<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2083721Normal { text-align: center; 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.s2083721HG4 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2083721DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2083721HG4C { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2083721Normal-000000 { text-align: justify; 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class="s2083721Normal"><span xml:space="preserve" class="s2083721HG4">CHAPTER </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41</span></a></p><p dir="ltr" class="s2083721Normal"><span xml:space="preserve" class="s2083721HG4C">HEALTH MAINTENANCE ORGANIZATIONS </span></p><p dir="ltr" class="s2083721Normal-000000"><span xml:space="preserve" class="s2083721DefaultParagraphFont"> </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Definition of terms. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-2" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-2</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Organizations subject to chapter. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-3" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-3</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-4" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-4</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Application for certificate of authority required. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-5" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-5</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-5" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-5</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 1985, ch 393, § 7</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-6" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-6</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Verification and form of application--Contents. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-7" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-7</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Financial statements required with application. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-8" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-8</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Copies of forms required with application. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-9" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-9</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Marketing, charges, and financial plans required with application. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-10" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-10</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Appointment to receive process required of foreign applicant. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-11" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-11</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Surety bond or deposit required--Waiver. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-12" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-12</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Determination of health care qualifications. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-13" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-13</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Coordination with federal professional standards review. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-14" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-14</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-14" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-14</span></a><span class="s2083721DefaultParagraphFont">. Obsolete</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-15" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-15</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Health maintenance not considered practice of healing arts. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-15.1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-15.1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Certain healing arts practitioners to participate in alternate health care delivery systems. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-16" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-16</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-16" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-16</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 2013, ch 256, § 7.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-17" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-17</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Issuance or denial of certificate--Fee--Conditions for issuance. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-18" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-18</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Factors considered in determining financial responsibility. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-19" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-19</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Insurance arrangements permitted. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-20" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-20</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Corporation operating after certification. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-21" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-21</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Foreign corporations qualifying--Exemption from other requirements. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-22" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-22</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Filing of notice of modification of operation--Approval if not disapproved--Exemptions. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-23" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-23</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Composition of governing body--Consumer representation. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-24" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-24</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Mechanisms for enrollee participation in policy and operation of governing body. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-25" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-25</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Fiduciary responsibilities to enrollees. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-25.1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-25.1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Investments. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-26" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-26</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Exemption from insurance laws--Exceptions--Taxation. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-27" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-27</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-27" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-27</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 1985, ch 393, § 9</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-28" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-28</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Solicitation of enrollment not deemed professional advertising. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-29" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-29</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contracts and necessary activities. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-29.1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-29.1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Notice required for rate increase in health maintenance contract by a health maintenance organization. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-30" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-30</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Sources of payment for enrollee services--Application by medical assistance recipient. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-31" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-31</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Direct payments to enrollees prohibited. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-32" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-32</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Use of words descriptive of insurance, casualty, or surety business as misdemeanor--Exception. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-33" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-33</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Trade practice laws applicable. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-34" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-34</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Evidence of coverage issued to enrollees. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-35</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contents required in evidence of coverage. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-35.1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Alcoholism coverage to be offered at time contract is negotiated. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.2" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-35.2</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.2" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-35.2</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont"> to 58-41-35.4. Repealed by SL 2001, ch 274, §§ 10 to 12</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.5" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-35.5</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Grandfathered contracts required to cover low-dose mammography--Extent of coverage. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.6" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-35.6</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    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="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.7" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-35.7</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contracts required to cover occult breast cancer screening. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-36" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-36</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Unfair and misleading information in evidence of coverage as misdemeanor. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-37" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-37</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Deceptive advertising or evidence of coverage as misdemeanor. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-38" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-38</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Statements deemed untrue. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-39" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-39</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Statements deemed misleading. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-40" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-40</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Evidence of coverage deemed deceptive. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-41" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-41</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Issuance to enrollees of change in evidence of coverage. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-42" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-42</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Evidence of coverage to be approved before use--Violation as misdemeanor. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-43" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-43</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Filing and approval requirements applicable. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-44" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-44</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Charges to enrollees--Fairness--Actuary's certificate. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-45" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-45</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Discrimination as misdemeanor. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-46" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-46</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-46" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-46</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont"> to 58-41-49. Repealed by SL 2013, ch 256, §§ 12 to 15.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-50" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-50</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Authorized expenses. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-51</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-51</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 2013, ch 256, § 16.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51.1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-51.1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51.2" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-51.2</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Conversion privileges of insured's spouse upon divorce. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51.3" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-51.3</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Continuation and conversion coverage to be offered. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-52</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contracts with providers of health care services. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-52.1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Collection for covered services prohibited.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.2" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-52.2</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contracts--Hold harmless provision.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.3" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-52.3</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Hold harmless provision--Language of provision.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-53" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-53</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-53" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-53</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 1999, ch 245, § 21</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-54" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-54</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contracts with insurance companies and nonprofit health service plan corporations authorized--Limitations. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-55" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-55</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Insurance contracts authorized--Group coverage--Benefit payments. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-56" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-56</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contracts for management and administrative services authorized. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-57" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-57</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Payment of unreasonably high expenses as misdemeanor. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-58" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-58</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-58" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-58</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont"> to 58-41-62. Repealed by SL 1996, ch 296, §§ 9 to 13</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-63" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-63</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    General annual report required--Form and contents. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-64" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-64</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-64" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-64</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 1985, ch 393, § 10</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-65" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-65</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Applications, filings and reports as public documents. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-66" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-66</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Annual summary for enrollees required--Contents. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-67" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-67</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Promulgation of rules. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-68" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-68</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-68" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-68</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont"> to 58-41-72. Repealed by SL 2013, ch 256, §§ 20 to 24.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-73" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-73</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Physician-patient privileges. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-74" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-74</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Confidential data--Exceptions. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-75" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-75</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-75" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-75</span></a><span class="s2083721DefaultParagraphFont">, 58-41-76. Repealed by SL 2013, ch 256, §§ 25, 26.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-77</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-77</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 1978, ch 359, § 3</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-78" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-78</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Cease and desist orders. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-79" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-79</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Hearing on cease and desist order--Procedure--Judicial review. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-80" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-80</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Injunctive relief against violations--Venue. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-81" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-81</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Suspension or revocation of certificate of authority on findings by director. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-82" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-82</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Additional grounds for suspension or revocation. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-83" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-83</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Voluntary conference before commencing actions for violation. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-84" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-84</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Informality in voluntary conferences. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-85" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-85</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Money penalty in lieu of suspension or revocation. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-86" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-86</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Requirements for suspension or revocation. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-86.1" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-86.1</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Suspension without notice or hearing. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-87" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-87</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-88" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-88</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Administrative procedure and rules. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-89" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-89</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-89" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-89</span></a><span class="s2083721DefaultParagraphFont">. Repealed by SL 2013, ch 256, § 32.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-90" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-90</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Action of director after hearing--Written findings. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-91" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-91</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Judicial review. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-92" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-92</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Activities prohibited during suspension of certificate. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-93" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-93</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Winding up after revocation of certificate--Continued operation to protect enrollees. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-94" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-94</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Summary proceeding to reorganize organization--Grounds. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-95" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-95</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Rehabilitation, liquidation, or conservation under insurance company laws. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-96" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-96</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Severability of provisions. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-97" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-97</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Citation of chapter. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-98" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-98</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Coverage for phenylketonuria. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-99" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-99</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Formation of voluntary health insurance purchasing organizations.</span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-100" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-100</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Membership of voluntary health insurance purchasing organizations. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-101" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-101</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Purchasing organization's responsibility for negotiating terms and conditions. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-102" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-102</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Purchasing organization's notice of premium charge. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-103" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-103</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Additional chapters applicable to purchasing organization. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-104" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-104</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Approval of purchasing organization by Division of Insurance. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-105" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-105</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Premiums held in trust by purchasing organization. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-106" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-106</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Rates for group health insurance issued to purchasing organizations. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-107" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-107</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Reasonable participation requirements for group members of purchasing organizations. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-108" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-108</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Purchasing organizations exempt from antitrust provisions. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-109" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-109</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Promulgation of rules for purchasing organizations. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-110" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-110</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Application of chapter to provider contracting with state. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-111" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-111</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Application of chapter to provider contracting with licensed health maintenance organization. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-112" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-112</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Minimum inpatient care coverage following delivery. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-113" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-113</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Shorter hospital stay permitted--Follow-up visit within forty-eight hours required. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-114" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-114</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Notice to enrollees--Disclosures. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-115" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-115</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Health insurance policies to provide coverage for biologically-based mental illnesses. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-116" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-116</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Application--Exemptions. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-117" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-117</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-118" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-118</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Diabetes coverage not required of certain plans and policies. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-119" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-119</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Contracts to provide coverage for prostate cancer screening. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-120" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-120</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Annual report on risk bearing entities. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-121" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-121</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Documents provided to risk bearing entity by health maintenance organization. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-122" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-122</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Documents provided to health maintenance organization by risk bearing entity. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-123" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-123</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Notice by risk bearing entity of change in conditions--Assignment of contract. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-124" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-124</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Notice to director that risk bearing entity has materially failed to perform contract. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-125" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-125</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Confidentiality of information. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-126" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-126</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Nontransferable responsibilities of health maintenance organization. </span></p><p dir="ltr" class="s2083721B"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-127" rel="noopener"><span class="s2083721DefaultParagraphFont">58-41-127</span></a><span xml:space="preserve" class="s2083721DefaultParagraphFont">    Coverage for treatment of hearing impairment for persons under age nineteen. </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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077120Normal { 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.s2077120SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077120CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077120Normal-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.s2077120DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077120Normal-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.s2077120000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077120SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077120SCL-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="s2077120Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-1"><span class="s2077120SENU">58-41-1</span></a><span xml:space="preserve" class="s2077120SENU">. </span><span class="s2077120CL">Definition of terms.</span></p><p dir="ltr" class="s2077120Normal-000000"><span class="s2077120DefaultParagraphFont">Terms used in this chapter mean:</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(1)    "Comprehensive health maintenance services," a set of comprehensive health services which the enrollees might reasonably require to be maintained in good health, including as a minimum, but not limited to, emergency care, inpatient hospital and physician care, outpatient medical services, and preventive medical services;</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(2)    "Director," the director of the Division of Insurance or his designee;</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(3)    "Enrollee," any person who has entered into, or is covered by a health maintenance contract;</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(4)    "Evidence of coverage," any certificate, agreement, or contract issued to an enrollee which sets out the coverage to which he is entitled under the health maintenance contract which covers him;</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(5)    "Health maintenance contract," any contract whereby a health maintenance organization agrees to provide comprehensive health maintenance services to enrollees, provided that the contract may contain reasonable enrollee copayment provisions. Any contract may provide for health care services in addition to those set forth in subdivision (1);</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(6)    "Limited health service," dental care services, vision care services, mental health services, substance abuse services, pharmaceutical services, podiatric care services, and such other services as may be determined by the director to be limited health services. Limited health service does not include hospital, medical, surgical, or emergency services except as these services are provided incident to the limited health services;</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(7)    "Provider," any person who furnishes health services and is licensed or otherwise authorized to render such services in the state;</span></p><p dir="ltr" class="s2077120Normal-000001"><span class="s2077120DefaultParagraphFont">(8)    "Risk bearing entity," an intermediary organization that is a financial risk for services provided through contractual assumption of the obligation for the delivery of specified health care services to covered persons of the health maintenance organization.</span></p><p dir="ltr" class="s2077120Normal"><span xml:space="preserve" class="s2077120000002"> </span></p><p dir="ltr" class="s2077120Normal"><span class="s2077120SCL">Source:</span><span xml:space="preserve" class="s2077120SCL-000003"> SL 1974, ch 321, § 2; SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077121Normal { 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.s2077121SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077121CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077121Normal-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.s2077121DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077121000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077121SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077121SCL-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="s2077121Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-2"><span class="s2077121SENU">58-41-2</span></a><span xml:space="preserve" class="s2077121SENU">. </span><span class="s2077121CL">Organizations subject to chapter.</span></p><p dir="ltr" class="s2077121Normal-000000"><span class="s2077121DefaultParagraphFont">As used in this chapter a health maintenance organization is a corporation organized under Title 47, controlled and operated as provided in this chapter, which provides, either directly or through arrangements with providers or other persons, comprehensive health maintenance services, or arranges for the provision of such services, to enrollees on the basis of a fixed prepaid sum without regard to the frequency or extent of services furnished to any particular enrollee. A health maintenance organization may be organized pursuant to this chapter on a limited health service basis. Nothing in this chapter prohibits a health maintenance organization holding a certificate of authority in this state from issuing contracts to enrollees on a preferred provider, exclusive provider, or closed panel basis. Nothing in this chapter requires a licensed pharmacy benefit manager to obtain a certificate of authority as a health maintenance organization provided that the pharmacy benefit manager does not assume insurance risk directly from an insured.