section prohibits a group health plan, and a health insurance issuer offering group health insurance coverage, from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion or disease prevention.</span></p><p dir="ltr" class="s2075472Normal"><span xml:space="preserve" class="s2075472000001"> </span></p><p dir="ltr" class="s2075472Normal"><span class="s2075472SCL">Source:</span><span xml:space="preserve" class="s2075472SCL-000002"> SL 1995, ch 281, § 10; SL 1997, ch 289, § 15; SL 2001, ch 279, § 2.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075473Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075473SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075473CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075473Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075473DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075473Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075473000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075473SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075473SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075473Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-18"><span class="s2075473SENU">58-18B-18</span></a><span xml:space="preserve" class="s2075473SENU">. </span><span class="s2075473CL">Promulgation of rules for rating practices.</span></p><p dir="ltr" class="s2075473Normal-000000"><span xml:space="preserve" class="s2075473DefaultParagraphFont">The director may promulgate rules pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075473DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2075473DefaultParagraphFont"> to implement the provisions of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-1"><span class="s2075473DefaultParagraphFont">58-18B-1</span></a><span xml:space="preserve" class="s2075473DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-3"><span class="s2075473DefaultParagraphFont">58-18B-3</span></a><span xml:space="preserve" class="s2075473DefaultParagraphFont">, inclusive, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-7"><span class="s2075473DefaultParagraphFont">58-18B-7</span></a><span xml:space="preserve" class="s2075473DefaultParagraphFont">, §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-15"><span class="s2075473DefaultParagraphFont">58-18B-15</span></a><span xml:space="preserve" class="s2075473DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-18"><span class="s2075473DefaultParagraphFont">58-18B-18</span></a><span class="s2075473DefaultParagraphFont">, inclusive, and to assure that rating practices used by small employer carriers are consistent with the purposes of this chapter, including rules that:</span></p><p dir="ltr" class="s2075473Normal-000001"><span class="s2075473DefaultParagraphFont">(1)    Assure that differences in rates charged for health benefit plans by small employer carriers are reasonable and reflect objective differences in plan design not including differences due to the nature of the groups assumed to select particular health benefit plans; and</span></p><p dir="ltr" class="s2075473Normal-000001"><span class="s2075473DefaultParagraphFont">(2)    Prescribe the manner in which case characteristics may be used by small employer carriers.</span></p><p dir="ltr" class="s2075473Normal"><span xml:space="preserve" class="s2075473000002"> </span></p><p dir="ltr" class="s2075473Normal"><span class="s2075473SCL">Source:</span><span xml:space="preserve" class="s2075473SCL-000003"> SL 1995, ch 281, § 11.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-19 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-19 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-19"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-19. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1998, ch 289, &#167;&nbsp;13<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075475Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075475SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075475CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075475Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075475DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075475Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s2075475Normal-000002 { text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075475DefaultParagraphFont-000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075475000004 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075475SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075475SCL-000005 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075475Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-20"><span class="s2075475SENU">58-18B-20</span></a><span xml:space="preserve" class="s2075475SENU">. </span><span class="s2075475CL">Small employer carrier to issue plan to any small employer--Criteria--Exceptions--Two percent earned premium threshold.</span></p><p dir="ltr" class="s2075475Normal-000000"><span class="s2075475DefaultParagraphFont">A small employer carrier shall issue health benefit plans to any small employer that applies for a plan and agrees to make the required premium payments and to satisfy the other reasonable provisions of the health benefit plan not inconsistent with this chapter. If, on the first day of the plan year, a small employer plan has fewer than two participants who are current employees, the carrier is not required to issue a policy to the small employer. A small employer carrier may apply reasonable criteria in determining whether to accept a small employer into a particular class of business if:</span></p><p dir="ltr" class="s2075475Normal-000001"><span class="s2075475DefaultParagraphFont">(1)    The criteria are not related to the health status or claim experience of the small employer;</span></p><p dir="ltr" class="s2075475Normal-000001"><span class="s2075475DefaultParagraphFont">(2)    The criteria are applied consistently to all small employers applying for coverage in the class of business; and</span></p><p dir="ltr" class="s2075475Normal-000001"><span class="s2075475DefaultParagraphFont">(3)    The small employer carrier provides for the acceptance of all eligible small employers into one or more classes of business.</span></p><p dir="ltr" class="s2075475Normal-000002"><span class="s2075475DefaultParagraphFont">The provisions of this section do not apply to a class of business into which the small employer carrier is no longer enrolling new small businesses. If the director determines that all carriers in the small employer market have met the two percent threshold, the threshold shall, upon order of the director, be expanded an additional two percent. The threshold shall be expanded in additional two percent increments if all small employer carriers meet the previous threshold. No small employer carrier is required to issue coverage to any small employer if the small employers who are at high</span><span class="s2075475DefaultParagraphFont-000003">-</span><span xml:space="preserve" class="s2075475DefaultParagraphFont">risk constitute two percent of that carrier's earned premium on an annual basis from small employer health benefit plans. The director may promulgate rules pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075475DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2075475DefaultParagraphFont"> to determine which policies may be used to determine the two percent threshold, the procedures involved, and the applicable time frames. In making that determination, the director shall develop a method designed to limit the number of high risk groups to which any one carrier may be required to issue coverage.</span></p><p dir="ltr" class="s2075475Normal"><span xml:space="preserve" class="s2075475000004"> </span></p><p dir="ltr" class="s2075475Normal"><span class="s2075475SCL">Source:</span><span xml:space="preserve" class="s2075475SCL-000005"> SL 1995, ch 281, § 14; SL 1997, ch 289, § 16; SL 1998, ch 289, § 14; SL 2001, ch 279, § 3.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-21 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-21 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-21"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-21, 58-18B-22. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1998, ch 289, &#167;&#167;&nbsp;15, 16<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075477Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075477SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075477CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075477Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075477DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075477000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075477SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075477SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075477Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-23"><span class="s2075477SENU">58-18B-23</span></a><span xml:space="preserve" class="s2075477SENU">. </span><span class="s2075477CL">Uniform application of requirements used to determine eligibility of employers.</span></p><p dir="ltr" class="s2075477Normal-000000"><span xml:space="preserve" class="s2075477DefaultParagraphFont">Except as provided in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-26"><span class="s2075477DefaultParagraphFont">58-18B-26</span></a><span class="s2075477DefaultParagraphFont">, requirements used by a small employer carrier in determining whether to provide coverage to a small employer, including requirements for minimum participation of eligible employees and minimum employer contributions, shall be applied uniformly among all small employers with the same number of eligible employees applying for coverage or receiving coverage from the small employer carrier. An association of small employer plans may require, as a condition of obtaining or continuing coverage, membership in the association.</span></p><p dir="ltr" class="s2075477Normal"><span xml:space="preserve" class="s2075477000001"> </span></p><p dir="ltr" class="s2075477Normal"><span class="s2075477SCL">Source:</span><span xml:space="preserve" class="s2075477SCL-000002"> SL 1995, ch 281, § 17.