</span></p><p dir="ltr" class="s2077121Normal"><span xml:space="preserve" class="s2077121000001"> </span></p><p dir="ltr" class="s2077121Normal"><span class="s2077121SCL">Source:</span><span xml:space="preserve" class="s2077121SCL-000002"> SL 1974, ch 321, § 2 (3); SL 1985, ch 393, § 1; SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077122Normal { 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.s2077122SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077122CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077122Normal-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.s2077122DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077122000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077122SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077122SCL-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="s2077122Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-3"><span class="s2077122SENU">58-41-3</span></a><span xml:space="preserve" class="s2077122SENU">. </span><span class="s2077122CL">Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor.</span></p><p dir="ltr" class="s2077122Normal-000000"><span class="s2077122DefaultParagraphFont">No person shall establish or operate a health maintenance organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with a health maintenance organization or health maintenance contract unless such organization has a certificate of authority under this chapter. Violation of this section is a Class 2 misdemeanor.</span></p><p dir="ltr" class="s2077122Normal"><span xml:space="preserve" class="s2077122000001"> </span></p><p dir="ltr" class="s2077122Normal"><span class="s2077122SCL">Source:</span><span xml:space="preserve" class="s2077122SCL-000002"> SL 1974, ch 321, §§ 3, 50; SDCL Supp, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077122SCL-000002">58-41-77</span></a><span class="s2077122SCL-000002">; SL 1978, ch 359, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077123Normal { 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.s2077123SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077123CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077123Normal-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.s2077123DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077123000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077123SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077123SCL-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="s2077123Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-4"><span class="s2077123SENU">58-41-4</span></a><span xml:space="preserve" class="s2077123SENU">. </span><span class="s2077123CL">Application for certificate of authority required.</span></p><p dir="ltr" class="s2077123Normal-000000"><span class="s2077123DefaultParagraphFont">Notwithstanding any law of this state to the contrary, any corporation organized to do so shall apply to the director of the Division of Insurance for a certificate of authority to establish and operate a health maintenance organization in compliance with the provisions of this chapter.</span></p><p dir="ltr" class="s2077123Normal"><span xml:space="preserve" class="s2077123000001"> </span></p><p dir="ltr" class="s2077123Normal"><span class="s2077123SCL">Source:</span><span xml:space="preserve" class="s2077123SCL-000002"> SL 1974, ch 321, § 3; SL 1985, ch 393, § 2.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-5 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-5 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-5"> </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 --> 58-41-5. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1985, ch 393, &#167;&nbsp;7<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077125Normal { 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.s2077125SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077125CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077125Normal-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.s2077125DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077125Normal-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.s2077125Normal-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.s2077125000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077125SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077125SCL-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="s2077125Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-6"><span class="s2077125SENU">58-41-6</span></a><span xml:space="preserve" class="s2077125SENU">. </span><span class="s2077125CL">Verification and form of application--Contents.</span></p><p dir="ltr" class="s2077125Normal-000000"><span class="s2077125DefaultParagraphFont">Each application for a certificate of authority shall be verified by an officer or authorized representative of the applicant, shall include an application fee, and shall be in a form prescribed by the director. Each application shall include the following:</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(1)    A copy of the basic organizational document, if any, of the applicant, such as the articles of incorporation, or other applicable documents, and all amendments thereto;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(2)    A copy of the bylaws, rules, and regulations, or similar document, if any, and all amendments thereto which regulate the conduct of the affairs of the applicant;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(3)    A list of the names, addresses, and official positions of all members of the board of directors, and the principal officers of the organization, which shall contain a full disclosure in the application of the extent and nature of any contract or financial arrangements between them and the health maintenance organization, including a full disclosure of any financial arrangements between them and any provider or other person concerning any financial relationship with the health maintenance organization;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(4)    A statement generally describing the health maintenance organization, its health care plan or plans, facilities, and personnel, including a statement describing the manner in which the applicant proposes to provide enrollees with comprehensive health maintenance services or limited health services;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(5)    A statement reasonably describing the geographic area or areas to be served and the type or types of enrollees to be served;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(6)    A description of the complaint procedures to be utilized;</span></p><p dir="ltr" class="s2077125Normal-000001"><span xml:space="preserve" class="s2077125DefaultParagraphFont">(7)    A description of the procedures and programs to be implemented to meet the requirements of subdivisions 58-41-12(2) and (3) and chapters </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17G"><span class="s2077125DefaultParagraphFont">58-17G</span></a><span xml:space="preserve" class="s2077125DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17H"><span class="s2077125DefaultParagraphFont">58-17H</span></a><span xml:space="preserve" class="s2077125DefaultParagraphFont"> and to monitor the quality of health care provided to enrollees;</span></p><p dir="ltr" class="s2077125Normal-000001"><span xml:space="preserve" class="s2077125DefaultParagraphFont">(8)    A description of the mechanism by which enrollees will be afforded an opportunity to participate in matters of policy and operation under §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-23"><span class="s2077125DefaultParagraphFont">58-41-23</span></a><span xml:space="preserve" class="s2077125DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-24"><span class="s2077125DefaultParagraphFont">58-41-24</span></a><span class="s2077125DefaultParagraphFont">;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(9)    Such other information as the director may reasonably require to be provided;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(10)    A copy of the form of any contract made, or to be made, between the applicant and any providers regarding the provision of limited health services to enrollees;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(11)    A copy of the form of any contract made, or to be made, between the applicant and any person listed in subdivision (3) of this section;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(12)    A copy of the form of any contract made, or to be made, between the applicant and any person, corporation, partnership, or other entity for the performance on the applicant's behalf of any functions including marketing, administration, enrollment, investment management, and subcontracting for the provision of limited health services to enrollees;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(13)    A copy of the form of any group contract that is to be issued to employers, unions, trustees, or other organizations and a copy of any form of evidence of coverage to be issued to subscribers;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(14)    A copy of the applicant's financial plan, including a three-year projection of anticipated operating results, a statement of the sources of working capital, and any other sources of funding and provisions for contingencies;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(15)    A schedule of rates and charges;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(16)    A description of the proposed method of marketing;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(17)    A copy of the applicant's financial statements showing the applicant's assets, liabilities, and sources of financial support, including a copy of the applicant's most recent audited financial statement and an unaudited current financial statement, or if the information is not applicable to the applicant, a list of the assets representing the initial net worth of the applicant;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(18)    A financial plan that provides a three-year projection of operating results, including:</span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(a)    A projection of balance sheets;</span></p><p dir="ltr" class="s2077125Normal-000002"><span xml:space="preserve" class="s2077125000003"> </span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(b)    Income and expense statements anticipated from the start of operations until the organization has had net income for at least one year;</span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(c)    Cash flow statements showing any capital expenditures, purchase and sale of investments and deposits with the state;</span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(d)    Detailed enrollment projections;</span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(e)    The methodology for determining premium rates to be charged that has been certified by a qualified actuary; and</span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(f)    A statement as to the sources of working capital as well as any other sources of funding;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(19)    The names and addresses of the applicants's qualified actuary and external auditors;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(20)    If the applicant has a parent company and the director determines that additional solvency guarantees are necessary, the parent company's guaranty, on a form acceptable to the director, that the applicant will maintain the minimum net worth required under this chapter. If no parent company exists, a statement regarding the availability of future funds, if needed;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(21)    A description of the nature and extent of any reinsurance program to be implemented, including a detailed risk retention schedule indicating direct, assumed, ceded, and net maximum risk exposures on any one risk;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(22)    A demonstration that errors and omission insurance or other arrangements satisfactory to the director will be in place upon the applicant's receipt of a certificate of authority;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(23)    If the applicant is a foreign corporation, a statement from the appropriate regulatory agency of the applicant's state of domicile stating that:</span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(a)    The applicant is authorized to operate as a health maintenance organization in the state of domicile;</span></p><p dir="ltr" class="s2077125Normal-000002"><span class="s2077125DefaultParagraphFont">(b)    The regulatory agency has no objection to the applicant applying for a certificate of authority in this state;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(24)    The name and address of the applicant's statutory agent for service of process, notice, or demand, or if not domiciled in this state, a power of attorney duly executed by the applicant, appointing the director and duly authorized deputies, as the true and lawful attorney of the applicant in and for this state upon whom all lawful process in any legal action or proceeding against the health maintenance organization on a cause of action arising in this state may be served;</span></p><p dir="ltr" class="s2077125Normal-000001"><span xml:space="preserve" class="s2077125DefaultParagraphFont">(25)    A description of the proposed policies, standards, and procedures for the management of health information, including proposed policies, standards, and procedures that guard against the unauthorized collection, use, or disclosure of protected health information, that complies with §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-2-40"><span class="s2077125DefaultParagraphFont">58-2-40</span></a><span xml:space="preserve" class="s2077125DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-2-41"><span class="s2077125DefaultParagraphFont">58-2-41</span></a><span class="s2077125DefaultParagraphFont">;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(26)    A description of the proposed quality assessment and improvement activities regarding the maintenance and improvement of the quality of health care services provided to covered persons;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(27)    A description of the proposed health care provider credentialing program;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(28)    If the health maintenance organization will provide or perform utilization review services, a description of the proposed utilization review procedures;</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(29)    A description of the proposed internal grievance procedures; and</span></p><p dir="ltr" class="s2077125Normal-000001"><span class="s2077125DefaultParagraphFont">(30)    A description of the proposed external review procedures.</span></p><p dir="ltr" class="s2077125Normal"><span xml:space="preserve" class="s2077125000003"> </span></p><p dir="ltr" class="s2077125Normal"><span class="s2077125SCL">Source:</span><span xml:space="preserve" class="s2077125SCL-000004"> SL 1974, ch 321, § 6 (1) to (4), (10) to (14); SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077126Normal { 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.s2077126SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077126CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077126Normal-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.s2077126DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077126000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077126SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077126SCL-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="s2077126Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-7"><span class="s2077126SENU">58-41-7</span></a><span xml:space="preserve" class="s2077126SENU">. </span><span class="s2077126CL">Financial statements required with application.</span></p><p dir="ltr" class="s2077126Normal-000000"><span class="s2077126DefaultParagraphFont">Each application for a certificate of authority shall include financial statements showing the applicant's assets, liabilities, and sources of financial support. If the applicant's financial affairs are audited by independent certified public accountants, a copy of the applicant's most recent regular certified financial statement shall be deemed to satisfy this requirement unless the director directs that additional or more recent financial information is required for the proper administration of this chapter.</span></p><p dir="ltr" class="s2077126Normal"><span xml:space="preserve" class="s2077126000001"> </span></p><p dir="ltr" class="s2077126Normal"><span class="s2077126SCL">Source:</span><span xml:space="preserve" class="s2077126SCL-000002"> SL 1974, ch 321, § 6 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077127Normal { 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.s2077127SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077127CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077127Normal-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.s2077127DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077127Normal-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.s2077127000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077127SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077127SCL-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="s2077127Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-8"><span class="s2077127SENU">58-41-8</span></a><span xml:space="preserve" class="s2077127SENU">. </span><span class="s2077127CL">Copies of forms required with application.</span></p><p dir="ltr" class="s2077127Normal-000000"><span class="s2077127DefaultParagraphFont">Each application for a certificate of authority shall include:</span></p><p dir="ltr" class="s2077127Normal-000001"><span class="s2077127DefaultParagraphFont">(1)    A copy of the form of each evidence of coverage to be issued to the enrollees;</span></p><p dir="ltr" class="s2077127Normal-000001"><span class="s2077127DefaultParagraphFont">(2)    A copy of the form of each individual or group health maintenance contract which is to be issued to enrollees or their representatives.</span></p><p dir="ltr" class="s2077127Normal"><span xml:space="preserve" class="s2077127000002"> </span></p><p dir="ltr" class="s2077127Normal"><span class="s2077127SCL">Source:</span><span xml:space="preserve" class="s2077127SCL-000003"> SL 1974, ch 321, § 6 (5), (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077128Normal { 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.s2077128SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077128CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077128Normal-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.s2077128DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077128DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077128000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077128SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077128SCL-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="s2077128Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-9"><span class="s2077128SENU">58-41-9</span></a><span xml:space="preserve" class="s2077128SENU">. </span><span class="s2077128CL">Marketing, charges, and financial plans required with application.</span></p><p dir="ltr" class="s2077128Normal-000000"><span class="s2077128DefaultParagraphFont">Each application for a certificate of authority shall include a description of the proposed method of marketing the plan, a schedule of proposed charges, and a financial plan which includes a three</span><span class="s2077128DefaultParagraphFont-000001">-</span><span class="s2077128DefaultParagraphFont">year projection of the expenses and income and other sources of future capital.</span></p><p dir="ltr" class="s2077128Normal"><span xml:space="preserve" class="s2077128000002"> </span></p><p dir="ltr" class="s2077128Normal"><span class="s2077128SCL">Source:</span><span xml:space="preserve" class="s2077128SCL-000003"> SL 1974, ch 321, § 6 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077129Normal { 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.s2077129SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077129CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077129Normal-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.s2077129DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077129000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077129SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077129SCL-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="s2077129Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-10"><span class="s2077129SENU">58-41-10</span></a><span xml:space="preserve" class="s2077129SENU">. </span><span class="s2077129CL">Appointment to receive process required of foreign applicant.</span></p><p dir="ltr" class="s2077129Normal-000000"><span class="s2077129DefaultParagraphFont">Each application for a certificate of authority by an applicant not domiciled in this state shall include a power of attorney duly executed by such applicant, appointing the director and his successors in office, and duly authorized deputies, as the true and lawful attorney of such applicant in and for this state upon whom all lawful process in any legal action or proceeding against the health maintenance organization on a cause of action arising in this state may be served.</span></p><p dir="ltr" class="s2077129Normal"><span xml:space="preserve" class="s2077129000001"> </span></p><p dir="ltr" class="s2077129Normal"><span class="s2077129SCL">Source:</span><span xml:space="preserve" class="s2077129SCL-000002"> SL 1974, ch 321, § 6 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077130Normal { 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.s2077130SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077130CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077130Normal-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.s2077130DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077130000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077130SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077130SCL-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="s2077130Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-11"><span class="s2077130SENU">58-41-11</span></a><span xml:space="preserve" class="s2077130SENU">. </span><span class="s2077130CL">Surety bond or deposit required--Waiver.</span></p><p dir="ltr" class="s2077130Normal-000000"><span class="s2077130DefaultParagraphFont">Each health maintenance organization shall furnish a surety bond in an amount satisfactory to the director or deposit with the director cash or securities acceptable to him in at least the same amount as a guarantee that the obligations to the enrollees will be performed. The director may waive this requirement whenever he is satisfied that the assets of the organization or its contracts with insurers, hospital or medical service corporations, governments, or other organizations are sufficient to reasonably assure the performance of its obligations.</span></p><p dir="ltr" class="s2077130Normal"><span xml:space="preserve" class="s2077130000001"> </span></p><p dir="ltr" class="s2077130Normal"><span class="s2077130SCL">Source:</span><span xml:space="preserve" class="s2077130SCL-000002"> SL 1974, ch 321, § 31.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077131Normal { 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.s2077131SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077131CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077131Normal-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.s2077131DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077131Normal-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.s2077131000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077131SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077131SCL-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="s2077131Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-12"><span class="s2077131SENU">58-41-12</span></a><span xml:space="preserve" class="s2077131SENU">. </span><span class="s2077131CL">Determination of health care qualifications.</span></p><p dir="ltr" class="s2077131Normal-000000"><span class="s2077131DefaultParagraphFont">The director shall determine whether the applicant for a certificate of authority has:</span></p><p dir="ltr" class="s2077131Normal-000001"><span xml:space="preserve" class="s2077131DefaultParagraphFont">(1)    Demonstrated the willingness and potential ability to assure that health care services will be provided in a manner to assure both the availability and accessibility of adequate personnel and facilities consistent with the requirements of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17F"><span class="s2077131DefaultParagraphFont">58-17F</span></a><span class="s2077131DefaultParagraphFont">;</span></p><p dir="ltr" class="s2077131Normal-000001"><span xml:space="preserve" class="s2077131DefaultParagraphFont">(2)    Arrangements, established in accordance with regulations promulgated by the director for an ongoing quality of health care assurance program consistent with the requirements of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17F"><span class="s2077131DefaultParagraphFont">58-17F</span></a><span class="s2077131DefaultParagraphFont">, concerning health care processes and outcomes;</span></p><p dir="ltr" class="s2077131Normal-000001"><span xml:space="preserve" class="s2077131DefaultParagraphFont">(3)    A procedure, established in accordance with rules promulgated pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2077131DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2077131DefaultParagraphFont"> by the director, to develop, compile, evaluate, and report statistics relating to the cost of its operations, the pattern of utilization of its services, the availability and accessibility of its services, and such other matters as may be reasonably required by the director; and</span></p><p dir="ltr" class="s2077131Normal-000001"><span class="s2077131DefaultParagraphFont">(4)    Reasonable provisions for emergency and out-of-area health care services.</span></p><p dir="ltr" class="s2077131Normal"><span xml:space="preserve" class="s2077131000002"> </span></p><p dir="ltr" class="s2077131Normal"><span class="s2077131SCL">Source:</span><span xml:space="preserve" class="s2077131SCL-000003"> SL 1974, ch 321, § 8; SL 1999, ch 245, § 20; SL 2011, ch 219, § 101; SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077132Normal { 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.s2077132SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077132CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077132Normal-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.s2077132DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077132000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077132SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077132SCL-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="s2077132Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-13"><span class="s2077132SENU">58-41-13</span></a><span xml:space="preserve" class="s2077132SENU">. </span><span class="s2077132CL">Coordination with federal professional standards review.</span></p><p dir="ltr" class="s2077132Normal-000000"><span class="s2077132DefaultParagraphFont">To the extent that it furthers the purposes of this chapter, the director shall attempt to coordinate the operations of this chapter relating to the quality of health care services with the operations of 42 U.S.C. sections 1320c to 1320c-19.</span></p><p dir="ltr" class="s2077132Normal"><span xml:space="preserve" class="s2077132000001"> </span></p><p dir="ltr" class="s2077132Normal"><span class="s2077132SCL">Source:</span><span xml:space="preserve" class="s2077132SCL-000002"> SL 1974, ch 321, § 54; SL 2013, ch 256, § 5.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-14 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-14 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-14"> </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 --> 58-41-14. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Obsolete<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077134Normal { 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.s2077134SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077134CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077134Normal-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.s2077134DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077134000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077134SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077134SCL-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="s2077134Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-15"><span class="s2077134SENU">58-41-15</span></a><span xml:space="preserve" class="s2077134SENU">. </span><span class="s2077134CL">Health maintenance not considered practice of healing arts.</span></p><p dir="ltr" class="s2077134Normal-000000"><span class="s2077134DefaultParagraphFont">Any health maintenance organization authorized under this chapter shall not be deemed to be practicing a healing art.</span></p><p dir="ltr" class="s2077134Normal"><span xml:space="preserve" class="s2077134000001"> </span></p><p dir="ltr" class="s2077134Normal"><span class="s2077134SCL">Source:</span><span xml:space="preserve" class="s2077134SCL-000002"> SL 1974, ch 321, § 53.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077135Normal { 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.s2077135SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077135CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077135Normal-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.s2077135DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077135000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077135SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077135SCL-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="s2077135Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-15.1"><span class="s2077135SENU">58-41-15.1</span></a><span xml:space="preserve" class="s2077135SENU">. </span><span class="s2077135CL">Certain healing arts practitioners to participate in alternate health care delivery systems.</span></p><p dir="ltr" class="s2077135Normal-000000"><span xml:space="preserve" class="s2077135DefaultParagraphFont">Any optometrist licensed pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=36-7"><span class="s2077135DefaultParagraphFont">36-7</span></a><span xml:space="preserve" class="s2077135DefaultParagraphFont">, podiatrist licensed pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=36-8"><span class="s2077135DefaultParagraphFont">36-8</span></a><span xml:space="preserve" class="s2077135DefaultParagraphFont">, chiropractor licensed pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=36-5"><span class="s2077135DefaultParagraphFont">36-5</span></a><span xml:space="preserve" class="s2077135DefaultParagraphFont">, psychologist licensed pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=36-27A"><span class="s2077135DefaultParagraphFont">36-27A</span></a><span xml:space="preserve" class="s2077135DefaultParagraphFont">, dentist licensed pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=36-6A"><span class="s2077135DefaultParagraphFont">36-6A</span></a><span xml:space="preserve" class="s2077135DefaultParagraphFont">, or social worker licensed under § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=36-26-17"><span class="s2077135DefaultParagraphFont">36-26-17</span></a><span class="s2077135DefaultParagraphFont">, may organize or contract for services with a corporation organized under the laws of this state by licensed practitioners of the healing arts, for the purpose of negotiating group health care contracts and providing services within the scope of their respective licenses with alternate health care delivery systems, including health maintenance organizations, preferred provider organizations, individual practices organizations, or other similar entities.</span></p><p dir="ltr" class="s2077135Normal"><span xml:space="preserve" class="s2077135000001"> </span></p><p dir="ltr" class="s2077135Normal"><span class="s2077135SCL">Source:</span><span xml:space="preserve" class="s2077135SCL-000002"> SL 1987, ch 269, § 2; SL 2013, ch 256, § 6.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-16 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-16 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-16"> </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 --> 58-41-16. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2013, ch 256, &#167;&nbsp;7.<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077137Normal { 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.s2077137SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077137CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077137Normal-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.s2077137DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077137Normal-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.s2077137Normal-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.s2077137000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077137SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077137SCL-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="s2077137Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-17"><span class="s2077137SENU">58-41-17</span></a><span xml:space="preserve" class="s2077137SENU">. </span><span class="s2077137CL">Issuance or denial of certificate--Fee--Conditions for issuance.</span></p><p dir="ltr" class="s2077137Normal-000000"><span xml:space="preserve" class="s2077137DefaultParagraphFont">The director of the Division of Insurance shall issue or deny a certificate of authority to any person filing an application pursuant to this chapter. Issuance of a certificate of authority shall be granted upon payment of the application fee prescribed in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-26"><span class="s2077137DefaultParagraphFont">58-41-26</span></a><span xml:space="preserve" class="s2077137DefaultParagraphFont"> if the director is satisfied that the following conditions are met:</span></p><p dir="ltr" class="s2077137Normal-000001"><span class="s2077137DefaultParagraphFont">(1)    The persons responsible for the conduct of the affairs of the applicant are competent, trustworthy, and possess good reputations;</span></p><p dir="ltr" class="s2077137Normal-000001"><span xml:space="preserve" class="s2077137DefaultParagraphFont">(2)    The health maintenance organization's proposed plan of operation meets the requirements of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-12"><span class="s2077137DefaultParagraphFont">58-41-12</span></a><span class="s2077137DefaultParagraphFont">;</span></p><p dir="ltr" class="s2077137Normal-000001"><span class="s2077137DefaultParagraphFont">(3)    The health maintenance contract constitutes an appropriate mechanism whereby the health maintenance organization will effectively provide or arrange for the provision of comprehensive health maintenance services on a prepaid basis, through insurance or otherwise, except to the extent of reasonable requirements for copayments;</span></p><p dir="ltr" class="s2077137Normal-000001"><span class="s2077137DefaultParagraphFont">(4)    The health maintenance organization is financially responsible and may reasonably be expected to meet its obligations to enrollees and prospective enrollees;</span></p><p dir="ltr" class="s2077137Normal-000001"><span class="s2077137DefaultParagraphFont">(5)    The health maintenance organization will assume full financial risk on a prospective basis for the provision of comprehensive health maintenance services, including hospital care;</span></p><p dir="ltr" class="s2077137Normal-000001"><span xml:space="preserve" class="s2077137DefaultParagraphFont">(6)    The enrollees will be afforded an opportunity to participate in matters of policy and operation pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-23"><span class="s2077137DefaultParagraphFont">58-41-23</span></a><span xml:space="preserve" class="s2077137DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-24"><span class="s2077137DefaultParagraphFont">58-41-24</span></a><span class="s2077137DefaultParagraphFont">; and</span></p><p dir="ltr" class="s2077137Normal-000001"><span xml:space="preserve" class="s2077137DefaultParagraphFont">(7)    Nothing in the proposed method of operation, as shown by the information submitted pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-4"><span class="s2077137DefaultParagraphFont">58-41-4</span></a><span xml:space="preserve" class="s2077137DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-10"><span class="s2077137DefaultParagraphFont">58-41-10</span></a><span class="s2077137DefaultParagraphFont">, inclusive, or by independent investigation, is contrary to the public interest.</span></p><p dir="ltr" class="s2077137Normal-000002"><span xml:space="preserve" class="s2077137DefaultParagraphFont">A certificate of authority may be denied only after compliance with the requirements of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-87"><span class="s2077137DefaultParagraphFont">58-41-87</span></a><span xml:space="preserve" class="s2077137DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-90"><span class="s2077137DefaultParagraphFont">58-41-90</span></a><span class="s2077137DefaultParagraphFont">, inclusive.</span></p><p dir="ltr" class="s2077137Normal"><span xml:space="preserve" class="s2077137000003"> </span></p><p dir="ltr" class="s2077137Normal"><span class="s2077137SCL">Source:</span><span xml:space="preserve" class="s2077137SCL-000004"> SL 1974, ch 321, § 10; SL 1985, ch 393, § 15; SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077138Normal { 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.s2077138SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077138CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077138Normal-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.s2077138DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077138Normal-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.s2077138000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077138SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077138SCL-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="s2077138Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-18"><span class="s2077138SENU">58-41-18</span></a><span xml:space="preserve" class="s2077138SENU">. </span><span class="s2077138CL">Factors considered in determining financial responsibility.</span></p><p dir="ltr" class="s2077138Normal-000000"><span class="s2077138DefaultParagraphFont">In making a determination under subdivision 58-41-17(4), the director may consider:</span></p><p dir="ltr" class="s2077138Normal-000001"><span class="s2077138DefaultParagraphFont">(1)    The financial soundness of the applicant's arrangements for health care services and the proposed schedule of charges used in connection therewith;</span></p><p dir="ltr" class="s2077138Normal-000001"><span class="s2077138DefaultParagraphFont">(2)    The adequacy of its working capital;</span></p><p dir="ltr" class="s2077138Normal-000001"><span class="s2077138DefaultParagraphFont">(3)    Arrangements which will guarantee for a reasonable period of time the continued availability or payment of the cost of health care services in the event of discontinuance of the health maintenance organization;</span></p><p dir="ltr" class="s2077138Normal-000001"><span class="s2077138DefaultParagraphFont">(4)    Agreements with providers for the provision of health care services; and</span></p><p dir="ltr" class="s2077138Normal-000001"><span xml:space="preserve" class="s2077138DefaultParagraphFont">(5)    Any surety bond or deposit of cash or securities submitted in accordance with § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-11"><span class="s2077138DefaultParagraphFont">58-41-11</span></a><span xml:space="preserve" class="s2077138DefaultParagraphFont"> as a guarantee that the obligations will be duly performed.</span></p><p dir="ltr" class="s2077138Normal"><span xml:space="preserve" class="s2077138000002"> </span></p><p dir="ltr" class="s2077138Normal"><span class="s2077138SCL">Source:</span><span xml:space="preserve" class="s2077138SCL-000003"> SL 1974, ch 321, § 10 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077139Normal { 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.s2077139SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077139CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077139Normal-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.s2077139DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077139Normal-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.s2077139DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077139000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077139SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077139SCL-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="s2077139Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-19"><span class="s2077139SENU">58-41-19</span></a><span xml:space="preserve" class="s2077139SENU">. </span><span class="s2077139CL">Insurance arrangements permitted.</span></p><p dir="ltr" class="s2077139Normal-000000"><span class="s2077139DefaultParagraphFont">The requirement of subdivision 58-41-17(5) shall not prohibit a health maintenance organization from obtaining insurance or making other arrangements:</span></p><p dir="ltr" class="s2077139Normal-000001"><span class="s2077139DefaultParagraphFont">(1)    For the cost of providing to any enrollee comprehensive health maintenance services, the aggregate value of which exceeds five thousand dollars in any year;</span></p><p dir="ltr" class="s2077139Normal-000001"><span class="s2077139DefaultParagraphFont">(2)    For the cost of providing comprehensive health care services to its members on a nonelective emergency basis, or while they are outside the area served by the organization; or</span></p><p dir="ltr" class="s2077139Normal-000001"><span class="s2077139DefaultParagraphFont">(3)    For not more than ninety</span><span class="s2077139DefaultParagraphFont-000002">-</span><span class="s2077139DefaultParagraphFont">five percent of the amount by which the health maintenance organization's costs for any of its fiscal years exceeds one hundred five percent of its income for such fiscal years.</span></p><p dir="ltr" class="s2077139Normal"><span xml:space="preserve" class="s2077139000003"> </span></p><p dir="ltr" class="s2077139Normal"><span class="s2077139SCL">Source:</span><span xml:space="preserve" class="s2077139SCL-000004"> SL 1974, ch 321, § 10 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077140Normal { 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.s2077140SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077140CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077140Normal-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.s2077140DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077140000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077140SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077140SCL-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="s2077140Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-20"><span class="s2077140SENU">58-41-20</span></a><span xml:space="preserve" class="s2077140SENU">. </span><span class="s2077140CL">Corporation operating after certification.</span></p><p dir="ltr" class="s2077140Normal-000000"><span class="s2077140DefaultParagraphFont">Any corporation may, upon obtaining a certificate of authority as required in this chapter, operate as a health maintenance organization.</span></p><p dir="ltr" class="s2077140Normal"><span xml:space="preserve" class="s2077140000001"> </span></p><p dir="ltr" class="s2077140Normal"><span class="s2077140SCL">Source:</span><span xml:space="preserve" class="s2077140SCL-000002"> SL 1974, ch 321, § 11; SL 1985, ch 393, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077141Normal { 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.s2077141SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077141CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077141Normal-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.s2077141DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077141000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077141SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077141SCL-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="s2077141Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-21"><span class="s2077141SENU">58-41-21</span></a><span xml:space="preserve" class="s2077141SENU">. </span><span class="s2077141CL">Foreign corporations qualifying--Exemption from other requirements.</span></p><p dir="ltr" class="s2077141Normal-000000"><span class="s2077141DefaultParagraphFont">A foreign corporation may qualify under this chapter, and if such corporation fully complies with the provisions of Title 58, then such corporation shall be exempt from complying with other provisions of the South Dakota Code concerning foreign corporations.</span></p><p dir="ltr" class="s2077141Normal"><span xml:space="preserve" class="s2077141000001"> </span></p><p dir="ltr" class="s2077141Normal"><span class="s2077141SCL">Source:</span><span xml:space="preserve" class="s2077141SCL-000002"> SL 1974, ch 321, § 3; SL 1985, ch 393, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077142Normal { 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.s2077142SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077142CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077142Normal-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.s2077142DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077142000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077142SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077142SCL-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="s2077142Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-22"><span class="s2077142SENU">58-41-22</span></a><span xml:space="preserve" class="s2077142SENU">. </span><span class="s2077142CL">Filing of notice of modification of operation--Approval if not disapproved--Exemptions.</span></p><p dir="ltr" class="s2077142Normal-000000"><span xml:space="preserve" class="s2077142DefaultParagraphFont">A health maintenance organization shall, unless otherwise provided for in this chapter, file a notice describing any modification of the operation set out in the information required by §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-6"><span class="s2077142DefaultParagraphFont">58-41-6</span></a><span xml:space="preserve" class="s2077142DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-10"><span class="s2077142DefaultParagraphFont">58-41-10</span></a><span class="s2077142DefaultParagraphFont">, inclusive. Such a notice shall be filed with the director prior to the modification. If the director does not disapprove within thirty days of filing, such modification shall be deemed approved. The director may promulgate rules and regulations exempting from the filing requirements of this section those items he deems unnecessary.</span></p><p dir="ltr" class="s2077142Normal"><span xml:space="preserve" class="s2077142000001"> </span></p><p dir="ltr" class="s2077142Normal"><span class="s2077142SCL">Source:</span><span xml:space="preserve" class="s2077142SCL-000002"> SL 1974, ch 321, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077143Normal { 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.s2077143SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077143CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077143Normal-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.s2077143DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077143000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077143SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077143SCL-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="s2077143Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-23"><span class="s2077143SENU">58-41-23</span></a><span xml:space="preserve" class="s2077143SENU">. </span><span class="s2077143CL">Composition of governing body--Consumer representation.</span></p><p dir="ltr" class="s2077143Normal-000000"><span class="s2077143DefaultParagraphFont">The governing body of any health maintenance organization may include enrollees, providers, or other individuals. However, after a health maintenance organization has been authorized under this chapter for one year, at least twenty percent of the governing body of a health maintenance organization shall be composed of consumers. A consumer, is any person other than a person whose occupation involves the administration of health activities or the providing of health services.</span></p><p dir="ltr" class="s2077143Normal"><span xml:space="preserve" class="s2077143000001"> </span></p><p dir="ltr" class="s2077143Normal"><span class="s2077143SCL">Source:</span><span xml:space="preserve" class="s2077143SCL-000002"> SL 1974, ch 321, §§ 2 (9), 16; SL 1985, ch 393, § 5; SL 2014, ch 244, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077144Normal { 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.s2077144SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077144CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077144Normal-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.s2077144DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077144000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077144SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077144SCL-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="s2077144Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-24"><span class="s2077144SENU">58-41-24</span></a><span xml:space="preserve" class="s2077144SENU">. </span><span class="s2077144CL">Mechanisms for enrollee participation in policy and operation of governing body.</span></p><p dir="ltr" class="s2077144Normal-000000"><span class="s2077144DefaultParagraphFont">The governing body shall establish a mechanism to afford the enrollees an opportunity to express their opinions in matters of policy and operation through the establishment of advisory panels, by the use of advisory referenda on major policy decisions, or through the use of other mechanisms as may be prescribed or permitted by the director.</span></p><p dir="ltr" class="s2077144Normal"><span xml:space="preserve" class="s2077144000001"> </span></p><p dir="ltr" class="s2077144Normal"><span class="s2077144SCL">Source:</span><span xml:space="preserve" class="s2077144SCL-000002"> SL 1974, ch 321, § 16; SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077145Normal { 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.s2077145SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077145CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077145Normal-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.s2077145DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077145000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077145SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077145SCL-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="s2077145Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-25"><span class="s2077145SENU">58-41-25</span></a><span xml:space="preserve" class="s2077145SENU">. </span><span class="s2077145CL">Fiduciary responsibilities to enrollees.</span></p><p dir="ltr" class="s2077145Normal-000000"><span class="s2077145DefaultParagraphFont">Any director, officer, or partner of a health maintenance organization who receives, collects, disburses, or invests funds in connection with the activities of such organization shall be responsible for such funds in a fiduciary relationship to the enrollees.</span></p><p dir="ltr" class="s2077145Normal"><span xml:space="preserve" class="s2077145000001"> </span></p><p dir="ltr" class="s2077145Normal"><span class="s2077145SCL">Source:</span><span xml:space="preserve" class="s2077145SCL-000002"> SL 1974, ch 321, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077146Normal { 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.s2077146SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077146CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077146Normal-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.s2077146DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077146000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077146SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077146SCL-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="s2077146Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-25.1"><span class="s2077146SENU">58-41-25.1</span></a><span xml:space="preserve" class="s2077146SENU">. </span><span class="s2077146CL">Investments.</span></p><p dir="ltr" class="s2077146Normal-000000"><span class="s2077146DefaultParagraphFont">The funds of any corporation subject to the provisions of this chapter shall be invested only in securities permitted by the laws of this state for the investment of assets of life insurance companies.</span></p><p dir="ltr" class="s2077146Normal"><span xml:space="preserve" class="s2077146000001"> </span></p><p dir="ltr" class="s2077146Normal"><span class="s2077146SCL">Source:</span><span xml:space="preserve" class="s2077146SCL-000002"> SL 1985, ch 393, § 14.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2079951Normal { 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.s2079951SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2079951CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2079951Statute { 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.s2079951DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } a.s2079951000000 { text-decoration: none; } p.s2079951Statute-000001 { 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.s2079951000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2079951DefaultParagraphFont-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2079951SCL { 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="s2079951Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-4"><span class="s2079951SENU">58-41-26</span></a><span xml:space="preserve" class="s2079951SENU">. </span><span class="s2079951CL">Exemption from insurance laws--Exceptions--Taxation.</span></p><p dir="ltr" class="s2079951Statute"><span xml:space="preserve" class="s2079951DefaultParagraphFont">Any health maintenance organization is exempt from all provisions of the insurance laws of this state other than this chapter. However, the corporation is subject to the </span><a id="_pagenumber32" class="s2079951000000"></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">provisions of this title on matters and procedures of mergers and licensure of insurance producers. The corporation is also subject to fees and taxation as insurers under § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-2"><span class="s2079951DefaultParagraphFont">58-2-29</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont"> and chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=10-44"><span class="s2079951DefaultParagraphFont">10-44</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">. The corporation is also subject to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17"><span class="s2079951DefaultParagraphFont">58-17-53</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17"><span class="s2079951DefaultParagraphFont">58-17-54</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont"> if entering into a contract after July 1, 1990, with the State of South Dakota, counties, school districts, municipalities, and any other unit of state government using public funds. The state, however, may not collect premium taxes for insurance written on individuals residing outside this state or property located outside this state if no comparable tax is paid by the direct writing health maintenance organization to any appropriate taxing authority. Health maintenance organizations are also subject to the following chapters: </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-1"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-2"><span class="s2079951DefaultParagraphFont">58-2</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-3"><span class="s2079951DefaultParagraphFont">58-3</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">, 58-4, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-5"><span class="s2079951DefaultParagraphFont">58-5</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-5A"><span class="s2079951DefaultParagraphFont">58-5</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">A, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-6"><span class="s2079951DefaultParagraphFont">58-6</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-7"><span class="s2079951DefaultParagraphFont">58-7</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-11"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">1, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-12"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">2, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-14"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">4, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">7, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17A"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">7A, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17F"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">7F, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17G"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">7G, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17H"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">7H, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17I"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">7I, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">8, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18A"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">8A, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">8B, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18C"><span class="s2079951DefaultParagraphFont">58-1</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">8C, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-26"><span class="s2079951DefaultParagraphFont">58-2</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">6, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-27"><span class="s2079951DefaultParagraphFont">58-2</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">7, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29B"><span class="s2079951DefaultParagraphFont">58-2</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">9B on the same basis as insurers, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-30"><span class="s2079951DefaultParagraphFont">58-3</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">0, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-33A"><span class="s2079951DefaultParagraphFont">58-3</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">3A; and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-43"><span class="s2079951DefaultParagraphFont">58-43</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont">. Nothing in chapters </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-5"><span class="s2079951DefaultParagraphFont">58-5</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont"> or </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-6"><span class="s2079951DefaultParagraphFont">58-6</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont"> may be construed to prohibit a nonprofit health maintenance organization from transacting business under this title based upon its nonprofit status.</span></p><p dir="ltr" class="s2079951Statute-000001"><span xml:space="preserve" class="s2079951DefaultParagraphFont">To the extent that a health maintenance organization is compliant with the provisions of chapters </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17F"><span class="s2079951DefaultParagraphFont">58-17F</span></a><span xml:space="preserve" class="s2079951DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17I"><span class="s2079951DefaultParagraphFont">58-17I</span></a><span class="s2079951DefaultParagraphFont">, inclusive, for purposes of network adequacy, quality assessment and improvements, utilization review and benefit determinations, and grievance procedure, the health maintenance organization is compliant with the provisions of this chapter.</span></p><p dir="ltr" class="s2079951Normal"><span xml:space="preserve" class="s2079951000002"> </span></p><p dir="ltr" class="s2079951Normal"><span xml:space="preserve" class="s2079951DefaultParagraphFont-000003">Source: </span><span class="s2079951SCL">SL 1974, ch 321, § 51; SL 1985, ch 393, § 8; SL 1990, ch 411; SL 2001, ch 286, § 226; SL 2007, ch 293, § 1; SL 2013, ch 256, § 10; SL 2020, ch 210, § 13.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-27 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-27 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-27"> </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 --> 58-41-27. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1985, ch 393, &#167;&nbsp;9<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077149Normal { 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.s2077149SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077149CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077149Normal-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.s2077149DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077149000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077149SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077149SCL-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="s2077149Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-28"><span class="s2077149SENU">58-41-28</span></a><span xml:space="preserve" class="s2077149SENU">. </span><span class="s2077149CL">Solicitation of enrollment not deemed professional advertising.</span></p><p dir="ltr" class="s2077149Normal-000000"><span class="s2077149DefaultParagraphFont">Solicitation of enrollees by a health maintenance organization granted a certificate of authority, or its representatives, shall not be construed to violate any provision of law relating to solicitation or advertising by health professionals.</span></p><p dir="ltr" class="s2077149Normal"><span xml:space="preserve" class="s2077149000001"> </span></p><p dir="ltr" class="s2077149Normal"><span class="s2077149SCL">Source:</span><span xml:space="preserve" class="s2077149SCL-000002"> SL 1974, ch 321, § 52.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077150Normal { 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.s2077150SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077150CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077150Normal-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.s2077150DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077150000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077150SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077150SCL-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="s2077150Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-29"><span class="s2077150SENU">58-41-29</span></a><span xml:space="preserve" class="s2077150SENU">. </span><span class="s2077150CL">Contracts and necessary activities.</span></p><p dir="ltr" class="s2077150Normal-000000"><span class="s2077150DefaultParagraphFont">A health maintenance organization may enter into health maintenance contracts in this state and engage in any other activities consistent with this chapter which are necessary to the performance of its obligations under such contracts or authorize its representatives to do so.</span></p><p dir="ltr" class="s2077150Normal"><span xml:space="preserve" class="s2077150000001"> </span></p><p dir="ltr" class="s2077150Normal"><span class="s2077150SCL">Source:</span><span xml:space="preserve" class="s2077150SCL-000002"> SL 1974, ch 321, § 12.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077151Normal { 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.s2077151SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077151CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077151Normal-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.s2077151DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077151DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077151000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077151SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077151SCL-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="s2077151Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-29.1"><span class="s2077151SENU">58-41-29.1</span></a><span xml:space="preserve" class="s2077151SENU">. </span><span class="s2077151CL">Notice required for rate increase in health maintenance contract by a health maintenance organization.</span></p><p dir="ltr" class="s2077151Normal-000000"><span class="s2077151DefaultParagraphFont">Forty</span><span class="s2077151DefaultParagraphFont-000001">-</span><span class="s2077151DefaultParagraphFont">five days before a health maintenance contract rate increase is effective, the health maintenance organization shall notify the enrolling unit in writing that the contract rate for the health maintenance contract offered by the organization will be increased.</span></p><p dir="ltr" class="s2077151Normal"><span xml:space="preserve" class="s2077151000002"> </span></p><p dir="ltr" class="s2077151Normal"><span class="s2077151SCL">Source:</span><span xml:space="preserve" class="s2077151SCL-000003"> SL 1989, ch 434, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077152Normal { 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.s2077152SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077152CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077152Normal-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.s2077152DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077152000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077152SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077152SCL-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="s2077152Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-30"><span class="s2077152SENU">58-41-30</span></a><span xml:space="preserve" class="s2077152SENU">. </span><span class="s2077152CL">Sources of payment for enrollee services--Application by medical assistance recipient.</span></p><p dir="ltr" class="s2077152Normal-000000"><span class="s2077152DefaultParagraphFont">Each health maintenance organization authorized to operate under this chapter or its representative, may accept from governmental agencies, private agencies, corporations, associations, groups, individuals, or other persons, payments covering all or part of the cost of health care service provided to enrollees. Any recipient of medical assistance, pursuant to Title 28, may make application to join a health maintenance organization which has been approved for medical assistance by the secretary of the Department of Social Services.</span></p><p dir="ltr" class="s2077152Normal"><span xml:space="preserve" class="s2077152000001"> </span></p><p dir="ltr" class="s2077152Normal"><span class="s2077152SCL">Source:</span><span xml:space="preserve" class="s2077152SCL-000002"> SL 1974, ch 321, § 15.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077153Normal { 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.s2077153SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077153CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077153Normal-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.s2077153DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077153000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077153SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077153SCL-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="s2077153Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-31"><span class="s2077153SENU">58-41-31</span></a><span xml:space="preserve" class="s2077153SENU">. </span><span class="s2077153CL">Direct payments to enrollees prohibited.</span></p><p dir="ltr" class="s2077153Normal-000000"><span class="s2077153DefaultParagraphFont">No health maintenance organization or representative thereof may by a health maintenance contract or evidence of coverage provide for the reimbursement of an enrollee other than through a policy of insurance, except to refund payments made by or on behalf of an enrollee.</span></p><p dir="ltr" class="s2077153Normal"><span xml:space="preserve" class="s2077153000001"> </span></p><p dir="ltr" class="s2077153Normal"><span class="s2077153SCL">Source:</span><span xml:space="preserve" class="s2077153SCL-000002"> SL 1974, ch 321, § 32 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077154Normal { 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.s2077154SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077154CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077154Normal-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.s2077154DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077154000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077154SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077154SCL-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="s2077154Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-32"><span class="s2077154SENU">58-41-32</span></a><span xml:space="preserve" class="s2077154SENU">. </span><span class="s2077154CL">Use of words descriptive of insurance, casualty, or surety business as misdemeanor--Exception.