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075478Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075478SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075478CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075478Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075478DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075478000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075478SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075478SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075478Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-24"><span class="s2075478SENU">58-18B-24</span></a><span xml:space="preserve" class="s2075478SENU">. </span><span class="s2075478CL">Application of minimum participation and minimum employer contribution requirements.</span></p><p dir="ltr" class="s2075478Normal-000000"><span class="s2075478DefaultParagraphFont">A small employer carrier may vary application of minimum participation requirements and minimum employer contribution requirements only by the size of the small employer group or by the class of business.</span></p><p dir="ltr" class="s2075478Normal"><span xml:space="preserve" class="s2075478000001"> </span></p><p dir="ltr" class="s2075478Normal"><span class="s2075478SCL">Source:</span><span xml:space="preserve" class="s2075478SCL-000002"> SL 1995, ch 281, § 18.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075479Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075479SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075479CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075479Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075479DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075479Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075479000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075479SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075479SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075479Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-25"><span class="s2075479SENU">58-18B-25</span></a><span xml:space="preserve" class="s2075479SENU">. </span><span class="s2075479CL">Considerations in applying minimum participation requirements--Premium discounts.</span></p><p dir="ltr" class="s2075479Normal-000000"><span class="s2075479DefaultParagraphFont">In applying minimum participation requirements with respect to a small employer, a small employer carrier may consider employees or dependents who have creditable coverage in determining whether the applicable percentage of participation is met. If any employee or dependent with other creditable coverage is to be considered towards calculating the applicable percentage of participation, the employee or dependent shall be counted as participating in the plan.</span></p><p dir="ltr" class="s2075479Normal-000001"><span class="s2075479DefaultParagraphFont">A carrier may provide up to a twenty percent discount for any small employer who achieves a one hundred percent participation rate in the prior year. The discount may be less than the base rate by a factor up to twenty percent. However, no discount below the base rate may be used in determining the index rate for that class of business.</span></p><p dir="ltr" class="s2075479Normal"><span xml:space="preserve" class="s2075479000002"> </span></p><p dir="ltr" class="s2075479Normal"><span class="s2075479SCL">Source:</span><span xml:space="preserve" class="s2075479SCL-000003"> SL 1995, ch 281, § 19; SL 1997, ch 289, § 17; SL 2001, ch 279, § 4; SL 2005, ch 271, § 1.</span></p><p dir="ltr" class="s2075479Normal"><span xml:space="preserve" class="s2075479000002"> </span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075480Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075480SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075480CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075480Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075480DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075480000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075480SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075480SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075480Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-26"><span class="s2075480SENU">58-18B-26</span></a><span xml:space="preserve" class="s2075480SENU">. </span><span class="s2075480CL">Increase in minimum requirements for employee participation or employer contribution prohibited after acceptance for coverage.</span></p><p dir="ltr" class="s2075480Normal-000000"><span class="s2075480DefaultParagraphFont">No small employer carrier may increase any requirement for minimum employee participation or any requirement for minimum employer contribution applicable to a small employer at any time after the small employer has been accepted for coverage.</span></p><p dir="ltr" class="s2075480Normal"><span xml:space="preserve" class="s2075480000001"> </span></p><p dir="ltr" class="s2075480Normal"><span class="s2075480SCL">Source:</span><span xml:space="preserve" class="s2075480SCL-000002"> SL 1995, ch 281, § 20.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075481Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075481SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075481CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075481Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075481DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075481DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075481000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075481SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075481SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075481Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-27"><span class="s2075481SENU">58-18B-27</span></a><span xml:space="preserve" class="s2075481SENU">. </span><span class="s2075481CL">Modification to exclude certain diseases prohibited.</span></p><p dir="ltr" class="s2075481Normal-000000"><span class="s2075481DefaultParagraphFont">No small employer carrier may modify a health benefit plan with respect to a small employer or any eligible employee or dependent through riders, endorsements, or otherwise, to restrict or exclude coverage for certain diseases or medical conditions otherwise covered by the health benefit plan. A small employer carrier may not establish rules for eligibility for any individual to enroll under a plan, including continued eligibility, based on health status</span><span class="s2075481DefaultParagraphFont-000001">-</span><span class="s2075481DefaultParagraphFont">related factors which include health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, including conditions arising out of acts of domestic violence, and disability.</span></p><p dir="ltr" class="s2075481Normal"><span xml:space="preserve" class="s2075481000002"> </span></p><p dir="ltr" class="s2075481Normal"><span class="s2075481SCL">Source:</span><span xml:space="preserve" class="s2075481SCL-000003"> SL 1995, ch 281, § 22; SL 1997, ch 289, § 18; SL 1998, ch 289, § 17.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075482Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075482SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075482CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075482Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075482DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075482Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075482000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075482SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075482SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075482Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-27.1"><span class="s2075482SENU">58-18B-27.1</span></a><span xml:space="preserve" class="s2075482SENU">. </span><span class="s2075482CL">Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.</span></p><p dir="ltr" class="s2075482Normal-000000"><span xml:space="preserve" class="s2075482DefaultParagraphFont">A health benefit plan of a small employer carrier that is delivered, issued for delivery, or renewed in this state may not exclude the payment of benefits for injuries sustained by an insured person because the insured was under the influence of alcohol or drugs, as defined by § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=32-23-1"><span class="s2075482DefaultParagraphFont">32-23-1</span></a><span class="s2075482DefaultParagraphFont">.</span></p><p dir="ltr" class="s2075482Normal-000001"><span class="s2075482DefaultParagraphFont">Nothing in this section precludes a hospital or medical service plan from excluding coverage for an insured for any sickness or injury caused in the commission of a felony.</span></p><p dir="ltr" class="s2075482Normal"><span xml:space="preserve" class="s2075482000002"> </span></p><p dir="ltr" class="s2075482Normal"><span class="s2075482SCL">Source:</span><span xml:space="preserve" class="s2075482SCL-000003"> SL 1997, ch 290, §§ 3, 7.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075483Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075483SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075483CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075483Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075483DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075483000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075483SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075483SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075483Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-28"><span class="s2075483SENU">58-18B-28</span></a><span xml:space="preserve" class="s2075483SENU">. </span><span class="s2075483CL">Requirements lifted from small employer carrier in financially impaired condition.</span></p><p dir="ltr" class="s2075483Normal-000000"><span xml:space="preserve" class="s2075483DefaultParagraphFont">No small employer carrier may be required to provide coverage to small employers pursuant to § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-20"><span class="s2075483DefaultParagraphFont">58-18B-20</span></a><span xml:space="preserve" class="s2075483DefaultParagraphFont">, for any period of time for which the director determines that requiring the acceptance of small employers in accordance with the provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-20"><span class="s2075483DefaultParagraphFont">58-18B-20</span></a><span class="s2075483DefaultParagraphFont">, would place the small employer carrier in a financially impaired condition.</span></p><p dir="ltr" class="s2075483Normal"><span xml:space="preserve" class="s2075483000001"> </span></p><p dir="ltr" class="s2075483Normal"><span class="s2075483SCL">Source:</span><span xml:space="preserve" class="s2075483SCL-000002"> SL 1995, ch 281, § 23.