</span></p><p dir="ltr" class="s2077154Normal-000000"><span class="s2077154DefaultParagraphFont">No health maintenance organization or representative thereof may use in its name, contracts, or literature any of the words "insurance," "casualty," "surety," "mutual," or any other words which are descriptive of the insurance, casualty, or surety business or deceptively similar to the name or description of any insurance or surety corporation doing business in this state; provided, however, that when a health maintenance organization has contracted with an insurance company for any coverage permitted by this chapter, it may so state. Violation of this section is a Class 2 misdemeanor.</span></p><p dir="ltr" class="s2077154Normal"><span xml:space="preserve" class="s2077154000001"> </span></p><p dir="ltr" class="s2077154Normal"><span class="s2077154SCL">Source:</span><span xml:space="preserve" class="s2077154SCL-000002"> SL 1974, ch 321, §§ 32 (3), 50; SDCL Supp, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077154SCL-000002">58-41-77</span></a><span class="s2077154SCL-000002">; SL 1978, ch 359, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077155Normal { 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.s2077155SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077155CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077155Normal-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.s2077155DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077155000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077155SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077155SCL-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="s2077155Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-33"><span class="s2077155SENU">58-41-33</span></a><span xml:space="preserve" class="s2077155SENU">. </span><span class="s2077155CL">Trade practice laws applicable.</span></p><p dir="ltr" class="s2077155Normal-000000"><span xml:space="preserve" class="s2077155DefaultParagraphFont">Each health maintenance organization, health maintenance contract, and evidence of coverage shall be subject to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-33"><span class="s2077155DefaultParagraphFont">58-33</span></a><span class="s2077155DefaultParagraphFont">, relating to the regulation of trade practices, except to the extent that the director determines that the nature of health maintenance organizations, health maintenance contracts, and evidences of coverage render such chapter clearly inappropriate.</span></p><p dir="ltr" class="s2077155Normal"><span xml:space="preserve" class="s2077155000001"> </span></p><p dir="ltr" class="s2077155Normal"><span class="s2077155SCL">Source:</span><span xml:space="preserve" class="s2077155SCL-000002"> SL 1974, ch 321, § 33.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077156Normal { 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.s2077156SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077156CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077156Normal-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.s2077156DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077156000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077156SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077156SCL-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="s2077156Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-34"><span class="s2077156SENU">58-41-34</span></a><span xml:space="preserve" class="s2077156SENU">. </span><span class="s2077156CL">Evidence of coverage issued to enrollees.</span></p><p dir="ltr" class="s2077156Normal-000000"><span class="s2077156DefaultParagraphFont">Every enrollee residing in this state is entitled to evidence of coverage under a health maintenance contract. The health maintenance organization or its designated representative shall issue the evidence of coverage.</span></p><p dir="ltr" class="s2077156Normal"><span xml:space="preserve" class="s2077156000001"> </span></p><p dir="ltr" class="s2077156Normal"><span class="s2077156SCL">Source:</span><span xml:space="preserve" class="s2077156SCL-000002"> SL 1974, ch 321, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077157Normal { 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.s2077157SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077157CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077157Normal-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.s2077157DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077157Normal-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.s2077157DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077157000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077157SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077157SCL-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="s2077157Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35"><span class="s2077157SENU">58-41-35</span></a><span xml:space="preserve" class="s2077157SENU">. </span><span class="s2077157CL">Contents required in evidence of coverage.</span></p><p dir="ltr" class="s2077157Normal-000000"><span class="s2077157DefaultParagraphFont">An evidence of coverage shall contain a clear, concise, and complete statement of:</span></p><p dir="ltr" class="s2077157Normal-000001"><span class="s2077157DefaultParagraphFont">(1)    The health care services and the insurance or other benefits, if any, to which the enrollee is entitled under the health care plan;</span></p><p dir="ltr" class="s2077157Normal-000001"><span class="s2077157DefaultParagraphFont">(2)    Any exclusions or limitations on the services, kind of services, benefits, or kind of benefits, to be provided, including any deductible or copayment feature;</span></p><p dir="ltr" class="s2077157Normal-000001"><span class="s2077157DefaultParagraphFont">(3)    Where and in what manner information is available as to how service, including emergency and out</span><span class="s2077157DefaultParagraphFont-000002">-</span><span class="s2077157DefaultParagraphFont">of</span><span class="s2077157DefaultParagraphFont-000002">-</span><span class="s2077157DefaultParagraphFont">area services, may be obtained;</span></p><p dir="ltr" class="s2077157Normal-000001"><span class="s2077157DefaultParagraphFont">(4)    The total amount of payment and copayment if any, for health care services and the indemnity or service benefits, if any, which the enrollee is obligated to pay with respect to individual contracts, or an indication whether the plan is contributory or noncontributory with respect to group certificates; and</span></p><p dir="ltr" class="s2077157Normal-000001"><span class="s2077157DefaultParagraphFont">(5)    A description of the health maintenance organization's method for resolving enrollee complaints.</span></p><p dir="ltr" class="s2077157Normal"><span xml:space="preserve" class="s2077157000003"> </span></p><p dir="ltr" class="s2077157Normal"><span class="s2077157SCL">Source:</span><span xml:space="preserve" class="s2077157SCL-000004"> SL 1974, ch 321, § 19 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077158Normal { 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.s2077158SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077158CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077158Normal-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.s2077158DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077158000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077158SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077158SCL-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="s2077158Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.1"><span class="s2077158SENU">58-41-35.1</span></a><span xml:space="preserve" class="s2077158SENU">. </span><span class="s2077158CL">Alcoholism coverage to be offered at time contract is negotiated.</span></p><p dir="ltr" class="s2077158Normal-000000"><span xml:space="preserve" class="s2077158DefaultParagraphFont">At the time of negotiation of any health maintenance contract, the health maintenance organization shall offer, in writing, to provide the coverage prescribed by §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-17-30.5"><span class="s2077158DefaultParagraphFont">58-17-30.5</span></a><span xml:space="preserve" class="s2077158DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18-7.1"><span class="s2077158DefaultParagraphFont">58-18-7.1</span></a><span class="s2077158DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077158Normal"><span xml:space="preserve" class="s2077158000001"> </span></p><p dir="ltr" class="s2077158Normal"><span class="s2077158SCL">Source:</span><span xml:space="preserve" class="s2077158SCL-000002"> SL 1979, ch 344, § 12.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-35.2 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-35.2 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-35.2"> </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 --> 58-41-35.2 to 58-41-35.4. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2001, ch 274, &#167;&#167;&nbsp;10 to 12<p> </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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s5e497c8ff68e42139bb42cb448dd6b73Normal { 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.s5e497c8ff68e42139bb42cb448dd6b73SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s5e497c8ff68e42139bb42cb448dd6b73CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s5e497c8ff68e42139bb42cb448dd6b73Normal-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.s5e497c8ff68e42139bb42cb448dd6b73DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s5e497c8ff68e42139bb42cb448dd6b73Normal-000001 { 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.s5e497c8ff68e42139bb42cb448dd6b73000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s5e497c8ff68e42139bb42cb448dd6b73SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s5e497c8ff68e42139bb42cb448dd6b73SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s5e497c8ff68e42139bb42cb448dd6b73DefaultParagraphFont-000004 { 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 58-41-35.5 - Grandfathered contracts required to cover low-dose mammography--Extent of coverage."><meta property="og:description" content="SDLRC Codified Law 58-41-35.5 - Grandfathered contracts required to cover low-dose mammography--Extent of coverage."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-41-35.5"><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="s5e497c8ff68e42139bb42cb448dd6b73Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-41-35.5" rel="noopener"><span class="s5e497c8ff68e42139bb42cb448dd6b73SENU">58-41-35.5</span></a><span xml:space="preserve" class="s5e497c8ff68e42139bb42cb448dd6b73SENU">. </span><span class="s5e497c8ff68e42139bb42cb448dd6b73CL">Grandfathered contracts required to cover low-dose mammography--Extent of coverage.</span></p><p dir="ltr" class="s5e497c8ff68e42139bb42cb448dd6b73Normal-000000"><span class="s5e497c8ff68e42139bb42cb448dd6b73DefaultParagraphFont">Each health maintenance contract that covers a female and that is delivered, issued for delivery, or renewed in this state, except for a contract that provides coverage for specified disease or other limited benefit coverage, shall provide coverage for screening by low-dose mammography for the presence of occult breast cancer that is subject to the same dollar limits, deductibles, and coinsurance factors as for other radiological examinations. Coverage for the screening shall be provided as follows: ages thirty-five to thirty-nine, one baseline mammography; ages forty to forty-nine, a mammography every other year; and age fifty and older, a mammography every year.</span></p><p dir="ltr" class="s5e497c8ff68e42139bb42cb448dd6b73Normal-000001"><span class="s5e497c8ff68e42139bb42cb448dd6b73DefaultParagraphFont">As used in this section, "low-dose mammography" means the X ray examination of the breast using equipment dedicated specifically for mammography, including the X ray tube, filter, compression device, screens, films, and cassettes, with an average radiation exposure delivery of less than one rad midbreast, with two views for each breast and with interpretation by a qualified radiologist.</span></p><p dir="ltr" class="s5e497c8ff68e42139bb42cb448dd6b73Normal-000001"><span class="s5e497c8ff68e42139bb42cb448dd6b73DefaultParagraphFont">The provisions of this section apply only to grandfathered plans pursuant to 75 Fed. Reg. 116 (2010) to be codified at 26 C.F.R. §§ 54 and 602, 29 C.F.R. § 2590, and 45 C.F.R. § 147.</span></p><p dir="ltr" class="s5e497c8ff68e42139bb42cb448dd6b73Normal"><span xml:space="preserve" class="s5e497c8ff68e42139bb42cb448dd6b73000002"> </span></p><p dir="ltr" class="s5e497c8ff68e42139bb42cb448dd6b73Normal"><span class="s5e497c8ff68e42139bb42cb448dd6b73SCL">Source:</span><span xml:space="preserve" class="s5e497c8ff68e42139bb42cb448dd6b73SCL-000003"> SL 1990, ch 397, §§ 1, 7; SL 1991, ch 400, § 7; SL 2011, ch 216, § 12.</span></p><p dir="ltr" class="s5e497c8ff68e42139bb42cb448dd6b73Normal"><span xml:space="preserve" class="s5e497c8ff68e42139bb42cb448dd6b73000002"> </span></p><p dir="ltr" class="s5e497c8ff68e42139bb42cb448dd6b73Normal"><span xml:space="preserve" class="s5e497c8ff68e42139bb42cb448dd6b73DefaultParagraphFont-000004">Commission Note: </span><span class="s5e497c8ff68e42139bb42cb448dd6b73DefaultParagraphFont">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 xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077161Normal { 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.s2077161SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077161CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077161Normal-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.s2077161DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077161Normal-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.s2077161000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077161SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077161SCL-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="s2077161Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35.6"><span class="s2077161SENU">58-41-35.6</span></a><span xml:space="preserve" class="s2077161SENU">. </span><span class="s2077161CL">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="s2077161Normal-000000"><span xml:space="preserve" class="s2077161DefaultParagraphFont">A health maintenance contract 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="s2077161DefaultParagraphFont">32-23-1</span></a><span class="s2077161DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077161Normal-000001"><span class="s2077161DefaultParagraphFont">Nothing in this section precludes a health maintenance contract from excluding coverage for an insured for any sickness or injury caused in the commission of a felony.</span></p><p dir="ltr" class="s2077161Normal"><span xml:space="preserve" class="s2077161000002"> </span></p><p dir="ltr" class="s2077161Normal"><span class="s2077161SCL">Source:</span><span xml:space="preserve" class="s2077161SCL-000003"> SL 1997, ch 290, §§ 6, 7.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.se575869b59fe4b869060ac4b49c4e935Normal { 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.se575869b59fe4b869060ac4b49c4e935SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.se575869b59fe4b869060ac4b49c4e935CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.se575869b59fe4b869060ac4b49c4e935Normal-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.se575869b59fe4b869060ac4b49c4e935DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.se575869b59fe4b869060ac4b49c4e935Normal-000001 { 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.se575869b59fe4b869060ac4b49c4e935000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.se575869b59fe4b869060ac4b49c4e935SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.se575869b59fe4b869060ac4b49c4e935SCL-000003 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.se575869b59fe4b869060ac4b49c4e935DefaultParagraphFont-000004 { 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 58-41-35.7 - Contracts required to cover occult breast cancer screening."><meta property="og:description" content="SDLRC Codified Law 58-41-35.7 - Contracts required to cover occult breast cancer screening."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-41-35.7"><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="se575869b59fe4b869060ac4b49c4e935Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-41-35.7" rel="noopener"><span class="se575869b59fe4b869060ac4b49c4e935SENU">58-41-35.7</span></a><span xml:space="preserve" class="se575869b59fe4b869060ac4b49c4e935SENU">. </span><span class="se575869b59fe4b869060ac4b49c4e935CL">Contracts required to cover occult breast cancer screening.</span></p><p dir="ltr" class="se575869b59fe4b869060ac4b49c4e935Normal-000000"><span class="se575869b59fe4b869060ac4b49c4e935DefaultParagraphFont">Each health maintenance contract that covers a female and that is delivered, issued for delivery, or renewed in this state, except for a contract that provides coverage for specified disease or other limited benefit coverage, shall provide coverage for screening for the presence of occult breast cancer.</span></p><p dir="ltr" class="se575869b59fe4b869060ac4b49c4e935Normal-000001"><span class="se575869b59fe4b869060ac4b49c4e935DefaultParagraphFont">The provisions of this section apply only to plans that are not grandfathered pursuant to 75 Fed. Reg. 116 (2010) to be codified at 26 C.F.R. §§ 54 and 602, 29 C.F.R. § 2590, and 45 C.F.R. § 147.</span></p><p dir="ltr" class="se575869b59fe4b869060ac4b49c4e935Normal"><span xml:space="preserve" class="se575869b59fe4b869060ac4b49c4e935000002"> </span></p><p dir="ltr" class="se575869b59fe4b869060ac4b49c4e935Normal"><span class="se575869b59fe4b869060ac4b49c4e935SCL">Source:</span><span xml:space="preserve" class="se575869b59fe4b869060ac4b49c4e935SCL-000003"> SL 2011, ch 216, § 17.</span></p><p dir="ltr" class="se575869b59fe4b869060ac4b49c4e935Normal"><span xml:space="preserve" class="se575869b59fe4b869060ac4b49c4e935000002"> </span></p><p dir="ltr" class="se575869b59fe4b869060ac4b49c4e935Normal"><span xml:space="preserve" class="se575869b59fe4b869060ac4b49c4e935DefaultParagraphFont-000004">Commission Note: </span><span class="se575869b59fe4b869060ac4b49c4e935DefaultParagraphFont">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 xmlns="http://www.w3.org/1999/xhtml"><head><meta charset="UTF-8" /><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077163Normal { 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.s2077163SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077163CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077163Normal-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.s2077163DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077163000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077163SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077163SCL-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="s2077163Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-36"><span class="s2077163SENU">58-41-36</span></a><span xml:space="preserve" class="s2077163SENU">. </span><span class="s2077163CL">Unfair and misleading information in evidence of coverage as misdemeanor.</span></p><p dir="ltr" class="s2077163Normal-000000"><span xml:space="preserve" class="s2077163DefaultParagraphFont">No evidence of coverage shall contain provisions or statements which are unjust, unfair, inequitable, misleading, or deceptive, as defined in §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-37"><span class="s2077163DefaultParagraphFont">58-41-37</span></a><span xml:space="preserve" class="s2077163DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-40"><span class="s2077163DefaultParagraphFont">58-41-40</span></a><span class="s2077163DefaultParagraphFont">, inclusive. Violation of this section is a Class 2 misdemeanor.</span></p><p dir="ltr" class="s2077163Normal"><span xml:space="preserve" class="s2077163000001"> </span></p><p dir="ltr" class="s2077163Normal"><span class="s2077163SCL">Source:</span><span xml:space="preserve" class="s2077163SCL-000002"> SL 1974, ch 321, §§ 19 (1), 50; SDCL Supp, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077163SCL-000002">58-41-77</span></a><span class="s2077163SCL-000002">; SL 1978, ch 359, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077164Normal { 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.s2077164SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077164CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077164Normal-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.s2077164DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077164000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077164SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077164SCL-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="s2077164Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-37"><span class="s2077164SENU">58-41-37</span></a><span xml:space="preserve" class="s2077164SENU">. </span><span class="s2077164CL">Deceptive advertising or evidence of coverage as misdemeanor.</span></p><p dir="ltr" class="s2077164Normal-000000"><span class="s2077164DefaultParagraphFont">No health maintenance organization or representative thereof may cause or knowingly permit the use of advertising or solicitation which is untrue or misleading, or any form of evidence of coverage which is deceptive. Violation of this section is a Class 2 misdemeanor.</span></p><p dir="ltr" class="s2077164Normal"><span xml:space="preserve" class="s2077164000001"> </span></p><p dir="ltr" class="s2077164Normal"><span class="s2077164SCL">Source:</span><span xml:space="preserve" class="s2077164SCL-000002"> SL 1974, ch 321, §§ 32 (1), 50; SDCL, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077164SCL-000002">58-41-77</span></a><span class="s2077164SCL-000002">; SL 1978, ch 359, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077165Normal { 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.s2077165SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077165CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077165Normal-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.s2077165DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077165000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077165SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077165SCL-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="s2077165Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-38"><span class="s2077165SENU">58-41-38</span></a><span xml:space="preserve" class="s2077165SENU">. </span><span class="s2077165CL">Statements deemed untrue.</span></p><p dir="ltr" class="s2077165Normal-000000"><span class="s2077165DefaultParagraphFont">For the purposes of this chapter, a statement or item of information shall be deemed to be untrue if it does not conform to fact in any respect which is or may be significant to an enrollee of, or person considering enrollment in, a health maintenance organization.</span></p><p dir="ltr" class="s2077165Normal"><span xml:space="preserve" class="s2077165000001"> </span></p><p dir="ltr" class="s2077165Normal"><span class="s2077165SCL">Source:</span><span xml:space="preserve" class="s2077165SCL-000002"> SL 1974, ch 321, § 32 (1) (a).</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077166Normal { 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.s2077166SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077166CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077166Normal-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.s2077166DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077166000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077166SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077166SCL-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="s2077166Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-39"><span class="s2077166SENU">58-41-39</span></a><span xml:space="preserve" class="s2077166SENU">. </span><span class="s2077166CL">Statements deemed misleading.</span></p><p dir="ltr" class="s2077166Normal-000000"><span class="s2077166DefaultParagraphFont">For the purposes of this chapter, a statement or item of information shall be deemed to be misleading, whether or not it may be literally untrue, if, in the total context in which such statement is made or such item of information is communicated, such statement or item of information may be reasonably understood by a reasonable person, not possessing special knowledge regarding health care coverage, as indicating any benefit or advantage or the absence of any exclusion, limitation, or disadvantage of possible significance to an enrollee of, or person considering enrollment in, a health care plan, if such benefit or advantage or absence of limitation, exclusion, or disadvantage does not in fact exist.</span></p><p dir="ltr" class="s2077166Normal"><span xml:space="preserve" class="s2077166000001"> </span></p><p dir="ltr" class="s2077166Normal"><span class="s2077166SCL">Source:</span><span xml:space="preserve" class="s2077166SCL-000002"> SL 1974, ch 321, § 32 (1) (b).</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077167Normal { 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.s2077167SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077167CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077167Normal-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.s2077167DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077167000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077167SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077167SCL-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="s2077167Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-40"><span class="s2077167SENU">58-41-40</span></a><span xml:space="preserve" class="s2077167SENU">. </span><span class="s2077167CL">Evidence of coverage deemed deceptive.</span></p><p dir="ltr" class="s2077167Normal-000000"><span class="s2077167DefaultParagraphFont">For the purposes of this chapter, an evidence of coverage shall be deemed to be deceptive if the evidence of coverage taken as a whole, and with consideration given to typography and format, as well as language, shall be such as to cause a reasonable person, not possessing special knowledge regarding health care plans and evidences of coverage therefor, to expect benefits, services, charges, or other advantages which the evidence of coverage does not regularly make available for enrollees covered under such evidence of coverage.</span></p><p dir="ltr" class="s2077167Normal"><span xml:space="preserve" class="s2077167000001"> </span></p><p dir="ltr" class="s2077167Normal"><span class="s2077167SCL">Source:</span><span xml:space="preserve" class="s2077167SCL-000002"> SL 1974, ch 321, § 32 (1) (c).</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077168Normal { 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.s2077168SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077168CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077168Normal-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.s2077168DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077168000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077168SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077168SCL-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="s2077168Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-41"><span class="s2077168SENU">58-41-41</span></a><span xml:space="preserve" class="s2077168SENU">. </span><span class="s2077168CL">Issuance to enrollees of change in evidence of coverage.</span></p><p dir="ltr" class="s2077168Normal-000000"><span class="s2077168DefaultParagraphFont">Any approved change in evidence of coverage shall be issued to each enrollee.</span></p><p dir="ltr" class="s2077168Normal"><span xml:space="preserve" class="s2077168000001"> </span></p><p dir="ltr" class="s2077168Normal"><span class="s2077168SCL">Source:</span><span xml:space="preserve" class="s2077168SCL-000002"> SL 1974, ch 321, § 21.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077169Normal { 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.s2077169SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077169CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077169Normal-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.s2077169DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077169000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077169SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077169SCL-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="s2077169Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-42"><span class="s2077169SENU">58-41-42</span></a><span xml:space="preserve" class="s2077169SENU">. </span><span class="s2077169CL">Evidence of coverage to be approved before use--Violation as misdemeanor.</span></p><p dir="ltr" class="s2077169Normal-000000"><span class="s2077169DefaultParagraphFont">No evidence of coverage or amendment thereto shall be issued or delivered to any person in this state until a copy of the form of the evidence of coverage or amendment thereto has been filed with and approved by the director. Violation of this section is a Class 2 misdemeanor.</span></p><p dir="ltr" class="s2077169Normal"><span xml:space="preserve" class="s2077169000001"> </span></p><p dir="ltr" class="s2077169Normal"><span class="s2077169SCL">Source:</span><span xml:space="preserve" class="s2077169SCL-000002"> SL 1974, ch 321, §§ 20, 50; SDCL Supp, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077169SCL-000002">58-41-77</span></a><span class="s2077169SCL-000002">; SL 1978, ch 359, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077170Normal { 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.s2077170SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077170CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077170Normal-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.s2077170DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077170000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077170SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077170SCL-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="s2077170Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-43"><span class="s2077170SENU">58-41-43</span></a><span xml:space="preserve" class="s2077170SENU">. </span><span class="s2077170CL">Filing and approval requirements applicable.</span></p><p dir="ltr" class="s2077170Normal-000000"><span xml:space="preserve" class="s2077170DefaultParagraphFont">A copy of the form of evidence of coverage to be used in this state, and any amendment thereto, shall be subject to the filing and approval requirements of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-42"><span class="s2077170DefaultParagraphFont">58-41-42</span></a><span xml:space="preserve" class="s2077170DefaultParagraphFont"> unless it is subject to the jurisdiction of the director under the laws governing health insurance or hospital or medical service corporations in which event the filing and approval provisions of such laws shall apply. To the extent, however, that such provisions do not fulfill the requirements of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-35"><span class="s2077170DefaultParagraphFont">58-41-35</span></a><span xml:space="preserve" class="s2077170DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-36"><span class="s2077170DefaultParagraphFont">58-41-36</span></a><span class="s2077170DefaultParagraphFont">, the requirements of said sections shall be applicable.</span></p><p dir="ltr" class="s2077170Normal"><span xml:space="preserve" class="s2077170000001"> </span></p><p dir="ltr" class="s2077170Normal"><span class="s2077170SCL">Source:</span><span xml:space="preserve" class="s2077170SCL-000002"> SL 1974, ch 321, § 22.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077171Normal { 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.s2077171SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077171CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077171Normal-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.s2077171DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077171000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077171SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077171SCL-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="s2077171Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-44"><span class="s2077171SENU">58-41-44</span></a><span xml:space="preserve" class="s2077171SENU">. </span><span class="s2077171CL">Charges to enrollees--Fairness--Actuary's certificate.</span></p><p dir="ltr" class="s2077171Normal-000000"><span class="s2077171DefaultParagraphFont">Charges for comprehensive health maintenance services may be established in accordance with actuarial principles for various categories of enrollees, provided that such charges applicable to an enrollee shall not be individually determined based on the status of his health. However, the charges shall not be excessive, inadequate, or unfairly discriminatory. A certification, by a qualified actuary, to the appropriateness of the charges, based on reasonable assumptions, shall accompany the filing along with adequate supporting information.</span></p><p dir="ltr" class="s2077171Normal"><span xml:space="preserve" class="s2077171000001"> </span></p><p dir="ltr" class="s2077171Normal"><span class="s2077171SCL">Source:</span><span xml:space="preserve" class="s2077171SCL-000002"> SL 1974, ch 321, § 23 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077172Normal { 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.s2077172SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077172CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077172Normal-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.s2077172DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077172Normal-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.s2077172000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077172SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077172SCL-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="s2077172Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-45"><span class="s2077172SENU">58-41-45</span></a><span xml:space="preserve" class="s2077172SENU">. </span><span class="s2077172CL">Discrimination as misdemeanor.</span></p><p dir="ltr" class="s2077172Normal-000000"><span class="s2077172DefaultParagraphFont">No health maintenance organization or representative thereof may discriminate in the rates charged enrollees except in accordance with accepted actuarial principles.</span></p><p dir="ltr" class="s2077172Normal-000001"><span class="s2077172DefaultParagraphFont">Violation of this section is a Class 2 misdemeanor.</span></p><p dir="ltr" class="s2077172Normal"><span xml:space="preserve" class="s2077172000002"> </span></p><p dir="ltr" class="s2077172Normal"><span class="s2077172SCL">Source:</span><span xml:space="preserve" class="s2077172SCL-000003"> SL 1974, ch 321, §§ 32 (6), (7), 50; SDCL Supp, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077172SCL-000003">58-41-77</span></a><span class="s2077172SCL-000003">; SL 1978, ch 359, § 2; SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-46 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-46 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-46"> </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 --> 58-41-46 to 58-41-49. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2013, ch 256, &#167;&#167;&nbsp;12 to 15.<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077174Normal { 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.s2077174SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077174CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077174Normal-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.s2077174DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077174Normal-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.s2077174000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077174SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077174SCL-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="s2077174Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-50"><span class="s2077174SENU">58-41-50</span></a><span xml:space="preserve" class="s2077174SENU">. </span><span class="s2077174CL">Authorized expenses.</span></p><p dir="ltr" class="s2077174Normal-000000"><span class="s2077174DefaultParagraphFont">Authorized expenses of health maintenance organizations include:</span></p><p dir="ltr" class="s2077174Normal-000001"><span class="s2077174DefaultParagraphFont">(1)    Cash rebates to enrollees, or to persons who have made payments on behalf of enrollees;</span></p><p dir="ltr" class="s2077174Normal-000001"><span class="s2077174DefaultParagraphFont">(2)    Free or reduced cost health service to enrollees; or</span></p><p dir="ltr" class="s2077174Normal-000001"><span class="s2077174DefaultParagraphFont">(3)    Payments to providers or other persons based upon the efficient provision of services or as incentives to provide quality care.</span></p><p dir="ltr" class="s2077174Normal"><span xml:space="preserve" class="s2077174000002"> </span></p><p dir="ltr" class="s2077174Normal"><span class="s2077174SCL">Source:</span><span xml:space="preserve" class="s2077174SCL-000003"> SL 1974, ch 321, §§ 32 (8), 50; SDCL Supp, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077174SCL-000003">58-41-77</span></a><span class="s2077174SCL-000003">; SL 1978, ch 359, § 2; SL 1985, ch 393, § 6.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-51 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-51 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-51"> </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 --> 58-41-51. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2013, ch 256, &#167;&nbsp;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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077176Normal { 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.s2077176SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077176CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077176Normal-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.s2077176DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077176000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077176SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077176SCL-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="s2077176Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51.1"><span class="s2077176SENU">58-41-51.1</span></a><span xml:space="preserve" class="s2077176SENU">. </span><span class="s2077176CL">Individual policy required for covered spouse of insured--Eligibility--Coverage--Waiting periods.</span></p><p dir="ltr" class="s2077176Normal-000000"><span class="s2077176DefaultParagraphFont">No accident or health insurance policy providing coverage of hospital or medical expense which in addition to covering the insured also provides coverage to the spouse of the insured shall be issued without a provision that provides that upon eligibility for medicare or social security disability benefits by one spouse the other spouse shall be entitled to have issued to him or her, without evidence of insurability, upon application to the company within sixty days following the eligibility, and upon payment of the appropriate premium, an individual policy of accident or health insurance. Such policy shall provide the coverage then being issued by the insurer which is most nearly similar to the existing coverages. This obligation can be met by continuation of coverage for spouse under existing policy at the appropriate premium. Any and all probationary or waiting periods set forth in such policy shall be considered as being met to the extent coverage was in force under the prior policy.</span></p><p dir="ltr" class="s2077176Normal"><span xml:space="preserve" class="s2077176000001"> </span></p><p dir="ltr" class="s2077176Normal"><span class="s2077176SCL">Source:</span><span xml:space="preserve" class="s2077176SCL-000002"> SL 1979, ch 343.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077177Normal { 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.s2077177SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077177CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077177Normal-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.s2077177DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077177000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077177SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077177SCL-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="s2077177Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51.2"><span class="s2077177SENU">58-41-51.2</span></a><span xml:space="preserve" class="s2077177SENU">. </span><span class="s2077177CL">Conversion privileges of insured's spouse upon divorce.</span></p><p dir="ltr" class="s2077177Normal-000000"><span class="s2077177DefaultParagraphFont">No accident or health insurance policy providing coverage of hospital or medical expense which in addition to covering the insured also provides coverage to the spouse of the insured shall be issued without a provision that provides that upon divorce of the insured and the insured's spouse, the spouse is entitled to have issued to him or her, without evidence of insurability, upon application to the company within thirty days following the eligibility, and upon payment of the appropriate premium, an individual policy of accident or health insurance. Such policy shall provide the coverage then being issued by the insurer which is most nearly similar to the existing coverages. This obligation can be met by continuation of coverage for spouse under existing policy at the appropriate premium. Any and all probationary or waiting periods set forth in such policy shall be considered as being met to the extent coverage was in force under the prior policy.</span></p><p dir="ltr" class="s2077177Normal"><span xml:space="preserve" class="s2077177000001"> </span></p><p dir="ltr" class="s2077177Normal"><span class="s2077177SCL">Source:</span><span xml:space="preserve" class="s2077177SCL-000002"> SL 1980, ch 354.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077178Normal { 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.s2077178SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077178CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077178Normal-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.s2077178DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077178000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077178SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077178SCL-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="s2077178Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-51.3"><span class="s2077178SENU">58-41-51.3</span></a><span xml:space="preserve" class="s2077178SENU">. </span><span class="s2077178CL">Continuation and conversion coverage to be offered.</span></p><p dir="ltr" class="s2077178Normal-000000"><span xml:space="preserve" class="s2077178DefaultParagraphFont">At the time of negotiation of any health maintenance contract, the health maintenance organization shall offer, in writing, to provide the coverage prescribed by §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18-7.5"><span class="s2077178DefaultParagraphFont">58-18-7.5</span></a><span xml:space="preserve" class="s2077178DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18-7.15"><span class="s2077178DefaultParagraphFont">58-18-7.15</span></a><span class="s2077178DefaultParagraphFont">, inclusive.</span></p><p dir="ltr" class="s2077178Normal"><span xml:space="preserve" class="s2077178000001"> </span></p><p dir="ltr" class="s2077178Normal"><span class="s2077178SCL">Source:</span><span xml:space="preserve" class="s2077178SCL-000002"> SL 1985, ch 393, § 13.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077179Normal { 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.s2077179SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077179CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077179Normal-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.s2077179DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077179000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077179SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077179SCL-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="s2077179Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52"><span class="s2077179SENU">58-41-52</span></a><span xml:space="preserve" class="s2077179SENU">. </span><span class="s2077179CL">Contracts with providers of health care services.</span></p><p dir="ltr" class="s2077179Normal-000000"><span class="s2077179DefaultParagraphFont">A health maintenance organization may contract with providers of health care services to render the services the health maintenance organization has promised to provide under the terms of its health maintenance contracts.</span></p><p dir="ltr" class="s2077179Normal"><span xml:space="preserve" class="s2077179000001"> </span></p><p dir="ltr" class="s2077179Normal"><span class="s2077179SCL">Source:</span><span xml:space="preserve" class="s2077179SCL-000002"> SL 1974, ch 321, § 13.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title> <meta name="Generator" content="PowerTools for Open XML" /> <style>span { white-space: pre-wrap; } p.pt-Normal { 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.pt-SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.pt-Statute { 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.pt-DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } a.pt-000000 { text-decoration: none; } span.pt-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.pt-NoIndent { text-indent: 0.00in; 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.pt-DefaultParagraphFont-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-SCL { 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="pt-Normal"> <a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.1"> <span class="pt-SENU">58-41-52.1</span> </a> <span xml:space="preserve" class="pt-SENU">. </span> <span class="pt-CL">Collection for covered services prohibited.</span> </p> <p dir="ltr" class="pt-Statute"> <span xml:space="preserve" class="pt-DefaultParagraphFont">Except for coinsurance, deductibles, or copayments as specifically provided in the evidence of coverage, in no event, including nonpayment by the health maintenance organization, insolvency of the health maintenance organization, or breach of contract among the health maintenance organization, risk bearing entity, or participating provider, may a risk bearing entity or participating provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against an enrollee or a person other than the health maintenance organization acting on behalf of </span> <a id="_pagenumber31" class="pt-000000"></a> <span class="pt-DefaultParagraphFont">the enrollee for covered services provided. No risk bearing entity or participating provider, nor any agent, trustee or assignee of the risk bearing entity or participating provider may maintain an action at law against an enrollee to collect sums owed by the health maintenance organization.</span> </p> <p dir="ltr" class="pt-Normal"> <span xml:space="preserve" class="pt-000001"> </span> </p> <p dir="ltr" class="pt-NoIndent"> <span xml:space="preserve" class="pt-DefaultParagraphFont-000002">Source: </span> <span class="pt-SCL">SL 2020, ch 210, § 10.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title> <meta name="Generator" content="PowerTools for Open XML" /> <style>span { white-space: pre-wrap; } p.pt-Normal { 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.pt-SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.pt-Statute { 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.pt-DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.pt-000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.pt-NoIndent { text-indent: 0.00in; 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.pt-DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-SCL { 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="pt-Normal"> <a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.2"> <span class="pt-SENU">58-41-52.2</span> </a> <span xml:space="preserve" class="pt-SENU">. </span> <span class="pt-CL">Contracts--Hold harmless provision.</span> </p> <p dir="ltr" class="pt-Statute"> <span xml:space="preserve" class="pt-DefaultParagraphFont">All contracts among health maintenance organizations, risk bearing entities, and participating providers shall include a hold harmless provision specifying protection for enrollees consistent with §§ </span> <a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.1"> <span class="pt-DefaultParagraphFont">58-41-52.1</span> </a> <span xml:space="preserve" class="pt-DefaultParagraphFont"> to 58-41-52.3, inclusive. Any attempted waiver or amendment in a manner materially adverse to the interests of enrollees of a hold harmless provision are null and void and unenforceable. Any violation of the provisions of this section 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="pt-DefaultParagraphFont">58-33</span> </a> <span class="pt-DefaultParagraphFont">.</span> </p> <p dir="ltr" class="pt-Normal"> <span xml:space="preserve" class="pt-000000"> </span> </p> <p dir="ltr" class="pt-NoIndent"> <span xml:space="preserve" class="pt-DefaultParagraphFont-000001">Source: </span> <span class="pt-SCL">SL 2020, ch 210, § 11.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title> <meta name="Generator" content="PowerTools for Open XML" /> <style>span { white-space: pre-wrap; } p.pt-Normal { 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.pt-SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.pt-Statute { 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.pt-DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.pt-StatuteNumber1 { margin-left: 0.75in; text-indent: 0.00in; 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.pt-000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.pt-NoIndent { text-indent: 0.00in; 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.pt-DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.pt-SCL { 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="pt-Normal"> <a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.3"> <span class="pt-SENU">58-41-52.3</span> </a> <span xml:space="preserve" class="pt-SENU">. </span> <span class="pt-CL">Hold harmless provision--Language of provision.</span> </p> <p dir="ltr" class="pt-Statute"> <span xml:space="preserve" class="pt-DefaultParagraphFont">The requirements of § </span> <a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-52.2"> <span class="pt-DefaultParagraphFont">58-41-52.2</span> </a> <span xml:space="preserve" class="pt-DefaultParagraphFont"> shall be met by including a provision substantially similar to the following:</span> </p> <p dir="ltr" class="pt-StatuteNumber1"> <span class="pt-DefaultParagraphFont">Provider agrees that in no event, including but not limited to nonpayment by the health maintenance organization or intermediary organization, insolvency of the health maintenance organization or intermediary organization, or breach of this agreement, may the provider bill, charge, collect a deposit from, seek compensation, remuneration or reimbursement from, or have any recourse against an enrollee or a person (other than the health maintenance organization or intermediary organization) acting on behalf of the enrollee for covered services provided pursuant to this agreement. This agreement does not prohibit the provider from collecting coinsurance, deductibles, copayments or services in excess of limits, as specifically provided in the evidence of coverage, or fees for uncovered services delivered on a fee-for-service basis to enrollees.</span> </p> <p dir="ltr" class="pt-Normal"> <span xml:space="preserve" class="pt-000000"> </span> </p> <p dir="ltr" class="pt-NoIndent"> <span xml:space="preserve" class="pt-DefaultParagraphFont-000001">Source: </span> <span class="pt-SCL">SL 2020, ch 210, § 12.</span> </p> </div> </body> </html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-53 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-53 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-53"> </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 --> 58-41-53. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1999, ch 245, &#167;&nbsp;21<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077181Normal { 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.s2077181SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077181CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077181Normal-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.s2077181DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077181000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077181SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077181SCL-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="s2077181Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-54"><span class="s2077181SENU">58-41-54</span></a><span xml:space="preserve" class="s2077181SENU">. </span><span class="s2077181CL">Contracts with insurance companies and nonprofit health service plan corporations authorized--Limitations.</span></p><p dir="ltr" class="s2077181Normal-000000"><span xml:space="preserve" class="s2077181DefaultParagraphFont">A health maintenance organization may, subject to the limitations of subdivision 58-41-17(5) and of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-19"><span class="s2077181DefaultParagraphFont">58-41-19</span></a><span class="s2077181DefaultParagraphFont">, contract with insurance companies and nonprofit health service plan corporations for insurance, indemnity, or reimbursement of its cost of providing health care services for enrollees or against the risks incurred by the health maintenance organization and may contract with insurance companies and nonprofit health service plan corporations to insure or cover the enrollees' costs and expenses in the health maintenance organization, including the customary prepayment amount and any copayment obligations. If contracts are made with insurance companies or nonprofit health service plan corporations, such companies or corporations must be authorized to transact business in this state.</span></p><p dir="ltr" class="s2077181Normal"><span xml:space="preserve" class="s2077181000001"> </span></p><p dir="ltr" class="s2077181Normal"><span class="s2077181SCL">Source:</span><span xml:space="preserve" class="s2077181SCL-000002"> SL 1974, ch 321, §§ 13, 14.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077182Normal { 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.s2077182SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077182CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077182Normal-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.s2077182DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077182000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077182SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077182SCL-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="s2077182Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-55"><span class="s2077182SENU">58-41-55</span></a><span xml:space="preserve" class="s2077182SENU">. </span><span class="s2077182CL">Insurance contracts authorized--Group coverage--Benefit payments.</span></p><p dir="ltr" class="s2077182Normal-000000"><span xml:space="preserve" class="s2077182DefaultParagraphFont">Notwithstanding any law to the contrary, an insurer or a hospital or medical service corporation may contract with a health maintenance organization to provide insurance or similar protection against the cost of care provided through health maintenance organizations and to provide coverage in the event of the failure of the health maintenance organization to meet its obligations. The enrollees of a health maintenance organization constitute a permissible group for group coverage under the insurance laws and the health service plan corporation laws of this state. Under such contracts, the insurer or health service plan corporation may make benefit payments to health maintenance organizations for health care services rendered, or to be rendered, by providers pursuant to the health care plan. Any insurer, or health service plan corporation, licensed to do business in this state, is authorized to provide the types of coverages described in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-54"><span class="s2077182DefaultParagraphFont">58-41-54</span></a><span class="s2077182DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077182Normal"><span xml:space="preserve" class="s2077182000001"> </span></p><p dir="ltr" class="s2077182Normal"><span class="s2077182SCL">Source:</span><span xml:space="preserve" class="s2077182SCL-000002"> SL 1974, ch 321, § 35.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077183Normal { 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.s2077183SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077183CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077183Normal-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.s2077183DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077183000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077183SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077183SCL-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="s2077183Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-56"><span class="s2077183SENU">58-41-56</span></a><span xml:space="preserve" class="s2077183SENU">. </span><span class="s2077183CL">Contracts for management and administrative services authorized.</span></p><p dir="ltr" class="s2077183Normal-000000"><span class="s2077183DefaultParagraphFont">A health maintenance organization may contract with other persons for the provision of services, including, but not limited to, managerial and administration, marketing and enrolling, data processing, actuarial analysis, and billing services.</span></p><p dir="ltr" class="s2077183Normal"><span xml:space="preserve" class="s2077183000001"> </span></p><p dir="ltr" class="s2077183Normal"><span class="s2077183SCL">Source:</span><span xml:space="preserve" class="s2077183SCL-000002"> SL 1974, ch 321, § 14.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077184Normal { 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.s2077184SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077184CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077184Normal-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.s2077184DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077184000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077184SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077184SCL-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="s2077184Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-57"><span class="s2077184SENU">58-41-57</span></a><span xml:space="preserve" class="s2077184SENU">. </span><span class="s2077184CL">Payment of unreasonably high expenses as misdemeanor.</span></p><p dir="ltr" class="s2077184Normal-000000"><span class="s2077184DefaultParagraphFont">No health maintenance organization shall incur or pay for any expense of any nature which is unreasonably high in relation to the value of the service or goods provided. Violation of this section is a Class 2 misdemeanor.</span></p><p dir="ltr" class="s2077184Normal"><span xml:space="preserve" class="s2077184000001"> </span></p><p dir="ltr" class="s2077184Normal"><span class="s2077184SCL">Source:</span><span xml:space="preserve" class="s2077184SCL-000002"> SL 1974, ch 321, §§ 41, 50; SDCL Supp, § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-77"><span class="s2077184SCL-000002">58-41-77</span></a><span class="s2077184SCL-000002">; SL 1978, ch 359, § 2.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-58 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-58 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-58"> </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 --> 58-41-58 to 58-41-62. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1996, ch 296, &#167;&#167;&nbsp;9 to 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077186Normal { 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.s2077186SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077186CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077186Normal-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.s2077186DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077186Normal-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.s2077186Normal-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.s2077186000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077186SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077186SCL-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="s2077186Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-63"><span class="s2077186SENU">58-41-63</span></a><span xml:space="preserve" class="s2077186SENU">. </span><span class="s2077186CL">General annual report required--Form and contents.</span></p><p dir="ltr" class="s2077186Normal-000000"><span class="s2077186DefaultParagraphFont">Every health maintenance organization shall annually, on or before March first, file a report verified by at least two principal officers with the director, covering the preceding calendar year. Such report shall be on forms prescribed by the director and shall include:</span></p><p dir="ltr" class="s2077186Normal-000001"><span class="s2077186DefaultParagraphFont">(1)    A financial statement of the organization, including its balance sheet and receipts and disbursements for the preceding year certified by an independent certified public accountant licensed by an appropriate jurisdiction, reflecting at least:</span></p><p dir="ltr" class="s2077186Normal-000002"><span class="s2077186DefaultParagraphFont">(a)    Prepayment and other payments received for health care services rendered;</span></p><p dir="ltr" class="s2077186Normal-000002"><span class="s2077186DefaultParagraphFont">(b)    Expenditures to all providers, by classes or groups of providers, and insurance companies or nonprofit health service plan corporations engaged to fulfill obligations arising out of the health maintenance contract; and</span></p><p dir="ltr" class="s2077186Normal-000002"><span class="s2077186DefaultParagraphFont">(c)    Expenditures for capital improvements, or additions thereto, including but not limited to construction, renovation or purchase of facilities and capital equipment;</span></p><p dir="ltr" class="s2077186Normal-000001"><span xml:space="preserve" class="s2077186DefaultParagraphFont">(2)    Any material changes in the information submitted pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-6"><span class="s2077186DefaultParagraphFont">58-41-6</span></a><span xml:space="preserve" class="s2077186DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-9"><span class="s2077186DefaultParagraphFont">58-41-9</span></a><span class="s2077186DefaultParagraphFont">, inclusive;</span></p><p dir="ltr" class="s2077186Normal-000001"><span class="s2077186DefaultParagraphFont">(3)    The number of new enrollees enrolled during the year, the number of enrollees as of the end of the year and the number of enrollees terminated during the year;</span></p><p dir="ltr" class="s2077186Normal-000001"><span class="s2077186DefaultParagraphFont">(4)    A summary of information compiled pursuant to subdivision 58-41-12(3) on such form as may be required by the director;</span></p><p dir="ltr" class="s2077186Normal-000001"><span class="s2077186DefaultParagraphFont">(5)    A report of the names and residence addresses of all persons set forth in subdivision 58-41-6(3), who were associated with the health maintenance organization during the preceding year, and the amount of wages, expense reimbursements, or other payments to such individuals for services to the health maintenance organization, including a full disclosure of all financial arrangements during the preceding year required to be disclosed pursuant to subdivision 58-41-6(3); and</span></p><p dir="ltr" class="s2077186Normal-000001"><span class="s2077186DefaultParagraphFont">(6)    Such other information relating to the performance of the health maintenance organization as is reasonably necessary to enable the director to carry out his duties under this chapter.</span></p><p dir="ltr" class="s2077186Normal"><span xml:space="preserve" class="s2077186000003"> </span></p><p dir="ltr" class="s2077186Normal"><span class="s2077186SCL">Source:</span><span xml:space="preserve" class="s2077186SCL-000004"> SL 1974, ch 321, § 24; SL 2013, ch 256, § 17.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-64 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-64 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-64"> </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 --> 58-41-64. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1985, ch 393, &#167;&nbsp;10<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077188Normal { 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.s2077188SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077188CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077188Normal-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.s2077188DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077188000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077188SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077188SCL-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="s2077188Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-65"><span class="s2077188SENU">58-41-65</span></a><span xml:space="preserve" class="s2077188SENU">. </span><span class="s2077188CL">Applications, filings and reports as public documents.</span></p><p dir="ltr" class="s2077188Normal-000000"><span xml:space="preserve" class="s2077188DefaultParagraphFont">All applications, filings, and reports required under this chapter are public documents except as provided for by § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-27-30"><span class="s2077188DefaultParagraphFont">1-27-30</span></a><span class="s2077188DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077188Normal"><span xml:space="preserve" class="s2077188000001"> </span></p><p dir="ltr" class="s2077188Normal"><span class="s2077188SCL">Source:</span><span xml:space="preserve" class="s2077188SCL-000002"> SL 1974, ch 321, § 57; SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077189Normal { 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.s2077189SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077189CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077189Normal-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.s2077189DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077189Normal-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.s2077189000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077189SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077189SCL-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="s2077189Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-66"><span class="s2077189SENU">58-41-66</span></a><span xml:space="preserve" class="s2077189SENU">. </span><span class="s2077189CL">Annual summary for enrollees required--Contents.</span></p><p dir="ltr" class="s2077189Normal-000000"><span class="s2077189DefaultParagraphFont">Every health maintenance organization or its representative shall annually, before April first, provide to its enrollees a summary of:</span></p><p dir="ltr" class="s2077189Normal-000001"><span class="s2077189DefaultParagraphFont">(1)    Its most recent annual financial statement, including a balance sheet and statement of receipts and disbursements;</span></p><p dir="ltr" class="s2077189Normal-000001"><span class="s2077189DefaultParagraphFont">(2)    A description of the health maintenance organization, its health care plan or plans, its facilities and personnel, and any material changes therein since the last report;</span></p><p dir="ltr" class="s2077189Normal-000001"><span class="s2077189DefaultParagraphFont">(3)    The current evidence of coverage; and</span></p><p dir="ltr" class="s2077189Normal-000001"><span class="s2077189DefaultParagraphFont">(4)    The health maintenance organization's method for resolving enrollee complaints.</span></p><p dir="ltr" class="s2077189Normal"><span xml:space="preserve" class="s2077189000002"> </span></p><p dir="ltr" class="s2077189Normal"><span class="s2077189SCL">Source:</span><span xml:space="preserve" class="s2077189SCL-000003"> SL 1974, ch 321, § 25.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077190Normal { 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.s2077190SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077190CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077190Normal-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.s2077190DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077190000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077190SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077190SCL-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="s2077190Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-67"><span class="s2077190SENU">58-41-67</span></a><span xml:space="preserve" class="s2077190SENU">. </span><span class="s2077190CL">Promulgation of rules.</span></p><p dir="ltr" class="s2077190Normal-000000"><span xml:space="preserve" class="s2077190DefaultParagraphFont">The director may, pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2077190DefaultParagraphFont">1-26</span></a><span class="s2077190DefaultParagraphFont">, promulgate such reasonable rules as are necessary to carry out the provisions of this chapter. Included among such rules shall be those which provide minimum requirements for the provision of comprehensive health maintenance services, as defined in subdivision 58-41-1(1), and reasonable exclusions therefrom.</span></p><p dir="ltr" class="s2077190Normal"><span xml:space="preserve" class="s2077190000001"> </span></p><p dir="ltr" class="s2077190Normal"><span class="s2077190SCL">Source:</span><span xml:space="preserve" class="s2077190SCL-000002"> SL 1974, ch 321, § 42; SL 1986, ch 22, § 43; SL 2013, ch 256, § 19.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-68 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-68 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-68"> </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 --> 58-41-68 to 58-41-72. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2013, ch 256, &#167;&#167;&nbsp;20 to 24.<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077192Normal { 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.s2077192SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077192CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077192CL-000000 { font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077192Normal-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.s2077192DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077192000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077192SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077192SCL-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="s2077192Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-73"><span class="s2077192SENU">58-41-73</span></a><span xml:space="preserve" class="s2077192SENU">. </span><span class="s2077192CL">Physician</span><span class="s2077192CL-000000">-</span><span class="s2077192CL">patient privileges.</span></p><p dir="ltr" class="s2077192Normal-000001"><span class="s2077192DefaultParagraphFont">A health maintenance organization shall be entitled to claim any statutory privileges against such disclosure which the provider who furnished such information to the health maintenance organization is entitled to claim.</span></p><p dir="ltr" class="s2077192Normal"><span xml:space="preserve" class="s2077192000002"> </span></p><p dir="ltr" class="s2077192Normal"><span class="s2077192SCL">Source:</span><span xml:space="preserve" class="s2077192SCL-000003"> SL 1974, ch 321, § 36 (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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077193Normal { 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.s2077193SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077193CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077193Normal-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.s2077193DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077193Normal-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.s2077193000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077193SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077193SCL-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="s2077193Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-74"><span class="s2077193SENU">58-41-74</span></a><span xml:space="preserve" class="s2077193SENU">. </span><span class="s2077193CL">Confidential data--Exceptions.</span></p><p dir="ltr" class="s2077193Normal-000000"><span class="s2077193DefaultParagraphFont">Any data or information pertaining to the diagnosis, treatment, or health of any enrollee, or any application obtained from any person, shall be confidential and shall not be disclosed to any person except:</span></p><p dir="ltr" class="s2077193Normal-000001"><span class="s2077193DefaultParagraphFont">(1)    To the extent that it may be necessary to carry out the purposes of this chapter;</span></p><p dir="ltr" class="s2077193Normal-000001"><span class="s2077193DefaultParagraphFont">(2)    Upon the express consent of the enrollee or applicant;</span></p><p dir="ltr" class="s2077193Normal-000001"><span class="s2077193DefaultParagraphFont">(3)    Pursuant to statute or court order for the production of evidence or the discovery thereof; or</span></p><p dir="ltr" class="s2077193Normal-000001"><span class="s2077193DefaultParagraphFont">(4)    In the event of a claim or litigation between such person and the provider or health maintenance organization wherein such data or information is pertinent.</span></p><p dir="ltr" class="s2077193Normal"><span xml:space="preserve" class="s2077193000002"> </span></p><p dir="ltr" class="s2077193Normal"><span class="s2077193SCL">Source:</span><span xml:space="preserve" class="s2077193SCL-000003"> SL 1974, ch 321, § 36 (5).</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-75 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-75 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-75"> </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 --> 58-41-75, 58-41-76. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2013, ch 256, &#167;&#167;&nbsp;25, 26.<p> </BODY> </HTML> <br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-77 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-77 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-77"> </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 --> 58-41-77. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 1978, ch 359, &#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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077196Normal { 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.s2077196SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077196CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077196Normal-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.s2077196DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077196000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077196SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077196SCL-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="s2077196Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-78"><span class="s2077196SENU">58-41-78</span></a><span xml:space="preserve" class="s2077196SENU">. </span><span class="s2077196CL">Cease and desist orders.</span></p><p dir="ltr" class="s2077196Normal-000000"><span class="s2077196DefaultParagraphFont">The director may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provision of this chapter.</span></p><p dir="ltr" class="s2077196Normal"><span xml:space="preserve" class="s2077196000001"> </span></p><p dir="ltr" class="s2077196Normal"><span class="s2077196SCL">Source:</span><span xml:space="preserve" class="s2077196SCL-000002"> SL 1974, ch 321, § 47.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077197Normal { 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.s2077197SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077197CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077197Normal-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.s2077197DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077197000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077197SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077197SCL-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="s2077197Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-79"><span class="s2077197SENU">58-41-79</span></a><span xml:space="preserve" class="s2077197SENU">. </span><span class="s2077197CL">Hearing on cease and desist order--Procedure--Judicial review.</span></p><p dir="ltr" class="s2077197Normal-000000"><span xml:space="preserve" class="s2077197DefaultParagraphFont">Within twenty days after service of the order to cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred. Such hearings shall be conducted pursuant to, and judicial review shall be available as provided by, chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2077197DefaultParagraphFont">1-26</span></a><span class="s2077197DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077197Normal"><span xml:space="preserve" class="s2077197000001"> </span></p><p dir="ltr" class="s2077197Normal"><span class="s2077197SCL">Source:</span><span xml:space="preserve" class="s2077197SCL-000002"> SL 1974, ch 321, § 48.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077198Normal { 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.s2077198SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077198CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077198Normal-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.s2077198DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077198000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077198SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077198SCL-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="s2077198Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-80"><span class="s2077198SENU">58-41-80</span></a><span xml:space="preserve" class="s2077198SENU">. </span><span class="s2077198CL">Injunctive relief against violations--Venue.</span></p><p dir="ltr" class="s2077198Normal-000000"><span xml:space="preserve" class="s2077198DefaultParagraphFont">In the event of any violation of the provisions of this chapter, if the director elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order pursuant to § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-79"><span class="s2077198DefaultParagraphFont">58-41-79</span></a><span class="s2077198DefaultParagraphFont">, the director may institute a proceeding to obtain injunctive relief or other appropriate relief in the circuit court serving Hughes County.</span></p><p dir="ltr" class="s2077198Normal"><span xml:space="preserve" class="s2077198000001"> </span></p><p dir="ltr" class="s2077198Normal"><span class="s2077198SCL">Source:</span><span xml:space="preserve" class="s2077198SCL-000002"> SL 1974, ch 321, § 49.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077199Normal { 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.s2077199SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077199CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077199Normal-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.s2077199DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077199Normal-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.s2077199000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077199SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077199SCL-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="s2077199Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-81"><span class="s2077199SENU">58-41-81</span></a><span xml:space="preserve" class="s2077199SENU">. </span><span class="s2077199CL">Suspension or revocation of certificate of authority on findings by director.</span></p><p dir="ltr" class="s2077199Normal-000000"><span class="s2077199DefaultParagraphFont">The director may suspend or revoke any certificate of authority issued to a health maintenance organization under this chapter if the director finds that any of the following conditions exists:</span></p><p dir="ltr" class="s2077199Normal-000001"><span class="s2077199DefaultParagraphFont">(1)    The health maintenance organization is operating significantly in contravention of its basic organizational document, its health maintenance contract, or in a manner contrary to that described in and reasonably inferred from any other information submitted under this chapter, unless amendments to such submissions have been filed with and approved by the director;</span></p><p dir="ltr" class="s2077199Normal-000001"><span xml:space="preserve" class="s2077199DefaultParagraphFont">(2)    The health maintenance organization issues evidence of coverage or uses a schedule or charges for health care services which do not comply with the requirements of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-34"><span class="s2077199DefaultParagraphFont">58-41-34</span></a><span xml:space="preserve" class="s2077199DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-45"><span class="s2077199DefaultParagraphFont">58-41-45</span></a><span class="s2077199DefaultParagraphFont">, inclusive;</span></p><p dir="ltr" class="s2077199Normal-000001"><span class="s2077199DefaultParagraphFont">(3)    The health care plan does not provide or arrange for comprehensive health maintenance services;</span></p><p dir="ltr" class="s2077199Normal-000001"><span class="s2077199DefaultParagraphFont">(4)    The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;</span></p><p dir="ltr" class="s2077199Normal-000001"><span xml:space="preserve" class="s2077199DefaultParagraphFont">(5)    The health maintenance organization has failed to implement a mechanism affording the enrollees an opportunity to participate in matters of policy and operation under the provisions of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-23"><span class="s2077199DefaultParagraphFont">58-41-23</span></a><span xml:space="preserve" class="s2077199DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-24"><span class="s2077199DefaultParagraphFont">58-41-24</span></a><span class="s2077199DefaultParagraphFont">;</span></p><p dir="ltr" class="s2077199Normal-000001"><span class="s2077199DefaultParagraphFont">(6)    The health maintenance organization has failed to implement the complaint system in a manner designed to reasonably resolve valid complaints;</span></p><p dir="ltr" class="s2077199Normal-000001"><span class="s2077199DefaultParagraphFont">(7)    The health maintenance organization, or any person acting with its sanction, has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner;</span></p><p dir="ltr" class="s2077199Normal-000001"><span class="s2077199DefaultParagraphFont">(8)    The continued operation of the health maintenance organization would be hazardous to its enrollees; or</span></p><p dir="ltr" class="s2077199Normal-000001"><span xml:space="preserve" class="s2077199DefaultParagraphFont">(9)    The health maintenance organization has otherwise failed to substantially comply with this chapter, has violated a provision of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-33"><span class="s2077199DefaultParagraphFont">58-33</span></a><span xml:space="preserve" class="s2077199DefaultParagraphFont"> or any other provision of law applicable to health maintenance organizations, or has submitted false information in any report required hereunder.</span></p><p dir="ltr" class="s2077199Normal"><span xml:space="preserve" class="s2077199000002"> </span></p><p dir="ltr" class="s2077199Normal"><span class="s2077199SCL">Source:</span><span xml:space="preserve" class="s2077199SCL-000003"> SL 1974, ch 321, § 37; SL 2000, ch 235, § 3; SL 2013, ch 256, § 27.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077200Normal { 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.s2077200SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077200CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077200Normal-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.s2077200DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077200Normal-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.s2077200000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077200SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077200SCL-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="s2077200Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-82"><span class="s2077200SENU">58-41-82</span></a><span xml:space="preserve" class="s2077200SENU">. </span><span class="s2077200CL">Additional grounds for suspension or revocation.</span></p><p dir="ltr" class="s2077200Normal-000000"><span class="s2077200DefaultParagraphFont">The director may suspend or revoke any certificate of authority issued to a health maintenance organization under this chapter if:</span></p><p dir="ltr" class="s2077200Normal-000001"><span xml:space="preserve" class="s2077200DefaultParagraphFont">(1)    The health maintenance organization does not meet the requirements of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-12"><span class="s2077200DefaultParagraphFont">58-41-12</span></a><span class="s2077200DefaultParagraphFont">; or</span></p><p dir="ltr" class="s2077200Normal-000001"><span class="s2077200DefaultParagraphFont">(2)    The health maintenance organization is unable to fulfill its obligations to furnish comprehensive health maintenance services as required under its health maintenance contract.</span></p><p dir="ltr" class="s2077200Normal"><span xml:space="preserve" class="s2077200000002"> </span></p><p dir="ltr" class="s2077200Normal"><span class="s2077200SCL">Source:</span><span xml:space="preserve" class="s2077200SCL-000003"> SL 1974, ch 321, § 37 (4); SL 2013, ch 256, § 28.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077201Normal { 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.s2077201SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077201CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077201Normal-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.s2077201DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077201000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077201SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077201SCL-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="s2077201Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-83"><span class="s2077201SENU">58-41-83</span></a><span xml:space="preserve" class="s2077201SENU">. </span><span class="s2077201CL">Voluntary conference before commencing actions for violation.</span></p><p dir="ltr" class="s2077201Normal-000000"><span xml:space="preserve" class="s2077201DefaultParagraphFont">If the director, for any reason, has cause to believe that any violation of this chapter has occurred or is threatened, the director may, before commencing action under § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-81"><span class="s2077201DefaultParagraphFont">58-41-81</span></a><span xml:space="preserve" class="s2077201DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-82"><span class="s2077201DefaultParagraphFont">58-41-82</span></a><span xml:space="preserve" class="s2077201DefaultParagraphFont">, </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-85"><span class="s2077201DefaultParagraphFont">58-41-85</span></a><span xml:space="preserve" class="s2077201DefaultParagraphFont">, or </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-87"><span class="s2077201DefaultParagraphFont">58-41-87</span></a><span class="s2077201DefaultParagraphFont">, give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violations, to arrange a voluntary conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the fact that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation.</span></p><p dir="ltr" class="s2077201Normal"><span xml:space="preserve" class="s2077201000001"> </span></p><p dir="ltr" class="s2077201Normal"><span class="s2077201SCL">Source:</span><span xml:space="preserve" class="s2077201SCL-000002"> SL 1974, ch 321, § 45; SL 2013, ch 256, § 29.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077202Normal { 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.s2077202SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077202CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077202Normal-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.s2077202DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077202000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077202SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077202SCL-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="s2077202Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-84"><span class="s2077202SENU">58-41-84</span></a><span xml:space="preserve" class="s2077202SENU">. </span><span class="s2077202CL">Informality in voluntary conferences.</span></p><p dir="ltr" class="s2077202Normal-000000"><span xml:space="preserve" class="s2077202DefaultParagraphFont">Proceedings under § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-83"><span class="s2077202DefaultParagraphFont">58-41-83</span></a><span xml:space="preserve" class="s2077202DefaultParagraphFont"> are not governed by any formal procedural requirements, and may be conducted in such manner as the director finds appropriate under the circumstances.</span></p><p dir="ltr" class="s2077202Normal"><span xml:space="preserve" class="s2077202000001"> </span></p><p dir="ltr" class="s2077202Normal"><span class="s2077202SCL">Source:</span><span xml:space="preserve" class="s2077202SCL-000002"> SL 1974, ch 321, § 46; SL 2013, ch 256, § 30.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077203Normal { 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.s2077203SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077203CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077203Normal-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.s2077203DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077203000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077203SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077203SCL-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="s2077203Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-85"><span class="s2077203SENU">58-41-85</span></a><span xml:space="preserve" class="s2077203SENU">. </span><span class="s2077203CL">Money penalty in lieu of suspension or revocation.</span></p><p dir="ltr" class="s2077203Normal-000000"><span xml:space="preserve" class="s2077203DefaultParagraphFont">The director may, in lieu of suspension or revocation of a certificate of authority under </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-81"><span class="s2077203DefaultParagraphFont">58-41-81</span></a><span xml:space="preserve" class="s2077203DefaultParagraphFont"> or </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-82"><span class="s2077203DefaultParagraphFont">58-41-82</span></a><span xml:space="preserve" class="s2077203DefaultParagraphFont">, levy a money penalty pursuant to § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-4-28.1"><span class="s2077203DefaultParagraphFont">58-4-28.1</span></a><span class="s2077203DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077203Normal"><span xml:space="preserve" class="s2077203000001"> </span></p><p dir="ltr" class="s2077203Normal"><span class="s2077203SCL">Source:</span><span xml:space="preserve" class="s2077203SCL-000002"> SL 1974, ch 321, § 44; SL 2000, ch 235, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077204Normal { 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.s2077204SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077204CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077204Normal-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.s2077204DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077204000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077204SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077204SCL-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="s2077204Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-86"><span class="s2077204SENU">58-41-86</span></a><span xml:space="preserve" class="s2077204SENU">. </span><span class="s2077204CL">Requirements for suspension or revocation.</span></p><p dir="ltr" class="s2077204Normal-000000"><span xml:space="preserve" class="s2077204DefaultParagraphFont">A certificate of authority shall be suspended or revoked only after compliance with the requirements of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-87"><span class="s2077204DefaultParagraphFont">58-41-87</span></a><span xml:space="preserve" class="s2077204DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-91"><span class="s2077204DefaultParagraphFont">58-41-91</span></a><span class="s2077204DefaultParagraphFont">, inclusive.</span></p><p dir="ltr" class="s2077204Normal"><span xml:space="preserve" class="s2077204000001"> </span></p><p dir="ltr" class="s2077204Normal"><span class="s2077204SCL">Source:</span><span xml:space="preserve" class="s2077204SCL-000002"> SL 1974, ch 321, § 37.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077205Normal { 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.s2077205SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077205CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077205Normal-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.s2077205DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077205000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077205SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077205SCL-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="s2077205Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-86.1"><span class="s2077205SENU">58-41-86.1</span></a><span xml:space="preserve" class="s2077205SENU">. </span><span class="s2077205CL">Suspension without notice or hearing.</span></p><p dir="ltr" class="s2077205Normal-000000"><span xml:space="preserve" class="s2077205DefaultParagraphFont">The director of the Division of Insurance may, without advance notice or a hearing thereon, immediately suspend the certificate of authority of a health maintenance organization as to which proceedings for receivership, conservatorship, rehabilitation, or other delinquency proceedings have been commenced in any state by the public supervisory official of such state. Proceedings in such actions shall be conducted in accordance with §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-6-49"><span class="s2077205DefaultParagraphFont">58-6-49</span></a><span xml:space="preserve" class="s2077205DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-6-61"><span class="s2077205DefaultParagraphFont">58-6-61</span></a><span class="s2077205DefaultParagraphFont">, inclusive.</span></p><p dir="ltr" class="s2077205Normal"><span xml:space="preserve" class="s2077205000001"> </span></p><p dir="ltr" class="s2077205Normal"><span class="s2077205SCL">Source:</span><span xml:space="preserve" class="s2077205SCL-000002"> SL 1985, ch 393, § 12.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077206Normal { 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.s2077206SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077206CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077206Normal-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.s2077206DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077206000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077206SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077206SCL-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="s2077206Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-87"><span class="s2077206SENU">58-41-87</span></a><span xml:space="preserve" class="s2077206SENU">. </span><span class="s2077206CL">Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted.</span></p><p dir="ltr" class="s2077206Normal-000000"><span xml:space="preserve" class="s2077206DefaultParagraphFont">If the director has cause to believe that grounds for the denial of an application for a certificate of authority exist, or that grounds for the suspension or revocation of a certificate of authority exist, the director shall notify the health maintenance organization in writing specifically stating the grounds for denial, suspension, or revocation and fixing a time of at least twenty days thereafter for a hearing on the matter, except in summary proceedings as provided in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-94"><span class="s2077206DefaultParagraphFont">58-41-94</span></a><span class="s2077206DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077206Normal"><span xml:space="preserve" class="s2077206000001"> </span></p><p dir="ltr" class="s2077206Normal"><span class="s2077206SCL">Source:</span><span xml:space="preserve" class="s2077206SCL-000002"> SL 1974, ch 321, § 39; SL 2013, ch 256, § 31.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077207Normal { 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.s2077207SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077207CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077207Normal-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.s2077207DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077207000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077207SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077207SCL-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="s2077207Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-88"><span class="s2077207SENU">58-41-88</span></a><span xml:space="preserve" class="s2077207SENU">. </span><span class="s2077207CL">Administrative procedure and rules.</span></p><p dir="ltr" class="s2077207Normal-000000"><span xml:space="preserve" class="s2077207DefaultParagraphFont">The provisions of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=1-26"><span class="s2077207DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2077207DefaultParagraphFont">, including the right of judicial review, apply to proceedings under §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-85"><span class="s2077207DefaultParagraphFont">58-41-85</span></a><span xml:space="preserve" class="s2077207DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-91"><span class="s2077207DefaultParagraphFont">58-41-91</span></a><span class="s2077207DefaultParagraphFont">, inclusive, to the extent those provisions are not in conflict with other provisions of such sections.</span></p><p dir="ltr" class="s2077207Normal"><span xml:space="preserve" class="s2077207000001"> </span></p><p dir="ltr" class="s2077207Normal"><span class="s2077207SCL">Source:</span><span xml:space="preserve" class="s2077207SCL-000002"> SL 1974, ch 321, § 39 (4); SL 2000, ch 235, § 5.</span></p></div></body></html><br /><hr><br /> <HTML> <HEAD> <HTML> <HEAD> <meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-41 - HEALTH MAINTENANCE ORGANIZATIONS58-41-89 </title> <META NAME="Keywords" Content="South Dakota Codified Laws SDCL 58-41-89 "> <META NAME="Description" Content="South Dakota Codified Laws 58-41-89"> </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 --> 58-41-89. <!-- WP Paired Style Off: SENU -->&nbsp;<!-- WP Style End: SENU --> Repealed by SL 2013, ch 256, &#167;&nbsp;32.<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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077209Normal { 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.s2077209SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077209CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077209Normal-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.s2077209DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077209000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077209SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077209SCL-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="s2077209Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-90"><span class="s2077209SENU">58-41-90</span></a><span xml:space="preserve" class="s2077209SENU">. </span><span class="s2077209CL">Action of director after hearing--Written findings.</span></p><p dir="ltr" class="s2077209Normal-000000"><span xml:space="preserve" class="s2077209DefaultParagraphFont">After hearing pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-87"><span class="s2077209DefaultParagraphFont">58-41-87</span></a><span xml:space="preserve" class="s2077209DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-88"><span class="s2077209DefaultParagraphFont">58-41-88</span></a><span class="s2077209DefaultParagraphFont">, or upon the failure of the health maintenance organization to appear at such hearing, the director shall take action as is deemed advisable on written findings which shall be mailed to the health maintenance organization.</span></p><p dir="ltr" class="s2077209Normal"><span xml:space="preserve" class="s2077209000001"> </span></p><p dir="ltr" class="s2077209Normal"><span class="s2077209SCL">Source:</span><span xml:space="preserve" class="s2077209SCL-000002"> SL 1974, ch 321, § 39 (2); SL 2013, ch 256, § 33.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077210Normal { 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.s2077210SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077210CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077210Normal-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.s2077210DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077210000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077210SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077210SCL-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="s2077210Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-91"><span class="s2077210SENU">58-41-91</span></a><span xml:space="preserve" class="s2077210SENU">. </span><span class="s2077210CL">Judicial review.</span></p><p dir="ltr" class="s2077210Normal-000000"><span class="s2077210DefaultParagraphFont">The action of the director is subject to the court of primary jurisdiction for claims of the nature and magnitude described. The court may, in disposing of the issue before it, modify, affirm, or reverse the order of the director in whole or in part.</span></p><p dir="ltr" class="s2077210Normal"><span xml:space="preserve" class="s2077210000001"> </span></p><p dir="ltr" class="s2077210Normal"><span class="s2077210SCL">Source:</span><span xml:space="preserve" class="s2077210SCL-000002"> SL 1974, ch 321, § 39 (3); SL 2013, ch 256, § 34.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077211Normal { 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.s2077211SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077211CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077211Normal-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.s2077211DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077211000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077211SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077211SCL-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="s2077211Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-92"><span class="s2077211SENU">58-41-92</span></a><span xml:space="preserve" class="s2077211SENU">. </span><span class="s2077211CL">Activities prohibited during suspension of certificate.</span></p><p dir="ltr" class="s2077211Normal-000000"><span xml:space="preserve" class="s2077211DefaultParagraphFont">When the certificate of authority of a health maintenance organization is suspended, the health maintenance organization may not, during the period of such suspension, enroll any additional enrollees except newborn children or other newly acquired dependents of existing enrollees, and may not engage in any advertising or solicitation whatsoever. A health maintenance organization may not enroll such additional enrollees if it is suspended on those grounds in subdivisions 58-41-81(4) and (8) and § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-86.1"><span class="s2077211DefaultParagraphFont">58-41-86.1</span></a><span class="s2077211DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077211Normal"><span xml:space="preserve" class="s2077211000001"> </span></p><p dir="ltr" class="s2077211Normal"><span class="s2077211SCL">Source:</span><span xml:space="preserve" class="s2077211SCL-000002"> SL 1974, ch 321, § 38; SL 1985, ch 393, § 11.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077212Normal { 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.s2077212SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077212CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077212Normal-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.s2077212DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077212000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077212SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077212SCL-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="s2077212Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-93"><span class="s2077212SENU">58-41-93</span></a><span xml:space="preserve" class="s2077212SENU">. </span><span class="s2077212CL">Winding up after revocation of certificate--Continued operation to protect enrollees.