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-29 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-29 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-29"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-29. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2001, ch 279, &#167;&nbsp;5<p> </BODY> </HTML> <br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-30 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-30 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-30"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-30. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1998, ch 289, &#167;&nbsp;18<p> </BODY> </HTML> <br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-31 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-31 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-31"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-31, 58-18B-32. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2001, ch 279, &#167;&#167;&nbsp;6, 7<p> </BODY> </HTML> <br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-33 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-33 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-33"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-33. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2004, ch 305, &#167;&nbsp;2<p> </BODY> </HTML> <br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-34 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-34 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-34"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-34. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2011, ch 220, &#167;&nbsp;1.<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075489Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075489SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075489CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075489Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075489DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075489DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075489Normal-000002 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075489000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075489SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075489SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075489Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-35"><span class="s2075489SENU">58-18B-35</span></a><span xml:space="preserve" class="s2075489SENU">. </span><span class="s2075489CL">Director to promulgate rules regulating sale of multiple employer trusts and welfare arrangements--Scope of rules.</span></p><p dir="ltr" class="s2075489Normal-000000"><span xml:space="preserve" class="s2075489DefaultParagraphFont">The director shall promulgate rules pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075489DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2075489DefaultParagraphFont"> regulating the solicitation and sale of multiple employer trusts and multiple employer welfare arrangements. In considering the promulgation of rules pursuant to this section, the director shall take into consideration, the status of the small employer market, the impact such rules would have on the availability of health insurance and the impact such rules may have on the fair marketing of health insurance in this state. Rules promulgated pursuant to this section may not directly or indirectly affect stop loss or excess insurance covering health claims of employees arising from self</span><span class="s2075489DefaultParagraphFont-000001">-</span><span class="s2075489DefaultParagraphFont">funded employee health programs. The rules may cover:</span></p><p dir="ltr" class="s2075489Normal-000002"><span class="s2075489DefaultParagraphFont">(1)    Suitability and eligibility of insureds for coverage;</span></p><p dir="ltr" class="s2075489Normal-000002"><span class="s2075489DefaultParagraphFont">(2)    Method of premium payments;</span></p><p dir="ltr" class="s2075489Normal-000002"><span class="s2075489DefaultParagraphFont">(3)    Contractual obligations and policy provisions of carriers;</span></p><p dir="ltr" class="s2075489Normal-000002"><span class="s2075489DefaultParagraphFont">(4)    Form filing requirements, including those for approval and disapproval;</span></p><p dir="ltr" class="s2075489Normal-000002"><span class="s2075489DefaultParagraphFont">(5)    Reporting and recordkeeping requirements;</span></p><p dir="ltr" class="s2075489Normal-000002"><span class="s2075489DefaultParagraphFont">(6)    Definition of terms; and</span></p><p dir="ltr" class="s2075489Normal-000002"><span class="s2075489DefaultParagraphFont">(7)    Eligibility of insurers.</span></p><p dir="ltr" class="s2075489Normal"><span xml:space="preserve" class="s2075489000003"> </span></p><p dir="ltr" class="s2075489Normal"><span class="s2075489SCL">Source:</span><span xml:space="preserve" class="s2075489SCL-000004"> SL 1995, ch 281, § 30; SL 1997, ch 289, § 20; SL 1998, ch 293, § 1.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075490Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075490SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075490CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075490Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075490DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075490Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s2075490Normal-000002 { text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075490000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075490SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075490SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075490Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-36"><span class="s2075490SENU">58-18B-36</span></a><span xml:space="preserve" class="s2075490SENU">. </span><span class="s2075490CL">Rules governing implementation and administration of this chapter.</span></p><p dir="ltr" class="s2075490Normal-000000"><span xml:space="preserve" class="s2075490DefaultParagraphFont">The director shall promulgate rules pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075490DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2075490DefaultParagraphFont"> to provide for the implementation and administration of this chapter. The rules shall cover:</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(1)    Terms of renewability;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(2)    Initial and subsequent conditions of eligibility;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(3)    Probationary periods;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(4)    Benefit limitations, exceptions and reductions;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(5)    Requirements for replacement;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(6)    Participation and contribution requirements;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(7)    Definition of terms;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(8)    Marketing practices;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(9)    Reporting and disclosure practices or requirements;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(10)    Compensation arrangements between insurers or other entities and their agents, representatives, or producers;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(11)    Guaranteed acceptance of small groups by small group carriers;</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(12)    Continuation and conversion rights; and</span></p><p dir="ltr" class="s2075490Normal-000001"><span class="s2075490DefaultParagraphFont">(13)    Group discontinuance and replacement.</span></p><p dir="ltr" class="s2075490Normal-000002"><span xml:space="preserve" class="s2075490DefaultParagraphFont">The director may promulgate rules pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075490DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2075490DefaultParagraphFont"> that specify prohibited policy or certificate provisions not otherwise specifically authorized by statute which, in the opinion of the director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a policy or certificate. If any federal standards are in place which would require additional steps to meet those standards beyond what is required by this chapter, the director may promulgate rules to require the offering of health insurance plans, in addition to those specifically required by § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-20"><span class="s2075490DefaultParagraphFont">58-18B-20</span></a><span class="s2075490DefaultParagraphFont">, the underwriting criteria that may be utilized for such health insurance plans, and other requirements related to the availability of health insurance to individuals in this state in order to minimally meet the federal standards.</span></p><p dir="ltr" class="s2075490Normal"><span xml:space="preserve" class="s2075490000003"> </span></p><p dir="ltr" class="s2075490Normal"><span class="s2075490SCL">Source:</span><span xml:space="preserve" class="s2075490SCL-000004"> SL 1995, ch 281, § 31; SL 1997, ch 289, § 21; SL 1998, ch 289, § 19.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075491Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075491SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075491CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075491Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075491DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075491DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075491000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075491SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075491SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075491Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-37"><span class="s2075491SENU">58-18B-37</span></a><span xml:space="preserve" class="s2075491SENU">. </span><span class="s2075491CL">Marketing health benefit plans--Denial of coverage to employer.</span></p><p dir="ltr" class="s2075491Normal-000000"><span class="s2075491DefaultParagraphFont">Each small employer carrier shall actively market health benefit plan coverage, to eligible small employers in the state. A small employer carrier may not deny coverage to a small employer on the basis of the health status or claims experience of the small employer or its employees or dependents. A network plan is not required to offer coverage to an employer whose employees do no work or reside within the carrier's established geographic service. A network plan may deny coverage to employers if it demonstrates it does not have the capacity to deliver services adequately to enrollees of any additional groups because of its obligations to existing group contract holders and enrollees, and if it is applying this denial of coverage uniformly to all employers without regard to the claims experience of those employers, and their employees and their dependents, or any health status</span><span class="s2075491DefaultParagraphFont-000001">-</span><span class="s2075491DefaultParagraphFont">related factor relating to the employees and dependents.</span></p><p dir="ltr" class="s2075491Normal"><span xml:space="preserve" class="s2075491000002"> </span></p><p dir="ltr" class="s2075491Normal"><span class="s2075491SCL">Source:</span><span xml:space="preserve" class="s2075491SCL-000003"> SL 1995, ch 281, § 32; SL 1997, ch 289, § 22; SL 1998, ch 289, § 20.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075492Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075492SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075492CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075492Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075492DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075492Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075492000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075492SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075492SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075492Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-38"><span class="s2075492SENU">58-18B-38</span></a><span xml:space="preserve" class="s2075492SENU">. </span><span class="s2075492CL">Prohibited activities of small employer carriers or insurance producers.</span></p><p dir="ltr" class="s2075492Normal-000000"><span class="s2075492DefaultParagraphFont">No small employer carrier or insurance producer may, directly or indirectly, engage in the following activities:</span></p><p dir="ltr" class="s2075492Normal-000001"><span class="s2075492DefaultParagraphFont">(1)    Encouraging or directing small employers to refrain from filing an application for coverage with the small employer carrier because of the health status, claims experience, industry, occupation, or geographic location of the small employer; or</span></p><p dir="ltr" class="s2075492Normal-000001"><span class="s2075492DefaultParagraphFont">(2)    Encouraging or directing small employers to seek coverage from another carrier because of the health status, claims experience, industry, occupation, or geographic location of the small employer.</span></p><p dir="ltr" class="s2075492Normal"><span xml:space="preserve" class="s2075492000002"> </span></p><p dir="ltr" class="s2075492Normal"><span class="s2075492SCL">Source:</span><span xml:space="preserve" class="s2075492SCL-000003"> SL 1995, ch 281, § 33; SL 2001, ch 286, § 123.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075493Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075493SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075493CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075493Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075493DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075493000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075493SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075493SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075493Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-39"><span class="s2075493SENU">58-18B-39</span></a><span xml:space="preserve" class="s2075493SENU">. </span><span class="s2075493CL">Information regarding restricted network provision of carrier.</span></p><p dir="ltr" class="s2075493Normal-000000"><span xml:space="preserve" class="s2075493DefaultParagraphFont">The provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-38"><span class="s2075493DefaultParagraphFont">58-18B-38</span></a><span xml:space="preserve" class="s2075493DefaultParagraphFont"> do not apply with respect to information provided by a small employer carrier or insurance producer to a small employer regarding a restricted network provision of a small employer carrier.</span></p><p dir="ltr" class="s2075493Normal"><span xml:space="preserve" class="s2075493000001"> </span></p><p dir="ltr" class="s2075493Normal"><span class="s2075493SCL">Source:</span><span xml:space="preserve" class="s2075493SCL-000002"> SL 1995, ch 281, § 34; SL 2001, ch 286, § 124.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075494Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075494SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075494CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075494Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075494DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075494Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075494000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075494SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075494SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075494Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-40"><span class="s2075494SENU">58-18B-40</span></a><span xml:space="preserve" class="s2075494SENU">. </span><span class="s2075494CL">Agent compensation based on characteristics of small employer prohibited--Commission on sale of health insurance plan through exchange.</span></p><p dir="ltr" class="s2075494Normal-000000"><span class="s2075494DefaultParagraphFont">No small employer carrier may, directly or indirectly, enter into any contract, agreement, or arrangement with an insurance producer that provides for or results in the compensation paid to an agent for the sale of a health benefit plan to be varied because of the health status, claims experience, industry, occupation, or geographic location of the small employer.</span></p><p dir="ltr" class="s2075494Normal-000001"><span class="s2075494DefaultParagraphFont">Any qualified health plan sold in South Dakota through a health care exchange, as mandated by the Patient Protection and Affordable Care Act of 2010, shall provide for placement through a licensed insurance producer upon enrollment. Any commission paid by a health insurance carrier for the sale of a health insurance plan through a health exchange shall be the same as commission paid by the same health insurance carrier outside the exchange for a similar plan.</span></p><p dir="ltr" class="s2075494Normal"><span xml:space="preserve" class="s2075494000002"> </span></p><p dir="ltr" class="s2075494Normal"><span class="s2075494SCL">Source:</span><span xml:space="preserve" class="s2075494SCL-000003"> SL 1995, ch 281, § 35; SL 2001, ch 286, § 125; SL 2013, ch 249, § 2.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075495Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075495SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075495CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075495Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075495DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075495000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075495SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075495SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075495Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-41"><span class="s2075495SENU">58-18B-41</span></a><span xml:space="preserve" class="s2075495SENU">. </span><span class="s2075495CL">Compensation of insurance producer based on percentage of premium.</span></p><p dir="ltr" class="s2075495Normal-000000"><span xml:space="preserve" class="s2075495DefaultParagraphFont">The provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-40"><span class="s2075495DefaultParagraphFont">58-18B-40</span></a><span xml:space="preserve" class="s2075495DefaultParagraphFont"> do not apply with respect to a compensation arrangement that provides compensation to an insurance producer on the basis of percentage of premium, if the percentage does not vary because of the health status, claims experience, industry, occupation, or geographic area of the small employer.</span></p><p dir="ltr" class="s2075495Normal"><span xml:space="preserve" class="s2075495000001"> </span></p><p dir="ltr" class="s2075495Normal"><span class="s2075495SCL">Source:</span><span xml:space="preserve" class="s2075495SCL-000002"> SL 1995, ch 281, § 36; SL 2001, ch 286, § 126.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-42 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-42 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-42"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-42. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2004, ch 305, &#167;&nbsp;3<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075497Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075497SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075497CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075497Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075497DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075497000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075497SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075497SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075497Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-43"><span class="s2075497SENU">58-18B-43</span></a><span xml:space="preserve" class="s2075497SENU">. </span><span class="s2075497CL">Status of insurance producer's employment may not be affected by health status, claims experience, occupation, or location of small employer placed with carrier.</span></p><p dir="ltr" class="s2075497Normal-000000"><span class="s2075497DefaultParagraphFont">No small employer carrier may terminate, fail to renew, or limit its contract or agreement of representation with an insurance producer for any reason related to the health status, claims experience, occupation, or geographic location of the small employers placed by the agent with the small employer carrier.</span></p><p dir="ltr" class="s2075497Normal"><span xml:space="preserve" class="s2075497000001"> </span></p><p dir="ltr" class="s2075497Normal"><span class="s2075497SCL">Source:</span><span xml:space="preserve" class="s2075497SCL-000002"> SL 1995, ch 281, § 38; SL 2001, ch 286, § 128.