</span></p><p dir="ltr" class="s2077212Normal-000000"><span class="s2077212DefaultParagraphFont">When the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs, and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It shall engage in no further advertising or solicitation whatsoever. The director may, by written order, permit further operation of the organization as he may find to be in the best interest of enrollees, to the end that enrollees will be afforded the greatest practical opportunity to obtain continuing health care coverage.</span></p><p dir="ltr" class="s2077212Normal"><span xml:space="preserve" class="s2077212000001"> </span></p><p dir="ltr" class="s2077212Normal"><span class="s2077212SCL">Source:</span><span xml:space="preserve" class="s2077212SCL-000002"> SL 1974, ch 321, § 38.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077213Normal { 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.s2077213SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077213CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077213Normal-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.s2077213DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077213000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077213SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077213SCL-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="s2077213Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-94"><span class="s2077213SENU">58-41-94</span></a><span xml:space="preserve" class="s2077213SENU">. </span><span class="s2077213CL">Summary proceeding to reorganize organization--Grounds.</span></p><p dir="ltr" class="s2077213Normal-000000"><span xml:space="preserve" class="s2077213DefaultParagraphFont">The director may apply for an order directing him to rehabilitate, liquidate, or conserve a health maintenance organization upon any one or more of the grounds set out in chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29B"><span class="s2077213DefaultParagraphFont">58-29B</span></a><span class="s2077213DefaultParagraphFont">, or when in his opinion the continued operation of the health maintenance organization would be hazardous either to the enrollees or the people of this state.</span></p><p dir="ltr" class="s2077213Normal"><span xml:space="preserve" class="s2077213000001"> </span></p><p dir="ltr" class="s2077213Normal"><span class="s2077213SCL">Source:</span><span xml:space="preserve" class="s2077213SCL-000002"> SL 1974, ch 321, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077214Normal { 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.s2077214SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077214CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077214Normal-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.s2077214DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077214000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077214SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077214SCL-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="s2077214Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-95"><span class="s2077214SENU">58-41-95</span></a><span xml:space="preserve" class="s2077214SENU">. </span><span class="s2077214CL">Rehabilitation, liquidation, or conservation under insurance company laws.</span></p><p dir="ltr" class="s2077214Normal-000000"><span xml:space="preserve" class="s2077214DefaultParagraphFont">Any rehabilitation, liquidation, or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance company and shall be conducted under the supervision of the director pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-29B"><span class="s2077214DefaultParagraphFont">58-29B</span></a><span class="s2077214DefaultParagraphFont">, except to the extent that the nature of health maintenance organizations renders such law clearly inappropriate.</span></p><p dir="ltr" class="s2077214Normal"><span xml:space="preserve" class="s2077214000001"> </span></p><p dir="ltr" class="s2077214Normal"><span class="s2077214SCL">Source:</span><span xml:space="preserve" class="s2077214SCL-000002"> SL 1974, ch 321, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077215Normal { 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.s2077215SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077215CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077215Normal-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.s2077215DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077215000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077215SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077215SCL-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="s2077215Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-96"><span class="s2077215SENU">58-41-96</span></a><span xml:space="preserve" class="s2077215SENU">. </span><span class="s2077215CL">Severability of provisions.</span></p><p dir="ltr" class="s2077215Normal-000000"><span class="s2077215DefaultParagraphFont">If a part of this chapter is invalid, all valid parts that are severable from the invalid part remain in effect. If a part of this chapter is invalid in one or more of its applications, the part remains in effect in all valid applications that are severable from the invalid applications.</span></p><p dir="ltr" class="s2077215Normal"><span xml:space="preserve" class="s2077215000001"> </span></p><p dir="ltr" class="s2077215Normal"><span class="s2077215SCL">Source:</span><span xml:space="preserve" class="s2077215SCL-000002"> SL 1974, ch 321, § 58.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077216Normal { 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.s2077216SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077216CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077216Normal-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.s2077216DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077216000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077216SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077216SCL-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="s2077216Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-97"><span class="s2077216SENU">58-41-97</span></a><span xml:space="preserve" class="s2077216SENU">. </span><span class="s2077216CL">Citation of chapter.</span></p><p dir="ltr" class="s2077216Normal-000000"><span class="s2077216DefaultParagraphFont">This chapter may be cited as the "Health Maintenance Organization Act of 1974."</span></p><p dir="ltr" class="s2077216Normal"><span xml:space="preserve" class="s2077216000001"> </span></p><p dir="ltr" class="s2077216Normal"><span class="s2077216SCL">Source:</span><span xml:space="preserve" class="s2077216SCL-000002"> SL 1974, ch 321, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077217Normal { 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.s2077217SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077217CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077217Normal-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.s2077217DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077217000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077217SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077217SCL-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="s2077217Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-98"><span class="s2077217SENU">58-41-98</span></a><span xml:space="preserve" class="s2077217SENU">. </span><span class="s2077217CL">Coverage for phenylketonuria.</span></p><p dir="ltr" class="s2077217Normal-000000"><span class="s2077217DefaultParagraphFont">Every health maintenance contract 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 offer coverage for testing, diagnosis, and treatment of phenylketonuria including dietary management, formulas, case management, intake and screening, assessment, comprehensive care planning, and service referral.</span></p><p dir="ltr" class="s2077217Normal"><span xml:space="preserve" class="s2077217000001"> </span></p><p dir="ltr" class="s2077217Normal"><span class="s2077217SCL">Source:</span><span xml:space="preserve" class="s2077217SCL-000002"> SL 1992, ch 348, § 6.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s2082885Normal { 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.s2082885SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2082885CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2082885Statute { 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.s2082885DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2082885000000 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2082885NoIndent { text-indent: 0.00in; 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.s2082885DefaultParagraphFont-000001 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2082885SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; 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 58-41-99 - Formation of voluntary health insurance purchasing organizations."><meta property="og:description" content="SDLRC Codified Law 58-41-99 - Formation of voluntary health insurance purchasing organizations."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-41-99"><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="s2082885Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-99" rel="noopener"><span class="s2082885SENU">58-41-99</span></a><span xml:space="preserve" class="s2082885SENU">. </span><span xml:space="preserve" class="s2082885CL">Formation of voluntary health insurance purchasing organizations. </span></p><p dir="ltr" class="s2082885Statute"><span xml:space="preserve" class="s2082885DefaultParagraphFont">Notwithstanding the provisions of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=47-34A" rel="noopener"><span class="s2082885DefaultParagraphFont">47-34A</span></a><span xml:space="preserve" class="s2082885DefaultParagraphFont"> and §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=47-15-2" rel="noopener"><span class="s2082885DefaultParagraphFont">47-15-2</span></a><span xml:space="preserve" class="s2082885DefaultParagraphFont"> and </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=47-22-4" rel="noopener"><span class="s2082885DefaultParagraphFont">47-22-4</span></a><span xml:space="preserve" class="s2082885DefaultParagraphFont">, any organization may form for the purposes of purchasing group health insurance on a voluntary basis. For purposes of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-99" rel="noopener"><span class="s2082885DefaultParagraphFont">58-41-99</span></a><span xml:space="preserve" class="s2082885DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-109" rel="noopener"><span class="s2082885DefaultParagraphFont">58-41-109</span></a><span class="s2082885DefaultParagraphFont">, inclusive, an organization means any nonprofit organization or nonprofit corporation formed under South Dakota law.</span></p><p dir="ltr" class="s2082885Normal"><span xml:space="preserve" class="s2082885000000"> </span></p><p dir="ltr" class="s2082885NoIndent"><span xml:space="preserve" class="s2082885DefaultParagraphFont-000001">Source: </span><span class="s2082885SCL">SL 1994, ch 382, § 1; SL 2021, ch 210, § 24.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077219Normal { 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.s2077219SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077219CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077219Normal-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.s2077219DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077219000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077219SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077219SCL-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="s2077219Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-100"><span class="s2077219SENU">58-41-100</span></a><span xml:space="preserve" class="s2077219SENU">. </span><span class="s2077219CL">Membership of voluntary health insurance purchasing organizations.</span></p><p dir="ltr" class="s2077219Normal-000000"><span class="s2077219DefaultParagraphFont">Any organization may have a group health insurance policy issued to that organization on behalf of its members who would be insured under such policy. Members may join the organization, for the purpose of obtaining group health insurance, as individuals, employers, labor unions, associations, or substantially similar groups.</span></p><p dir="ltr" class="s2077219Normal"><span xml:space="preserve" class="s2077219000001"> </span></p><p dir="ltr" class="s2077219Normal"><span class="s2077219SCL">Source:</span><span xml:space="preserve" class="s2077219SCL-000002"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077220Normal { 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.s2077220SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077220CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077220Normal-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.s2077220DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077220000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077220SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077220SCL-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="s2077220Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-101"><span class="s2077220SENU">58-41-101</span></a><span xml:space="preserve" class="s2077220SENU">. </span><span class="s2077220CL">Purchasing organization's responsibility for negotiating terms and conditions.</span></p><p dir="ltr" class="s2077220Normal-000000"><span class="s2077220DefaultParagraphFont">The organization shall be responsible for negotiating the terms and conditions of insurance contracts, collection of premiums, and providing notice to members.</span></p><p dir="ltr" class="s2077220Normal"><span xml:space="preserve" class="s2077220000001"> </span></p><p dir="ltr" class="s2077220Normal"><span class="s2077220SCL">Source:</span><span xml:space="preserve" class="s2077220SCL-000002"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077221Normal { 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.s2077221SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077221CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077221Normal-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.s2077221DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077221DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077221000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077221SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077221SCL-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="s2077221Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-102"><span class="s2077221SENU">58-41-102</span></a><span xml:space="preserve" class="s2077221SENU">. </span><span class="s2077221CL">Purchasing organization's notice of premium charge.</span></p><p dir="ltr" class="s2077221Normal-000000"><span class="s2077221DefaultParagraphFont">The organization may provide not less than forty</span><span class="s2077221DefaultParagraphFont-000001">-</span><span class="s2077221DefaultParagraphFont">five days advance notice of any benefit or premium change to its members.</span></p><p dir="ltr" class="s2077221Normal"><span xml:space="preserve" class="s2077221000002"> </span></p><p dir="ltr" class="s2077221Normal"><span class="s2077221SCL">Source:</span><span xml:space="preserve" class="s2077221SCL-000003"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077222Normal { 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.s2077222SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077222CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077222Normal-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.s2077222DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077222000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077222SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077222SCL-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="s2077222Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-103"><span class="s2077222SENU">58-41-103</span></a><span xml:space="preserve" class="s2077222SENU">. </span><span class="s2077222CL">Additional chapters applicable to purchasing organization.</span></p><p dir="ltr" class="s2077222Normal-000000"><span xml:space="preserve" class="s2077222DefaultParagraphFont">Any organization is subject to all applicable provisions of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-3"><span class="s2077222DefaultParagraphFont">58-3</span></a><span xml:space="preserve" class="s2077222DefaultParagraphFont"> and chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-33"><span class="s2077222DefaultParagraphFont">58-33</span></a><span class="s2077222DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077222Normal"><span xml:space="preserve" class="s2077222000001"> </span></p><p dir="ltr" class="s2077222Normal"><span class="s2077222SCL">Source:</span><span xml:space="preserve" class="s2077222SCL-000002"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077223Normal { 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.s2077223SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077223CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077223Normal-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.s2077223DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077223Normal-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.s2077223000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077223SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077223SCL-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="s2077223Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-104"><span class="s2077223SENU">58-41-104</span></a><span xml:space="preserve" class="s2077223SENU">. </span><span class="s2077223CL">Approval of purchasing organization by Division of Insurance.</span></p><p dir="ltr" class="s2077223Normal-000000"><span class="s2077223DefaultParagraphFont">Any organization shall, prior to its engaging in the business of insurance, obtain approval from the Division of Insurance. The division may deny approval or withdraw approval of an organization to engage in the business of insurance for any of the following reasons:</span></p><p dir="ltr" class="s2077223Normal-000001"><span xml:space="preserve" class="s2077223DefaultParagraphFont">(1)    Any of the grounds specified in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-6-8"><span class="s2077223DefaultParagraphFont">58-6-8</span></a><span class="s2077223DefaultParagraphFont">;</span></p><p dir="ltr" class="s2077223Normal-000001"><span class="s2077223DefaultParagraphFont">(2)    Insufficient membership control of the organization;</span></p><p dir="ltr" class="s2077223Normal-000001"><span class="s2077223DefaultParagraphFont">(3)    Unreasonable compensation to officers, directors, or employees of the organization;</span></p><p dir="ltr" class="s2077223Normal-000001"><span class="s2077223DefaultParagraphFont">(4)    Misuse of premiums; or</span></p><p dir="ltr" class="s2077223Normal-000001"><span class="s2077223DefaultParagraphFont">(5)    Refusal to be examined or to cooperate in an examination.</span></p><p dir="ltr" class="s2077223Normal"><span xml:space="preserve" class="s2077223000002"> </span></p><p dir="ltr" class="s2077223Normal"><span class="s2077223SCL">Source:</span><span xml:space="preserve" class="s2077223SCL-000003"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077224Normal { 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.s2077224SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077224CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077224Normal-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.s2077224DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077224000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077224SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077224SCL-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="s2077224Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-105"><span class="s2077224SENU">58-41-105</span></a><span xml:space="preserve" class="s2077224SENU">. </span><span class="s2077224CL">Premiums held in trust by purchasing organization.</span></p><p dir="ltr" class="s2077224Normal-000000"><span class="s2077224DefaultParagraphFont">The organization shall hold all premiums received in trust and promptly remit premiums to the person entitled thereto.</span></p><p dir="ltr" class="s2077224Normal"><span xml:space="preserve" class="s2077224000001"> </span></p><p dir="ltr" class="s2077224Normal"><span class="s2077224SCL">Source:</span><span xml:space="preserve" class="s2077224SCL-000002"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077225Normal { 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.s2077225SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077225CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077225Normal-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.s2077225DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077225000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077225SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077225SCL-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="s2077225Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-106"><span class="s2077225SENU">58-41-106</span></a><span xml:space="preserve" class="s2077225SENU">. </span><span class="s2077225CL">Rates for group health insurance issued to purchasing organizations.</span></p><p dir="ltr" class="s2077225Normal-000000"><span xml:space="preserve" class="s2077225DefaultParagraphFont">Any insurer issuing group health insurance pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-99"><span class="s2077225DefaultParagraphFont">58-41-99</span></a><span xml:space="preserve" class="s2077225DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-109"><span class="s2077225DefaultParagraphFont">58-41-109</span></a><span xml:space="preserve" class="s2077225DefaultParagraphFont">, inclusive, is subject to all of the provisions of chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18B"><span class="s2077225DefaultParagraphFont">58-18B</span></a><span xml:space="preserve" class="s2077225DefaultParagraphFont"> relating to rates.</span></p><p dir="ltr" class="s2077225Normal"><span xml:space="preserve" class="s2077225000001"> </span></p><p dir="ltr" class="s2077225Normal"><span class="s2077225SCL">Source:</span><span xml:space="preserve" class="s2077225SCL-000002"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077226Normal { 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.s2077226SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077226CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077226Normal-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.s2077226DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077226000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077226SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077226SCL-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="s2077226Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-107"><span class="s2077226SENU">58-41-107</span></a><span xml:space="preserve" class="s2077226SENU">. </span><span class="s2077226CL">Reasonable participation requirements for group members of purchasing organizations.</span></p><p dir="ltr" class="s2077226Normal-000000"><span class="s2077226DefaultParagraphFont">An insurer may as a condition of offering coverage or continuing coverage require reasonable participation requirements of groups who become members of an organization.</span></p><p dir="ltr" class="s2077226Normal"><span xml:space="preserve" class="s2077226000001"> </span></p><p dir="ltr" class="s2077226Normal"><span class="s2077226SCL">Source:</span><span xml:space="preserve" class="s2077226SCL-000002"> SL 1994, ch 382, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077227Normal { 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.s2077227SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077227CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077227Normal-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.s2077227DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077227000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077227SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077227SCL-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="s2077227Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-108"><span class="s2077227SENU">58-41-108</span></a><span xml:space="preserve" class="s2077227SENU">. </span><span class="s2077227CL">Purchasing organizations exempt from antitrust provisions.</span></p><p dir="ltr" class="s2077227Normal-000000"><span xml:space="preserve" class="s2077227DefaultParagraphFont">Any organization formed pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-99"><span class="s2077227DefaultParagraphFont">58-41-99</span></a><span xml:space="preserve" class="s2077227DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-109"><span class="s2077227DefaultParagraphFont">58-41-109</span></a><span xml:space="preserve" class="s2077227DefaultParagraphFont">, inclusive, is exempt from the antitrust provisions under chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=37-1"><span class="s2077227DefaultParagraphFont">37-1</span></a><span class="s2077227DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077227Normal"><span xml:space="preserve" class="s2077227000001"> </span></p><p dir="ltr" class="s2077227Normal"><span class="s2077227SCL">Source:</span><span xml:space="preserve" class="s2077227SCL-000002"> SL 1994, ch 382, § 10.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077228Normal { 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.s2077228SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077228CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077228Normal-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.s2077228DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077228Normal-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.s2077228000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077228SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077228SCL-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="s2077228Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-109"><span class="s2077228SENU">58-41-109</span></a><span xml:space="preserve" class="s2077228SENU">. </span><span class="s2077228CL">Promulgation of rules for purchasing organizations.</span></p><p dir="ltr" class="s2077228Normal-000000"><span xml:space="preserve" class="s2077228DefaultParagraphFont">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="s2077228DefaultParagraphFont">1-26</span></a><span xml:space="preserve" class="s2077228DefaultParagraphFont"> to further the provisions of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-99"><span class="s2077228DefaultParagraphFont">58-41-99</span></a><span xml:space="preserve" class="s2077228DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-109"><span class="s2077228DefaultParagraphFont">58-41-109</span></a><span xml:space="preserve" class="s2077228DefaultParagraphFont">, inclusive, and for purposes of carrying out the provisions of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18-1"><span class="s2077228DefaultParagraphFont">58-18-1</span></a><span xml:space="preserve" class="s2077228DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-18-6"><span class="s2077228DefaultParagraphFont">58-18-6</span></a><span class="s2077228DefaultParagraphFont">, inclusive, and to ensure that group health insurance coverage is issued to eligible groups and that organizations are formed and operated to further the purpose of providing economical group health insurance for its members. The rules may include:</span></p><p dir="ltr" class="s2077228Normal-000001"><span class="s2077228DefaultParagraphFont">(1)    Definition of terms;</span></p><p dir="ltr" class="s2077228Normal-000001"><span class="s2077228DefaultParagraphFont">(2)    Criteria for determining groups, associations, organizations, and trusts and their eligibility for coverage;</span></p><p dir="ltr" class="s2077228Normal-000001"><span class="s2077228DefaultParagraphFont">(3)    Criteria for determining substantially similar groups or for determining related industries;</span></p><p dir="ltr" class="s2077228Normal-000001"><span class="s2077228DefaultParagraphFont">(4)    Application requirements and procedures;</span></p><p dir="ltr" class="s2077228Normal-000001"><span class="s2077228DefaultParagraphFont">(5)    Reasonable compensation; and</span></p><p dir="ltr" class="s2077228Normal-000001"><span class="s2077228DefaultParagraphFont">(6)    Organizational structure.</span></p><p dir="ltr" class="s2077228Normal"><span xml:space="preserve" class="s2077228000002"> </span></p><p dir="ltr" class="s2077228Normal"><span class="s2077228SCL">Source:</span><span xml:space="preserve" class="s2077228SCL-000003"> SL 1994, ch 382, § 11.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077229Normal { 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.s2077229SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077229CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077229Normal-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.s2077229DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077229000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077229SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077229SCL-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="s2077229Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-110"><span class="s2077229SENU">58-41-110</span></a><span xml:space="preserve" class="s2077229SENU">. </span><span class="s2077229CL">Application of chapter to provider contracting with state.</span></p><p dir="ltr" class="s2077229Normal-000000"><span xml:space="preserve" class="s2077229DefaultParagraphFont">Nothing in this chapter applies to a medical provider who enters into a contract with the State of South Dakota for services pursuant to chapter </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=3-12A"><span class="s2077229DefaultParagraphFont">3-12A</span></a><span class="s2077229DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077229Normal"><span xml:space="preserve" class="s2077229000001"> </span></p><p dir="ltr" class="s2077229Normal"><span class="s2077229SCL">Source:</span><span xml:space="preserve" class="s2077229SCL-000002"> SL 1995, ch 294, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077230Normal { 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.s2077230SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077230CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077230Normal-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.s2077230DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077230000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077230SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077230SCL-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="s2077230Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-111"><span class="s2077230SENU">58-41-111</span></a><span xml:space="preserve" class="s2077230SENU">. </span><span class="s2077230CL">Application of chapter to provider contracting with licensed health maintenance organization.</span></p><p dir="ltr" class="s2077230Normal-000000"><span class="s2077230DefaultParagraphFont">Any medical provider who enters into a contract for medical services with a licensed health maintenance organization or a health insurer licensed pursuant to this title is not required to be licensed pursuant to this chapter.</span></p><p dir="ltr" class="s2077230Normal"><span xml:space="preserve" class="s2077230000001"> </span></p><p dir="ltr" class="s2077230Normal"><span class="s2077230SCL">Source:</span><span xml:space="preserve" class="s2077230SCL-000002"> SL 1995, ch 294, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077231Normal { 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.s2077231SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077231CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077231Normal-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.s2077231DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077231DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077231000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077231SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077231SCL-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="s2077231Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-112"><span class="s2077231SENU">58-41-112</span></a><span xml:space="preserve" class="s2077231SENU">. </span><span class="s2077231CL">Minimum inpatient care coverage following delivery.</span></p><p dir="ltr" class="s2077231Normal-000000"><span class="s2077231DefaultParagraphFont">If a health maintenance contract issued or renewed on or after July 1, 1996, by a health maintenance organization provides maternity coverage, the contract shall provide coverage for a minimum of forty</span><span class="s2077231DefaultParagraphFont-000001">-</span><span class="s2077231DefaultParagraphFont">eight hours of inpatient care following a vaginal delivery and a minimum of ninety</span><span class="s2077231DefaultParagraphFont-000001">-</span><span xml:space="preserve" class="s2077231DefaultParagraphFont">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="s2077231DefaultParagraphFont">34-12</span></a><span xml:space="preserve" class="s2077231DefaultParagraphFont">, except as otherwise provided in § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-113"><span class="s2077231DefaultParagraphFont">58-41-113</span></a><span class="s2077231DefaultParagraphFont">. Any individual policy and 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="s2077231Normal"><span xml:space="preserve" class="s2077231000002"> </span></p><p dir="ltr" class="s2077231Normal"><span class="s2077231SCL">Source:</span><span xml:space="preserve" class="s2077231SCL-000003"> SL 1996, ch 292, § 16; SL 1998, ch 290, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077232Normal { 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.s2077232SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077232CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077232CL-000000 { font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077232Normal-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.s2077232DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077232DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077232000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077232SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077232SCL-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="s2077232Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-113"><span class="s2077232SENU">58-41-113</span></a><span xml:space="preserve" class="s2077232SENU">. </span><span class="s2077232CL">Shorter hospital stay permitted--Follow</span><span class="s2077232CL-000000">-</span><span class="s2077232CL">up visit within forty</span><span class="s2077232CL-000000">-</span><span class="s2077232CL">eight hours required.