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075498Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075498SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075498CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075498Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075498DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075498000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075498SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075498SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075498Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-44"><span class="s2075498SENU">58-18B-44</span></a><span xml:space="preserve" class="s2075498SENU">. </span><span class="s2075498CL">Carrier or agent not to induce or encourage employer to exclude employee from coverage.</span></p><p dir="ltr" class="s2075498Normal-000000"><span class="s2075498DefaultParagraphFont">No small employer carrier or agent may induce or otherwise encourage a small employer to separate or otherwise exclude an employee from health coverage or benefits provided in connection with the employee's employment.</span></p><p dir="ltr" class="s2075498Normal"><span xml:space="preserve" class="s2075498000001"> </span></p><p dir="ltr" class="s2075498Normal"><span class="s2075498SCL">Source:</span><span xml:space="preserve" class="s2075498SCL-000002"> SL 1995, ch 281, § 39.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075499Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075499SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075499CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075499Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075499DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075499000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075499SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075499SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075499Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-45"><span class="s2075499SENU">58-18B-45</span></a><span xml:space="preserve" class="s2075499SENU">. </span><span class="s2075499CL">Reasons for denial of coverage to be in writing.</span></p><p dir="ltr" class="s2075499Normal-000000"><span class="s2075499DefaultParagraphFont">If a small employer carrier denies an application for coverage from a small employer, the denial shall be in writing and shall state the reason or reasons for the denial.</span></p><p dir="ltr" class="s2075499Normal"><span xml:space="preserve" class="s2075499000001"> </span></p><p dir="ltr" class="s2075499Normal"><span class="s2075499SCL">Source:</span><span xml:space="preserve" class="s2075499SCL-000002"> SL 1995, ch 281, § 40.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075500Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075500SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075500CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075500Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075500DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075500000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075500SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075500SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075500Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-46"><span class="s2075500SENU">58-18B-46</span></a><span xml:space="preserve" class="s2075500SENU">. </span><span class="s2075500CL">Rules for additional standards for fair marketing and broad availability of benefit plans to small employers--Penalties.</span></p><p dir="ltr" class="s2075500Normal-000000"><span xml:space="preserve" class="s2075500DefaultParagraphFont">The director may promulgate rules pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075500DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2075500DefaultParagraphFont"> setting forth additional standards to provide for the fair marketing and broad availability of health benefit plans to small employers in the state. Any violation of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-37"><span class="s2075500DefaultParagraphFont">58-18B-37</span></a><span xml:space="preserve" class="s2075500DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-48"><span class="s2075500DefaultParagraphFont">58-18B-48</span></a><span xml:space="preserve" class="s2075500DefaultParagraphFont">, inclusive, by a small employer carrier or an insurance producer constitutes an unfair trade practice under chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-33"><span class="s2075500DefaultParagraphFont">58-33</span></a><span class="s2075500DefaultParagraphFont">. Nothing in this section limits or excludes other penalties which are otherwise authorized by law.</span></p><p dir="ltr" class="s2075500Normal"><span xml:space="preserve" class="s2075500000001"> </span></p><p dir="ltr" class="s2075500Normal"><span class="s2075500SCL">Source:</span><span xml:space="preserve" class="s2075500SCL-000002"> SL 1995, ch 281, § 41; SL 2001, ch 286, § 129.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075501Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075501SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075501CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075501CL-000000 { font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075501Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075501DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075501DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075501000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075501SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075501SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075501Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-47"><span class="s2075501SENU">58-18B-47</span></a><span xml:space="preserve" class="s2075501SENU">. </span><span class="s2075501CL">Third</span><span class="s2075501CL-000000">-</span><span class="s2075501CL">party administrator treated as small employer carrier.</span></p><p dir="ltr" class="s2075501Normal-000001"><span class="s2075501DefaultParagraphFont">If a small employer carrier enters into a contract, agreement, or other arrangement with a third</span><span class="s2075501DefaultParagraphFont-000002">-</span><span class="s2075501DefaultParagraphFont">party administrator to provide administrative, marketing, or other services related to the offering of health benefit plans to small employers in the state, the third</span><span class="s2075501DefaultParagraphFont-000002">-</span><span xml:space="preserve" class="s2075501DefaultParagraphFont">party administrator is subject to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-37"><span class="s2075501DefaultParagraphFont">58-18B-37</span></a><span xml:space="preserve" class="s2075501DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-48"><span class="s2075501DefaultParagraphFont">58-18B-48</span></a><span class="s2075501DefaultParagraphFont">, inclusive, as if it were a small employer carrier.</span></p><p dir="ltr" class="s2075501Normal"><span xml:space="preserve" class="s2075501000003"> </span></p><p dir="ltr" class="s2075501Normal"><span class="s2075501SCL">Source:</span><span xml:space="preserve" class="s2075501SCL-000004"> SL 1995, ch 281, § 42.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075502Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075502SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075502CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075502Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075502DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075502Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075502DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075502000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075502SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075502SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075502Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-48"><span class="s2075502SENU">58-18B-48</span></a><span xml:space="preserve" class="s2075502SENU">. </span><span class="s2075502CL">Chapter not applicable to certain group health insurance plans.</span></p><p dir="ltr" class="s2075502Normal-000000"><span class="s2075502DefaultParagraphFont">Unless the carrier otherwise subjects itself to this chapter, this chapter does not apply to any bona fide association insurance plan or to the insurance carrier underwriting the group plan if the bona fide association meets the following criteria:</span></p><p dir="ltr" class="s2075502Normal-000001"><span class="s2075502DefaultParagraphFont">(1)    The association has been actively in existence for at least five years;</span></p><p dir="ltr" class="s2075502Normal-000001"><span class="s2075502DefaultParagraphFont">(2)    The association has been formed and maintained in good faith for purposes other than obtaining insurance;</span></p><p dir="ltr" class="s2075502Normal-000001"><span class="s2075502DefaultParagraphFont">(3)    The association does not condition membership in the association on any health status</span><span class="s2075502DefaultParagraphFont-000002">-</span><span xml:space="preserve" class="s2075502DefaultParagraphFont"> related factor relating to an individual, including an employee of an employer or a dependent of an employee;</span></p><p dir="ltr" class="s2075502Normal-000001"><span class="s2075502DefaultParagraphFont">(4)    Health insurance coverage offered through the association is available to all members regardless of any health status</span><span class="s2075502DefaultParagraphFont-000002">-</span><span class="s2075502DefaultParagraphFont">related factor relating to such members or individual eligible for coverage through a member;</span></p><p dir="ltr" class="s2075502Normal-000001"><span class="s2075502DefaultParagraphFont">(5)    The association does not make health insurance coverage offered through the association available other than in connection with a member of the association;</span></p><p dir="ltr" class="s2075502Normal-000001"><span xml:space="preserve" class="s2075502DefaultParagraphFont">(6)    The association and any plan issued through the association are complying with any applicable provisions of Title 47 and §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18-42"><span class="s2075502DefaultParagraphFont">58-18-42</span></a><span xml:space="preserve" class="s2075502DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18-62"><span class="s2075502DefaultParagraphFont">58-18-62</span></a><span class="s2075502DefaultParagraphFont">, inclusive.</span></p><p dir="ltr" class="s2075502Normal"><span xml:space="preserve" class="s2075502000003"> </span></p><p dir="ltr" class="s2075502Normal"><span class="s2075502SCL">Source:</span><span xml:space="preserve" class="s2075502SCL-000004"> SL 1995, ch 281, § 43; SL 1997, ch 289, § 23.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075503Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075503SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075503CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075503Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075503DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075503000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075503SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075503SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075503Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-49"><span class="s2075503SENU">58-18B-49</span></a><span xml:space="preserve" class="s2075503SENU">. </span><span class="s2075503CL">Establishing risk adjusters.</span></p><p dir="ltr" class="s2075503Normal-000000"><span class="s2075503DefaultParagraphFont">The director may establish a payment mechanism to adjust for the amount of risk covered by each small employer carrier. The director may appoint an advisory committee composed of individuals that have risk adjustment and actuarial expertise to help establish the risk adjusters.</span></p><p dir="ltr" class="s2075503Normal"><span xml:space="preserve" class="s2075503000001"> </span></p><p dir="ltr" class="s2075503Normal"><span class="s2075503SCL">Source:</span><span xml:space="preserve" class="s2075503SCL-000002"> SL 1995, ch 281, § 44.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075504Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075504SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075504CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075504Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075504DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075504DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075504000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075504SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075504SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075504Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-50"><span class="s2075504SENU">58-18B-50</span></a><span xml:space="preserve" class="s2075504SENU">. </span><span class="s2075504CL">Minimum inpatient care coverage following delivery.</span></p><p dir="ltr" class="s2075504Normal-000000"><span class="s2075504DefaultParagraphFont">If a health benefit plan of a small employer carrier that is issued or renewed on or after July 1, 1996, provides maternity coverage, the plan shall provide coverage for a minimum of forty</span><span class="s2075504DefaultParagraphFont-000001">-</span><span class="s2075504DefaultParagraphFont">eight hours of inpatient care following a vaginal delivery and a minimum of ninety</span><span class="s2075504DefaultParagraphFont-000001">-</span><span xml:space="preserve" class="s2075504DefaultParagraphFont">six hours of inpatient care following delivery by cesarean section for a mother and her newborn child in a health care facility licensed pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=34-12"><span class="s2075504DefaultParagraphFont">34-12</span></a><span xml:space="preserve" class="s2075504DefaultParagraphFont">, except as otherwise provided in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-51"><span class="s2075504DefaultParagraphFont">58-18B-51</span></a><span class="s2075504DefaultParagraphFont">. Any policy issued to employers with less than fifteen employees that provides coverage for complications of pregnancy, and does not provide other maternity benefits, is not required to comply with this section.</span></p><p dir="ltr" class="s2075504Normal"><span xml:space="preserve" class="s2075504000002"> </span></p><p dir="ltr" class="s2075504Normal"><span class="s2075504SCL">Source:</span><span xml:space="preserve" class="s2075504SCL-000003"> SL 1996, ch 292, § 7; SL 1998, ch 290, § 3.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075505Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075505SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075505CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075505CL-000000 { font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075505Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075505DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075505DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075505000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075505SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075505SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075505Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-51"><span class="s2075505SENU">58-18B-51</span></a><span xml:space="preserve" class="s2075505SENU">. </span><span class="s2075505CL">Shorter hospital stay permitted--Follow</span><span class="s2075505CL-000000">-</span><span class="s2075505CL">up visit within forty</span><span class="s2075505CL-000000">-</span><span class="s2075505CL">eight hours required.</span></p><p dir="ltr" class="s2075505Normal-000001"><span xml:space="preserve" class="s2075505DefaultParagraphFont">If the treating physician determines that the mother and the newborn meet medical criteria contained in Guidelines for Perinatal Care, Third Edition, of the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists as in effect on January 1, 1996, a health benefit plan may provide coverage for a shorter length of hospital inpatient stay for services related to maternity and newborn care than is required in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-50"><span class="s2075505DefaultParagraphFont">58-18B-50</span></a><span xml:space="preserve" class="s2075505DefaultParagraphFont"> if the coverage includes one follow</span><span class="s2075505DefaultParagraphFont-000002">-</span><span class="s2075505DefaultParagraphFont">up visit in the first forty</span><span class="s2075505DefaultParagraphFont-000002">-</span><span class="s2075505DefaultParagraphFont">eight hours after discharge to verify the condition of the mother and newborn.</span></p><p dir="ltr" class="s2075505Normal"><span xml:space="preserve" class="s2075505000003"> </span></p><p dir="ltr" class="s2075505Normal"><span class="s2075505SCL">Source:</span><span xml:space="preserve" class="s2075505SCL-000004"> SL 1996, ch 292, § 8.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075506Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075506SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075506CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075506Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075506DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075506000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075506SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075506SCL-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075506Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-52"><span class="s2075506SENU">58-18B-52</span></a><span xml:space="preserve" class="s2075506SENU">. </span><span class="s2075506CL">Notice to employees--Disclosures.</span></p><p dir="ltr" class="s2075506Normal-000000"><span xml:space="preserve" class="s2075506DefaultParagraphFont">The small employer carrier shall provide notice to employees regarding the coverage required by §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-50"><span class="s2075506DefaultParagraphFont">58-18B-50</span></a><span xml:space="preserve" class="s2075506DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-51"><span class="s2075506DefaultParagraphFont">58-18B-51</span></a><span xml:space="preserve" class="s2075506DefaultParagraphFont"> in accordance with rules adopted by the director of the Division of Insurance pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075506DefaultParagraphFont">1-26</span></a><span class="s2075506DefaultParagraphFont">. The notice shall be in writing and prominently positioned in any literature or correspondence. The notice shall be transmitted to employees in the next mailing to employees, in the yearly informational packet sent to employees, or by January 1, 1997, whichever is earliest.</span></p><p dir="ltr" class="s2075506Normal"><span xml:space="preserve" class="s2075506000001"> </span></p><p dir="ltr" class="s2075506Normal"><span class="s2075506SCL">Source:</span><span xml:space="preserve" class="s2075506SCL-000002"> SL 1996, ch 292, § 9.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075507Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075507SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075507CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075507CL-000000 { font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075507Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075507DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075507DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075507Normal-000003 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075507000004 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075507SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075507SCL-000005 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075507Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-53"><span class="s2075507SENU">58-18B-53</span></a><span xml:space="preserve" class="s2075507SENU">. </span><span class="s2075507CL">Health insurance policies to provide coverage for biologically</span><span class="s2075507CL-000000">-</span><span class="s2075507CL">based mental illnesses.</span></p><p dir="ltr" class="s2075507Normal-000001"><span class="s2075507DefaultParagraphFont">Every small employer health benefit plan that is delivered, issued for delivery, or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide, in writing, coverage for the treatment and diagnosis of biologically</span><span class="s2075507DefaultParagraphFont-000002">-</span><span class="s2075507DefaultParagraphFont">based mental illnesses with the same dollar limits, deductibles, coinsurance factors, and restrictions as for other covered illnesses.</span></p><p dir="ltr" class="s2075507Normal-000003"><span class="s2075507DefaultParagraphFont">The term, biologically</span><span class="s2075507DefaultParagraphFont-000002">-</span><span class="s2075507DefaultParagraphFont">based mental illness, means schizophrenia and other psychotic disorders, bipolar disorder, major depression, and obsessive</span><span class="s2075507DefaultParagraphFont-000002">-</span><span class="s2075507DefaultParagraphFont">compulsive disorder.