</span></p><p dir="ltr" class="s2077232Normal-000001"><span xml:space="preserve" class="s2077232DefaultParagraphFont">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 maintenance contract 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=58-41-112"><span class="s2077232DefaultParagraphFont">58-41-112</span></a><span xml:space="preserve" class="s2077232DefaultParagraphFont"> if the coverage includes one follow</span><span class="s2077232DefaultParagraphFont-000002">-</span><span class="s2077232DefaultParagraphFont">up visit in the first forty</span><span class="s2077232DefaultParagraphFont-000002">-</span><span class="s2077232DefaultParagraphFont">eight hours after discharge to verify the condition of the mother and newborn.</span></p><p dir="ltr" class="s2077232Normal"><span xml:space="preserve" class="s2077232000003"> </span></p><p dir="ltr" class="s2077232Normal"><span class="s2077232SCL">Source:</span><span xml:space="preserve" class="s2077232SCL-000004"> SL 1996, ch 292, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077233Normal { 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.s2077233SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077233CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077233Normal-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.s2077233DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077233000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077233SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077233SCL-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="s2077233Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-114"><span class="s2077233SENU">58-41-114</span></a><span xml:space="preserve" class="s2077233SENU">. </span><span class="s2077233CL">Notice to enrollees--Disclosures.</span></p><p dir="ltr" class="s2077233Normal-000000"><span xml:space="preserve" class="s2077233DefaultParagraphFont">The health maintenance organization shall provide notice to enrollees regarding the coverage required by § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-112"><span class="s2077233DefaultParagraphFont">58-41-112</span></a><span xml:space="preserve" class="s2077233DefaultParagraphFont"> 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="s2077233DefaultParagraphFont">1-26</span></a><span class="s2077233DefaultParagraphFont">. The notice shall be in writing and prominently positioned in any literature or correspondence. The notice shall be transmitted to enrollees in the next mailing to enrollees, in the yearly informational packet sent to enrollees, or by January 1, 1997, whichever is earliest.</span></p><p dir="ltr" class="s2077233Normal"><span xml:space="preserve" class="s2077233000001"> </span></p><p dir="ltr" class="s2077233Normal"><span class="s2077233SCL">Source:</span><span xml:space="preserve" class="s2077233SCL-000002"> SL 1996, ch 292, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077234Normal { 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.s2077234SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077234CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077234CL-000000 { font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077234Normal-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.s2077234DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077234DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077234Normal-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.s2077234000004 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077234SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077234SCL-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="s2077234Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-115"><span class="s2077234SENU">58-41-115</span></a><span xml:space="preserve" class="s2077234SENU">. </span><span class="s2077234CL">Health insurance policies to provide coverage for biologically</span><span class="s2077234CL-000000">-</span><span class="s2077234CL">based mental illnesses.</span></p><p dir="ltr" class="s2077234Normal-000001"><span class="s2077234DefaultParagraphFont">Every health maintenance contract 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="s2077234DefaultParagraphFont-000002">-</span><span class="s2077234DefaultParagraphFont">based mental illnesses with the same dollar limits, deductibles, coinsurance factors, and restrictions as for other covered illnesses.</span></p><p dir="ltr" class="s2077234Normal-000003"><span class="s2077234DefaultParagraphFont">The term, biologically</span><span class="s2077234DefaultParagraphFont-000002">-</span><span class="s2077234DefaultParagraphFont">based mental illness, means schizophrenia and other psychotic disorders, bipolar disorder, major depression, and obsessive</span><span class="s2077234DefaultParagraphFont-000002">-</span><span class="s2077234DefaultParagraphFont">compulsive disorder.</span></p><p dir="ltr" class="s2077234Normal"><span xml:space="preserve" class="s2077234000004"> </span></p><p dir="ltr" class="s2077234Normal"><span class="s2077234SCL">Source:</span><span xml:space="preserve" class="s2077234SCL-000005"> SL 1998, ch 291, § 6; SL 1999, ch 251, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077235Normal { 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.s2077235SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077235CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077235Normal-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.s2077235DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077235Normal-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.s2077235DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077235000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077235SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077235SCL-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="s2077235Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-116"><span class="s2077235SENU">58-41-116</span></a><span xml:space="preserve" class="s2077235SENU">. </span><span class="s2077235CL">Application--Exemptions.</span></p><p dir="ltr" class="s2077235Normal-000000"><span xml:space="preserve" class="s2077235DefaultParagraphFont">The provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-115"><span class="s2077235DefaultParagraphFont">58-41-115</span></a><span xml:space="preserve" class="s2077235DefaultParagraphFont"> do not apply to any plan, policy, or contract that provides coverage only for:</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(1)    Specified disease;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(2)    Hospital indemnity;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(3)    Fixed indemnity;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(4)    Accident</span><span class="s2077235DefaultParagraphFont-000002">-</span><span class="s2077235DefaultParagraphFont">only;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(5)    Credit;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(6)    Dental;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(7)    Vision;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(8)    Prescription drug;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(9)    Medicare supplement;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(10)    Long</span><span class="s2077235DefaultParagraphFont-000002">-</span><span class="s2077235DefaultParagraphFont">term care;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(11)    Disability income insurance;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(12)    Coverage issued as a supplement to liability insurance;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(13)    Workers' compensation or similar insurance;</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(14)    Automobile medical payment insurance; or</span></p><p dir="ltr" class="s2077235Normal-000001"><span class="s2077235DefaultParagraphFont">(15)    Individual health benefit plans of six</span><span class="s2077235DefaultParagraphFont-000002">-</span><span class="s2077235DefaultParagraphFont">months duration or less that are not renewable.</span></p><p dir="ltr" class="s2077235Normal"><span xml:space="preserve" class="s2077235000003"> </span></p><p dir="ltr" class="s2077235Normal"><span class="s2077235SCL">Source:</span><span xml:space="preserve" class="s2077235SCL-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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077236Normal { 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.s2077236SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077236CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077236Normal-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.s2077236DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077236DefaultParagraphFont-000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077236Normal-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.s2077236000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077236SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077236SCL-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="s2077236Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-117"><span class="s2077236SENU">58-41-117</span></a><span xml:space="preserve" class="s2077236SENU">. </span><span class="s2077236CL">Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations.</span></p><p dir="ltr" class="s2077236Normal-000000"><span class="s2077236DefaultParagraphFont">Every health maintenance contract 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="s2077236DefaultParagraphFont-000001">-</span><span class="s2077236DefaultParagraphFont">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="s2077236Normal-000002"><span class="s2077236DefaultParagraphFont">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="s2077236Normal-000002"><span class="s2077236DefaultParagraphFont">Diabetes self</span><span class="s2077236DefaultParagraphFont-000001">-</span><span class="s2077236DefaultParagraphFont">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="s2077236Normal-000002"><span class="s2077236DefaultParagraphFont">Coverage of diabetes self</span><span class="s2077236DefaultParagraphFont-000001">-</span><span class="s2077236DefaultParagraphFont">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="s2077236DefaultParagraphFont-000001">-</span><span class="s2077236DefaultParagraphFont">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="s2077236DefaultParagraphFont-000001">-</span><span class="s2077236DefaultParagraphFont">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="s2077236Normal-000002"><span class="s2077236DefaultParagraphFont">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 contract.</span></p><p dir="ltr" class="s2077236Normal"><span xml:space="preserve" class="s2077236000003"> </span></p><p dir="ltr" class="s2077236Normal"><span class="s2077236SCL">Source:</span><span xml:space="preserve" class="s2077236SCL-000004"> SL 1999, ch 252, § 11.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077237Normal { 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.s2077237SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077237CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077237Normal-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.s2077237DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077237Normal-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.s2077237DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077237000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077237SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077237SCL-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="s2077237Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-118"><span class="s2077237SENU">58-41-118</span></a><span xml:space="preserve" class="s2077237SENU">. </span><span class="s2077237CL">Diabetes coverage not required of certain plans and policies.</span></p><p dir="ltr" class="s2077237Normal-000000"><span xml:space="preserve" class="s2077237DefaultParagraphFont">The provisions of § </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-117"><span class="s2077237DefaultParagraphFont">58-41-117</span></a><span xml:space="preserve" class="s2077237DefaultParagraphFont"> do not apply to any plan, policy, or contract that provides coverage only for:</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(1)    Specified disease;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(2)    Hospital indemnity;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(3)    Fixed indemnity;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(4)    Accident</span><span class="s2077237DefaultParagraphFont-000002">-</span><span class="s2077237DefaultParagraphFont">only;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(5)    Credit;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(6)    Dental;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(7)    Vision;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(8)    Prescription drug;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(9)    Medicare supplement;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(10)    Long</span><span class="s2077237DefaultParagraphFont-000002">-</span><span class="s2077237DefaultParagraphFont">term care;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(11)    Disability income insurance;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(12)    Coverage issued as a supplement to liability insurance;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(13)    Workers' compensation or similar insurance;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(14)    Automobile medical payment insurance;</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(15)    Individual health benefit plans of six</span><span class="s2077237DefaultParagraphFont-000002">-</span><span class="s2077237DefaultParagraphFont">months' duration or less that are not renewable; or</span></p><p dir="ltr" class="s2077237Normal-000001"><span class="s2077237DefaultParagraphFont">(16)    Individual nonmajor medical insurance.</span></p><p dir="ltr" class="s2077237Normal"><span xml:space="preserve" class="s2077237000003"> </span></p><p dir="ltr" class="s2077237Normal"><span class="s2077237SCL">Source:</span><span xml:space="preserve" class="s2077237SCL-000004"> SL 1999, ch 252, § 12.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077238Normal { 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.s2077238SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077238CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077238Normal-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.s2077238DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077238Normal-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.s2077238DefaultParagraphFont-000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077238Normal-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.s2077238000004 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077238SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077238SCL-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="s2077238Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-119"><span class="s2077238SENU">58-41-119</span></a><span xml:space="preserve" class="s2077238SENU">. </span><span class="s2077238CL">Contracts to provide coverage for prostate cancer screening.</span></p><p dir="ltr" class="s2077238Normal-000000"><span class="s2077238DefaultParagraphFont">Every health maintenance contract that covers a male and 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 the following coverage for diagnostic screening for prostate cancer:</span></p><p dir="ltr" class="s2077238Normal-000001"><span class="s2077238DefaultParagraphFont">(1)    An annual medically recognized diagnostic examination, including a digital rectal examination and a prostate</span><span class="s2077238DefaultParagraphFont-000002">-</span><span class="s2077238DefaultParagraphFont">specific antigen test, as follows:</span></p><p dir="ltr" class="s2077238Normal-000003"><span class="s2077238DefaultParagraphFont">(a)    For asymptomatic men aged fifty and over; and</span></p><p dir="ltr" class="s2077238Normal-000003"><span class="s2077238DefaultParagraphFont">(b)    For men aged forty</span><span class="s2077238DefaultParagraphFont-000002">-</span><span class="s2077238DefaultParagraphFont">five and over at high risk for prostate cancer; and</span></p><p dir="ltr" class="s2077238Normal-000001"><span class="s2077238DefaultParagraphFont">(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="s2077238DefaultParagraphFont-000002">-</span><span class="s2077238DefaultParagraphFont">specific antigen test, and bone scan.</span></p><p dir="ltr" class="s2077238Normal"><span xml:space="preserve" class="s2077238000004"> </span></p><p dir="ltr" class="s2077238Normal"><span class="s2077238SCL">Source:</span><span xml:space="preserve" class="s2077238SCL-000005"> SL 2001, ch 277, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077239Normal { 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.s2077239SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077239CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077239Normal-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.s2077239DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077239000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077239SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077239SCL-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="s2077239Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-120"><span class="s2077239SENU">58-41-120</span></a><span xml:space="preserve" class="s2077239SENU">. </span><span class="s2077239CL">Annual report on risk bearing entities.</span></p><p dir="ltr" class="s2077239Normal-000000"><span class="s2077239DefaultParagraphFont">A health maintenance organization shall file annually, as part of its access plan, a list of all risk bearing entities with which it has an agreement or contract and the number of covered persons assigned or selected by each risk bearing entity.</span></p><p dir="ltr" class="s2077239Normal"><span xml:space="preserve" class="s2077239000001"> </span></p><p dir="ltr" class="s2077239Normal"><span class="s2077239SCL">Source:</span><span xml:space="preserve" class="s2077239SCL-000002"> SL 2013, ch 256, § 35.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077240Normal { 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.s2077240SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077240CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077240Normal-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.s2077240DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077240Normal-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.s2077240000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077240SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077240SCL-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="s2077240Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-121"><span class="s2077240SENU">58-41-121</span></a><span xml:space="preserve" class="s2077240SENU">. </span><span class="s2077240CL">Documents provided to risk bearing entity by health maintenance organization.</span></p><p dir="ltr" class="s2077240Normal-000000"><span class="s2077240DefaultParagraphFont">In entering into, amending, or renewing a contract with a risk bearing entity, a health maintenance organization shall, unless already specified in the contract, provide the following, upon request, to a risk bearing entity:</span></p><p dir="ltr" class="s2077240Normal-000001"><span class="s2077240DefaultParagraphFont">(1)    At the time the contract is entered into, a written statement describing the amount or method of remuneration to be paid to the risk bearing entity. If any part of the remuneration is a calculated amount based on variable factors, the payment methodology upon which the calculated amount will be determined. The statement shall specify the services and expenses for which the risk bearing entity is financially liable in whole or part;</span></p><p dir="ltr" class="s2077240Normal-000001"><span class="s2077240DefaultParagraphFont">(2)    At the time payment is made, the basis of the calculation of that payment;</span></p><p dir="ltr" class="s2077240Normal-000001"><span class="s2077240DefaultParagraphFont">(3)    For health benefit plans in which the covered persons are assigned to the risk bearing entity under a capitated payment arrangement, a list of enrollees and payments due to the risk bearing entity, to be provided monthly if not already available to the risk bearing entity;</span></p><p dir="ltr" class="s2077240Normal-000001"><span class="s2077240DefaultParagraphFont">(4)    At the time the contract is entered into, a copy of the health maintenance organization's most recent annual statement filed with the NAIC; and</span></p><p dir="ltr" class="s2077240Normal-000001"><span class="s2077240DefaultParagraphFont">(5)    Once the contract is in effect, the quarterly or annual statement.</span></p><p dir="ltr" class="s2077240Normal"><span xml:space="preserve" class="s2077240000002"> </span></p><p dir="ltr" class="s2077240Normal"><span class="s2077240SCL">Source:</span><span xml:space="preserve" class="s2077240SCL-000003"> SL 2013, ch 256, § 36.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077241Normal { 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.s2077241SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077241CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077241Normal-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.s2077241DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077241Normal-000001 { margin-top: 0; margin-bottom: 0; margin-left: 0.70in; text-indent: -0.45in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-right: 0; } p.s2077241Normal-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.s2077241000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077241SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077241SCL-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="s2077241Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-122"><span class="s2077241SENU">58-41-122</span></a><span xml:space="preserve" class="s2077241SENU">. </span><span class="s2077241CL">Documents provided to health maintenance organization by risk bearing entity.</span></p><p dir="ltr" class="s2077241Normal-000000"><span class="s2077241DefaultParagraphFont">A health maintenance organization shall include in any contract with a risk bearing entity a requirement that the risk bearing entity provide to the health maintenance organization at the time a contract is entered into and annually thereafter the following:</span></p><p dir="ltr" class="s2077241Normal-000001"><span class="s2077241DefaultParagraphFont">(1)    Annual audited GAAP report in accordance with generally accepted accounting principles in the United States (U.S. GAAP);</span></p><p dir="ltr" class="s2077241Normal-000001"><span class="s2077241DefaultParagraphFont">(2)    Documentation that satisfies the health maintenance organization that the risk bearing entity has sufficient ability to accept risk; and</span></p><p dir="ltr" class="s2077241Normal-000001"><span class="s2077241DefaultParagraphFont">(3)    Documentation that satisfies the health maintenance organization that the risk bearing entity has appropriate management expertise and infrastructure.</span></p><p dir="ltr" class="s2077241Normal-000002"><span class="s2077241DefaultParagraphFont">The contract shall also require that the risk bearing entity on a quarterly basis provide status reports that include the following:</span></p><p dir="ltr" class="s2077241Normal-000001"><span class="s2077241DefaultParagraphFont">(1)    Financial statements prepared in accordance with U.S. GAAP;</span></p><p dir="ltr" class="s2077241Normal-000001"><span class="s2077241DefaultParagraphFont">(2)    An aging report of the percentage of claims that have been paid, pended, or denied, across all contracts with risk bearing entities; and</span></p><p dir="ltr" class="s2077241Normal-000001"><span class="s2077241DefaultParagraphFont">(3)    On a monthly basis, a report of the estimated reported claims and incurred but not reported claims liability of the risk bearing entity.</span></p><p dir="ltr" class="s2077241Normal"><span xml:space="preserve" class="s2077241000003"> </span></p><p dir="ltr" class="s2077241Normal"><span class="s2077241SCL">Source:</span><span xml:space="preserve" class="s2077241SCL-000004"> SL 2013, ch 256, § 37.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077242Normal { 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.s2077242SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077242CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077242Normal-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.s2077242DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077242Normal-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.s2077242Normal-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.s2077242000003 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077242SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077242SCL-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="s2077242Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-123"><span class="s2077242SENU">58-41-123</span></a><span xml:space="preserve" class="s2077242SENU">. </span><span class="s2077242CL">Notice by risk bearing entity of change in conditions--Assignment of contract.</span></p><p dir="ltr" class="s2077242Normal-000000"><span class="s2077242DefaultParagraphFont">A health maintenance organization shall require in any contract with a risk bearing entity that the risk bearing entity provide notice to the health maintenance organization within thirty days of:</span></p><p dir="ltr" class="s2077242Normal-000001"><span class="s2077242DefaultParagraphFont">(1)    Any changes involving the ownership structure of the risk bearing entity; or</span></p><p dir="ltr" class="s2077242Normal-000001"><span class="s2077242DefaultParagraphFont">(2)    Financial or operational concerns regarding the financial viability of the risk bearing entity.</span></p><p dir="ltr" class="s2077242Normal-000002"><span xml:space="preserve" class="s2077242DefaultParagraphFont">A health maintenance organization shall also require in any contract with a risk bearing entity a provision that allows the director, in the event that a risk bearing entity fails to comply with any provision of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-120"><span class="s2077242DefaultParagraphFont">58-41-120</span></a><span xml:space="preserve" class="s2077242DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-126"><span class="s2077242DefaultParagraphFont">58-41-126</span></a><span class="s2077242DefaultParagraphFont">, inclusive, to assign for six months, the risk bearing entity's contract with providers to furnish covered services.</span></p><p dir="ltr" class="s2077242Normal"><span xml:space="preserve" class="s2077242000003"> </span></p><p dir="ltr" class="s2077242Normal"><span class="s2077242SCL">Source:</span><span xml:space="preserve" class="s2077242SCL-000004"> SL 2013, ch 256, § 38.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077243Normal { 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.s2077243SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077243CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077243Normal-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.s2077243DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077243000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077243SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077243SCL-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="s2077243Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-124"><span class="s2077243SENU">58-41-124</span></a><span xml:space="preserve" class="s2077243SENU">. </span><span class="s2077243CL">Notice to director that risk bearing entity has materially failed to perform contract.</span></p><p dir="ltr" class="s2077243Normal-000000"><span xml:space="preserve" class="s2077243DefaultParagraphFont">A health maintenance organization shall have procedures in place to notify the director within a reasonable time that a risk bearing entity has materially failed to perform under its contract with the health maintenance organization. A health maintenance organization is not in violation of this section if it acts in good faith in its attempt to comply with this section. A health maintenance organization shall maintain systems and controls for reviewing the information provided to the health maintenance organization by the risk bearing entity pursuant to §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-120"><span class="s2077243DefaultParagraphFont">58-41-120</span></a><span xml:space="preserve" class="s2077243DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-126"><span class="s2077243DefaultParagraphFont">58-41-126</span></a><span class="s2077243DefaultParagraphFont">, inclusive.</span></p><p dir="ltr" class="s2077243Normal"><span xml:space="preserve" class="s2077243000001"> </span></p><p dir="ltr" class="s2077243Normal"><span class="s2077243SCL">Source:</span><span xml:space="preserve" class="s2077243SCL-000002"> SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077244Normal { 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.s2077244SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077244CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077244Normal-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.s2077244DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077244000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077244SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077244SCL-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="s2077244Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-125"><span class="s2077244SENU">58-41-125</span></a><span xml:space="preserve" class="s2077244SENU">. </span><span class="s2077244CL">Confidentiality of information.</span></p><p dir="ltr" class="s2077244Normal-000000"><span xml:space="preserve" class="s2077244DefaultParagraphFont">Any information provided to the director by a health maintenance organization relative to risk bearing entities with which it is contracted is confidential and may not be disclosed to any person except to the extent that it is necessary to carry out the purposes of §§ </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-120"><span class="s2077244DefaultParagraphFont">58-41-120</span></a><span xml:space="preserve" class="s2077244DefaultParagraphFont"> to </span><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-126"><span class="s2077244DefaultParagraphFont">58-41-126</span></a><span class="s2077244DefaultParagraphFont">, inclusive, and as allowed by state law, regardless of whether the information is in the form of paper, is preserved on microfilm, or is stored in computer readable form. If the information is disclosed pursuant to this section, the health maintenance organization providing the notice is not liable for the disclosure or any subsequent use or misuse of the information. The health maintenance organization is entitled to claim any statutory privileges against disclosure that the entity that provided the information to the health maintenance organization is entitled to claim. This section is not intended to create a private right of action.</span></p><p dir="ltr" class="s2077244Normal"><span xml:space="preserve" class="s2077244000001"> </span></p><p dir="ltr" class="s2077244Normal"><span class="s2077244SCL">Source:</span><span xml:space="preserve" class="s2077244SCL-000002"> SL 2013, ch 256, § 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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077245Normal { 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.s2077245SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077245CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077245Normal-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.s2077245DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077245Normal-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.s2077245000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077245SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077245SCL-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="s2077245Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-126"><span class="s2077245SENU">58-41-126</span></a><span xml:space="preserve" class="s2077245SENU">. </span><span class="s2077245CL">Nontransferable responsibilities of health maintenance organization.</span></p><p dir="ltr" class="s2077245Normal-000000"><span class="s2077245DefaultParagraphFont">Notwithstanding any agreement to the contrary, the health maintenance organization shall:</span></p><p dir="ltr" class="s2077245Normal-000001"><span class="s2077245DefaultParagraphFont">(1)    Retain full responsibility on a prospective basis for the provision of health care services pursuant to any applicable health benefit plan; and</span></p><p dir="ltr" class="s2077245Normal-000001"><span class="s2077245DefaultParagraphFont">(2)    At all times, be able to demonstrate to the satisfaction of the director that the health maintenance organization can fulfill its nontransferable obligation to provide health care services to covered persons in any event, including the failure, for any reason, of a risk bearing entity.</span></p><p dir="ltr" class="s2077245Normal"><span xml:space="preserve" class="s2077245000002"> </span></p><p dir="ltr" class="s2077245Normal"><span class="s2077245SCL">Source:</span><span xml:space="preserve" class="s2077245SCL-000003"> SL 2013, ch 256, § 41.</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 58-41 - HEALTH MAINTENANCE ORGANIZATIONS</title><meta name="Generator" content="PowerTools for Open XML" /><style>span { white-space: pre-wrap; } p.s2077246Normal { 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.s2077246SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077246CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s2077246Normal-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.s2077246DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s2077246Normal-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.s2077246000002 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } span.s2077246SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s2077246SCL-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="s2077246Normal"><a href="https://sdlegislature.gov/Statutes/Codified_Laws/DisplayStatute.aspx?Type=Statute&amp;Statute=58-41-127"><span class="s2077246SENU">58-41-127</span></a><span xml:space="preserve" class="s2077246SENU">. </span><span class="s2077246CL">Coverage for treatment of hearing impairment for persons under age nineteen.</span></p><p dir="ltr" class="s2077246Normal-000000"><span xml:space="preserve" class="s2077246DefaultParagraphFont">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="s2077246DefaultParagraphFont">36-24</span></a><span class="s2077246DefaultParagraphFont">.</span></p><p dir="ltr" class="s2077246Normal-000001"><span class="s2077246DefaultParagraphFont">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="s2077246Normal-000001"><span class="s2077246DefaultParagraphFont">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="s2077246Normal"><span xml:space="preserve" class="s2077246000002"> </span></p><p dir="ltr" class="s2077246Normal"><span class="s2077246SCL">Source:</span><span xml:space="preserve" class="s2077246SCL-000003"> SL 2014, ch 237, § 4.</span></p></div></body></html>