</span></p><p dir="ltr" class="s2075507Normal"><span xml:space="preserve" class="s2075507000004"> </span></p><p dir="ltr" class="s2075507Normal"><span class="s2075507SCL">Source:</span><span xml:space="preserve" class="s2075507SCL-000005"> SL 1998, ch 291, § 3; SL 1999, ch 251, § 3.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075508Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075508SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075508CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075508Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075508DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075508Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075508DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075508000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075508SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075508SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075508Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-54"><span class="s2075508SENU">58-18B-54</span></a><span xml:space="preserve" class="s2075508SENU">. </span><span class="s2075508CL">Application--Exemptions.</span></p><p dir="ltr" class="s2075508Normal-000000"><span xml:space="preserve" class="s2075508DefaultParagraphFont">The provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-53"><span class="s2075508DefaultParagraphFont">58-18B-53</span></a><span xml:space="preserve" class="s2075508DefaultParagraphFont"> do not apply to any plan, policy, or contract that provides coverage only for:</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(1)    Specified disease;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(2)    Hospital indemnity;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(3)    Fixed indemnity;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(4)    Accident</span><span class="s2075508DefaultParagraphFont-000002">-</span><span class="s2075508DefaultParagraphFont">only;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(5)    Credit;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(6)    Dental;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(7)    Vision;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(8)    Prescription drug;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(9)    Medicare supplement;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(10)    Long</span><span class="s2075508DefaultParagraphFont-000002">-</span><span class="s2075508DefaultParagraphFont">term care;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(11)    Disability income insurance;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(12)    Coverage issued as a supplement to liability insurance;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(13)    Workers' compensation or similar insurance;</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(14)    Automobile medical payment insurance; or</span></p><p dir="ltr" class="s2075508Normal-000001"><span class="s2075508DefaultParagraphFont">(15)    Individual health benefit plans of six</span><span class="s2075508DefaultParagraphFont-000002">-</span><span class="s2075508DefaultParagraphFont">months duration or less that are not renewable.</span></p><p dir="ltr" class="s2075508Normal"><span xml:space="preserve" class="s2075508000003"> </span></p><p dir="ltr" class="s2075508Normal"><span class="s2075508SCL">Source:</span><span xml:space="preserve" class="s2075508SCL-000004"> SL 1998, ch 291, § 7.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075509Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075509SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075509CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075509Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075509DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075509DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075509Normal-000002 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075509000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075509SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075509SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075509Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-55"><span class="s2075509SENU">58-18B-55</span></a><span xml:space="preserve" class="s2075509SENU">. </span><span class="s2075509CL">Supplemental or short term individual health benefit plans exempt from provisions of chapter--Conditions.</span></p><p dir="ltr" class="s2075509Normal-000000"><span class="s2075509DefaultParagraphFont">Any policy or certificate of specified disease, short</span><span class="s2075509DefaultParagraphFont-000001">-</span><span class="s2075509DefaultParagraphFont">term hospital</span><span class="s2075509DefaultParagraphFont-000001">-</span><span class="s2075509DefaultParagraphFont">surgical care of six months or less duration, hospital confinement indemnity, limited benefit health insurance, or other policy or certificate that provide benefits less than that of a major medical plan that is offered to a small employer in this state is exempt from the provisions of this chapter only if the carrier offering the policy or certificate at the time of filing for policy form approval, submits a statement certifying that policies or certificates described in this section are being offered and marketed as supplemental health insurance or as individual health benefit plans of six</span><span class="s2075509DefaultParagraphFont-000001">-</span><span class="s2075509DefaultParagraphFont">month duration or less and not renewable, and not as a substitute for hospital or medical expense insurance or major medical insurance. For policy forms approved prior to July 1, 1998, the carrier shall submit such a statement with the director.</span></p><p dir="ltr" class="s2075509Normal-000002"><span xml:space="preserve" class="s2075509DefaultParagraphFont">For purposes of this section a major medical policy is any policy which provides benefits which are actuarially equivalent to or exceed the basic plan as was approved and adopted by rule by the director pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2075509DefaultParagraphFont">1-26</span></a><span class="s2075509DefaultParagraphFont">. Policies which are not certified pursuant to this section and which are not major medical policies may not be used as a substitute for major medical policies and must provide for adequate disclosure of the scope of the benefits contained therein.</span></p><p dir="ltr" class="s2075509Normal"><span xml:space="preserve" class="s2075509000003"> </span></p><p dir="ltr" class="s2075509Normal"><span class="s2075509SCL">Source:</span><span xml:space="preserve" class="s2075509SCL-000004"> SL 1998, ch 289, § 21; SL 2001, ch 279, § 8.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075510Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075510SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075510CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075510Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075510DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075510DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075510Normal-000002 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075510000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075510SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075510SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075510Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-56"><span class="s2075510SENU">58-18B-56</span></a><span xml:space="preserve" class="s2075510SENU">. </span><span class="s2075510CL">Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.</span></p><p dir="ltr" class="s2075510Normal-000000"><span class="s2075510DefaultParagraphFont">Every small employer health benefit plan delivered, issued for delivery, or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide, in writing, coverage for equipment, supplies, and self</span><span class="s2075510DefaultParagraphFont-000001">-</span><span class="s2075510DefaultParagraphFont">management training and education, including medical nutrition therapy, for treatment of persons diagnosed with diabetes if prescribed by a physician or other licensed health care provider legally authorized to prescribe such treatment. Medical nutrition therapy does not include any food items or nonprescription drugs.</span></p><p dir="ltr" class="s2075510Normal-000002"><span class="s2075510DefaultParagraphFont">Coverage for medically necessary equipment and supplies shall include blood glucose monitors, blood glucose monitors for the legally blind, test strips for glucose monitors, urine testing strips, insulin, injection aids, lancets, lancet devices, syringes, insulin pumps and all supplies for the pump, insulin infusion devices, prescribed oral agents for controlling blood sugars, glucose agents, glucagon kits, insulin measurement and administration aids for the visually impaired, and other medical devices for treatment of diabetes.</span></p><p dir="ltr" class="s2075510Normal-000002"><span class="s2075510DefaultParagraphFont">Diabetes self</span><span class="s2075510DefaultParagraphFont-000001">-</span><span class="s2075510DefaultParagraphFont">management training and education shall be covered if: (a) the service is provided by a physician, nurse, dietitian, pharmacist, or other licensed health care provider who satisfies the current academic eligibility requirements of the National Certification Board for Diabetic Educators and has completed a course in diabetes education and training or has been certified as a diabetes educator; and (b) the training and education is based upon a diabetes program recognized by the American Diabetes Association or a diabetes program with a curriculum approved by the American Diabetes Association or the South Dakota Department of Health.</span></p><p dir="ltr" class="s2075510Normal-000002"><span class="s2075510DefaultParagraphFont">Coverage of diabetes self</span><span class="s2075510DefaultParagraphFont-000001">-</span><span class="s2075510DefaultParagraphFont">management training is limited to (a) persons who are newly diagnosed with diabetes or have received no prior diabetes education; (b) persons who require a change in current therapy; (c) persons who have a co</span><span class="s2075510DefaultParagraphFont-000001">-</span><span class="s2075510DefaultParagraphFont">morbid condition such as heart disease or renal failure; or (d) persons whose diabetes condition is unstable. Under these circumstances, no more than two comprehensive education programs per lifetime and up to eight follow</span><span class="s2075510DefaultParagraphFont-000001">-</span><span class="s2075510DefaultParagraphFont">up visits per year need be covered. Coverage is limited to the closest available qualified education program that provides the necessary management training to accomplish the prescribed treatment.</span></p><p dir="ltr" class="s2075510Normal-000002"><span class="s2075510DefaultParagraphFont">The benefits provided in this section are subject to the same dollar limits, deductibles, coinsurance, and other restrictions established for all other benefits covered in the plan.</span></p><p dir="ltr" class="s2075510Normal"><span xml:space="preserve" class="s2075510000003"> </span></p><p dir="ltr" class="s2075510Normal"><span class="s2075510SCL">Source:</span><span xml:space="preserve" class="s2075510SCL-000004"> SL 1999, ch 252, § 5.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075511Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075511SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075511CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075511Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075511DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075511Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075511DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075511000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075511SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075511SCL-000004 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075511Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-57"><span class="s2075511SENU">58-18B-57</span></a><span xml:space="preserve" class="s2075511SENU">. </span><span class="s2075511CL">Diabetes coverage not required of certain plans.</span></p><p dir="ltr" class="s2075511Normal-000000"><span xml:space="preserve" class="s2075511DefaultParagraphFont">The provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-56"><span class="s2075511DefaultParagraphFont">58-18B-56</span></a><span xml:space="preserve" class="s2075511DefaultParagraphFont"> do not apply to any plan, policy, or contract that provides coverage only for:</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(1)    Specified disease;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(2)    Hospital indemnity;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(3)    Fixed indemnity;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(4)    Accident</span><span class="s2075511DefaultParagraphFont-000002">-</span><span class="s2075511DefaultParagraphFont">only;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(5)    Credit;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(6)    Dental;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(7)    Vision;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(8)    Prescription drug;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(9)    Medicare supplement;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(10)    Long</span><span class="s2075511DefaultParagraphFont-000002">-</span><span class="s2075511DefaultParagraphFont">term care;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(11)    Disability income insurance;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(12)    Coverage issued as a supplement to liability insurance;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(13)    Workers' compensation or similar insurance;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(14)    Automobile medical payment insurance;</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(15)    Individual health benefit plans of six</span><span class="s2075511DefaultParagraphFont-000002">-</span><span class="s2075511DefaultParagraphFont">months duration or less that are not renewable; or</span></p><p dir="ltr" class="s2075511Normal-000001"><span class="s2075511DefaultParagraphFont">(16)    Individual nonmajor medical insurance.</span></p><p dir="ltr" class="s2075511Normal"><span xml:space="preserve" class="s2075511000003"> </span></p><p dir="ltr" class="s2075511Normal"><span class="s2075511SCL">Source:</span><span xml:space="preserve" class="s2075511SCL-000004"> SL 1999, ch 252, § 6.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075512Normal { text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075512SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075512CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075512Normal-000000 { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075512DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075512Normal-000001 { margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075512DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075512Normal-000003 { margin-left: 1.14in; text-indent: -0.44in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s2075512000004 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075512SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075512SCL-000005 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style></head><body><div><p dir="ltr" class="s2075512Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-58"><span class="s2075512SENU">58-18B-58</span></a><span xml:space="preserve" class="s2075512SENU">. </span><span class="s2075512CL">Health benefit plans to provide coverage for prostate cancer screening.</span></p><p dir="ltr" class="s2075512Normal-000000"><span class="s2075512DefaultParagraphFont">Every health benefit plan of a small employer carrier that covers a male and that is delivered, issued for delivery, or renewed in this state shall provide the following coverage for diagnostic screening for prostate cancer:</span></p><p dir="ltr" class="s2075512Normal-000001"><span class="s2075512DefaultParagraphFont">(1)    An annual medically recognized diagnostic examination, including a digital rectal examination and a prostate</span><span class="s2075512DefaultParagraphFont-000002">-</span><span class="s2075512DefaultParagraphFont">specific antigen test, as follows:</span></p><p dir="ltr" class="s2075512Normal-000003"><span class="s2075512DefaultParagraphFont">(a)    For asymptomatic men aged fifty and over; and</span></p><p dir="ltr" class="s2075512Normal-000003"><span class="s2075512DefaultParagraphFont">(b)    For men aged forty</span><span class="s2075512DefaultParagraphFont-000002">-</span><span class="s2075512DefaultParagraphFont">five and over at high risk for prostate cancer; and</span></p><p dir="ltr" class="s2075512Normal-000001"><span class="s2075512DefaultParagraphFont">(2)    For males of any age who have a prior history of prostate cancer, medically indicated diagnostic testing at intervals recommended by a physician, including the digital rectal examination, prostate</span><span class="s2075512DefaultParagraphFont-000002">-</span><span class="s2075512DefaultParagraphFont">specific antigen test, and bone scan.</span></p><p dir="ltr" class="s2075512Normal"><span xml:space="preserve" class="s2075512000004"> </span></p><p dir="ltr" class="s2075512Normal"><span class="s2075512SCL">Source:</span><span xml:space="preserve" class="s2075512SCL-000005"> SL 2001, ch 277, § 3.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE 58-18B-59 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-18B-59 "> <META NAME="Description" Content="South Dakota Codified Laws 58-18B-59"> </HEAD> <BODY> <!-- File converted by Wp2Html Version 4.0 --> <!-- Email Andrew@brackenbeds.co.uk for more details --> <!-- WP Style Open: System_34 --><!-- WP Style End: System_34 --> <Div align="full"> <!-- WP Paired Style On: SENU -->&nbsp;&nbsp;&nbsp;&nbsp;<!-- WP Style End: SENU --> 58-18B-59. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2019, ch 212, &#167;&nbsp;12.<p> </BODY> </HTML> <br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-18B - REGULATION OF SMALL BUSINESSES' GROUP AND BLANKET HEALTH INSURANCE </title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2075514Normal { margin-top: 0; margin-bottom: 0; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075514SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075514CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2075514Normal-000000 { margin-top: 0; margin-bottom: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075514DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2075514Normal-000001 { margin-top: 0; margin-bottom: 0; text-indent: 0.25in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-left: 0; margin-right: 0; } span.s2075514000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2075514SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2075514SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style></head><body><div><p dir="ltr" class="s2075514Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B-60"><span class="s2075514SENU">58-18B-60</span></a><span xml:space="preserve" class="s2075514SENU">. </span><span class="s2075514CL">Coverage for treatment of hearing impairment for persons under age nineteen.</span></p><p dir="ltr" class="s2075514Normal-000000"><span xml:space="preserve" class="s2075514DefaultParagraphFont">Any qualified health plan issued on or after January 1, 2015, that offers coverage for professional audiology services shall include coverage for medically necessary physician services appropriate for the treatment of hearing impairment to a person under the age of nineteen. This shall include professional services rendered by an audiologist licensed pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=36-24"><span class="s2075514DefaultParagraphFont">36-24</span></a><span class="s2075514DefaultParagraphFont">.</span></p><p dir="ltr" class="s2075514Normal-000001"><span class="s2075514DefaultParagraphFont">The benefits provided shall be subject to the same dollar limits, deductibles, coinsurance and other limitations provided for other covered benefits in the policy.</span></p><p dir="ltr" class="s2075514Normal-000001"><span class="s2075514DefaultParagraphFont">Nothing in this section requires the payment by the health plan of hearing aids, devices, or equipment to correct hearing impairment or loss.</span></p><p dir="ltr" class="s2075514Normal"><span xml:space="preserve" class="s2075514000002"> </span></p><p dir="ltr" class="s2075514Normal"><span class="s2075514SCL">Source:</span><span xml:space="preserve" class="s2075514SCL-000003"> SL 2014, ch 237, § 3.</span></p></div></body></html>