South Dakota

58-17-1. Requirements for all health insurance policies delivered in state.

58-17-1.1. Grandfathered plans required to cover low-dose mammography--Extent of coverage.

58-17-1.2. Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.

58-17-1.3. Diabetes coverage not required of certain plans and policies.

58-17-1.4. Policies required to cover occult breast cancer screening.

58-17-2. Persons covered by policy.

58-17-2.1. Health insurance on a franchise plan.

58-17-2.2. Conversion privileges of insured's spouse upon divorce.

58-17-2.3. Dependent coverage termination--Age--Full-time students.

58-17-3. Time of commencement and termination to be set out in policy.

58-17-4. Consideration for policy to be stated.

58-17-4.1. Filing and approval of individual policy premium rates.

58-17-4.2. Premium rates required to be reasonable--Rules to establish minimum standards promulgated by director.

58-17-4.3. 58-17-4.3. Transferred to § 58-17-74.1 by SL 2005, ch 10, § 41.

58-17-5. Identification of forms, riders and endorsements--Form number, location.

58-17-6. Style and arrangement of policy provisions--Printing, size of type.

58-17-7. Documents forming part of policy--Setting forth in full, rates and classifications excepted.

58-17-8. Exceptions and reductions of coverage to be clearly set out.

58-17-9. Renewal of policy at option of insurer--Statement in policy so informing the policyholder.

58-17-10. 58-17-10. Repealed by SL 2006, ch 259, § 32.

58-17-10.1. Reduction of benefits because of increase in statutory disability benefits prohibited.

58-17-10.2. Individual policy for insured's spouse required in policies covering spouse--Eligibility--Coverage--Waiting periods.

58-17-11. Return of policy by purchaser--Refund of premium paid--Dissatisfaction with terms after examination.

58-17-11.1. Issuance of policies by insurance company, nonprofit hospital service plan, medical service corporation, or fraternal benefit society--Delivery receipts--Certificates of mailing--Term of retention.

58-17-12. Required provisions--Captions--Substitutes, approval by director.

58-17-13. Omission from policy of inapplicable provision--Approval of director--Modification of inconsistent provision.

58-17-14. Entire contract and change clauses required--Signed acceptance required for endorsements.

58-17-15. Time limit on certain defenses--Application of section.

58-17-16. 58-17-16. Repealed by SL 2011, ch 216, § 5.

58-17-17. Grace period on premiums required in policy.

58-17-18. Renewal of policy--Restriction on company's right to refuse.

58-17-19. Reinstatement when premium not paid within grace period.

58-17-20. Omission of provision as to application of premiums accepted in connection with reinstatement--Right of insured to continue policy in force by payment of premiums.

58-17-21. Notice of claim--Provision required in policy.

58-17-22. Notice of claim--Loss of time benefit--Optional provision, insertion by insurer.

58-17-23. Claim forms--Furnishing by insurer.

58-17-24. Proofs of loss--Provision required in policy.

58-17-25. Time of payment of claims--Provision required in policy.

58-17-26. Payment of claims--Persons to whom benefits payable--Provision required in policy.

58-17-27. Payment of claims--Optional provisions, insertion by insurer.

58-17-28. Physical examination of insured--Autopsy in death claims--Provision required in policy.

58-17-29. Action to recover under policy--Time for beginning.

58-17-30. Beneficiary--Changes reserved to insured.

58-17-30.1. Continuation of coverage for child with intellectual or physical disability--Proof of dependency.

58-17-30.2. Family coverage to include newborn or newly adopted children--Payment of claim not to be withheld during bonding period of adopted child.

58-17-30.3. Premature birth and congenital defects covered--Applicability.

58-17-30.4. Notice of birth or adoption required for continued coverage.

58-17-30.5. Coverage for inpatient alcoholism treatment required.

58-17-30.6. Alcoholism benefits provided--Days of care.

58-17-30.7. Policies excluded from alcoholism coverage requirements.

58-17-30.8. Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.

58-17-30.9. Notice that dependent is no longer eligible for coverage--Premium adjustment.

58-17-31. Optional policy provisions.

58-17-32. Occupational change--Policy provision for adjustment of premium or benefits.

58-17-33. Misstatement of age--Policy provision for adjustment of benefits.

58-17-34. Earnings of insured--Policy provision for adjustment of benefits.

58-17-35. Earnings adjustment clause to be coupled with insured's right to continue policy in force.

58-17-36. Option of insurer to define "valid loss of time coverage".

58-17-37. Unpaid premiums--Deduction from benefits.

58-17-38. Conformity with state statutes of insured.

58-17-39. Illegal occupation of insured.

58-17-40. Renewal of policy at option of insurer.

58-17-41. Order of policy provisions.

58-17-42. Age limit in policy--Effect of acceptance of premiums or misstatement of age.

58-17-43. Third parties taking policy covering insured.

58-17-44. Foreign or alien insurer--Policy provision required by home state.

58-17-45. Policy of domestic insurer delivered in other state--Compliance with laws of other state.

58-17-46. Policy provisions not subject to chapter--Conforming to statute required.

58-17-47. Nonconforming and conflicting provisions construed in conformity with statute.

58-17-48. Liability and workers' compensation insurance--Inapplicability of health insurance provisions.

58-17-49. Health insurance provisions inapplicable to group or blanket policy.

58-17-50. Life insurance, endowment or annuity contracts not subject to health insurance provisions.

58-17-51. Health insurance provisions inapplicable to reinsurance.

58-17-52. Prior contracts or policies excepted.

58-17-53. Optometric services--Reimbursement, exceptions.

58-17-54. Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans for public employees--Restrictions on policy limitations.

58-17-54.1. Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services.

58-17-55. Reimbursement provisions applicable to licensed hospitals.

58-17-56. Reimbursement for service rendered or supervised by qualified mental health professional.

58-17-57. "Abuse of health insurance" defined--Violation as misdemeanor.

58-17-58. Waiver of required deductible or co-payment for charitable purposes permitted.

58-17-59. When waiver presumed.

58-17-60. Certain payments exempt.

58-17-61. Assignment of health insurance proceeds to certain hospitals authorized.

58-17-62. Coverage for phenylketonuria.

58-17-63. "Health benefit plan" defined.

58-17-64. Minimum loss ratio for individual health benefit plans.

58-17-65. Individual health insurance plan used in conjunction with managed care plan or utilization review organization.

58-17-66. Definitions for 58-17-66 through 58-17-87.

58-17-67. "Professional association" defined.

58-17-68. "Professional association plan" defined.

58-17-69. "Creditable coverage" defined.

58-17-70. Application of 58-17-66 to 58-17-87, inclusive.

58-17-71. Separate classes of individual business--Reasons--Number.

58-17-72. Transitional period when additional class of business acquired.

58-17-73. Director approval required to establish additional classes of business--Rates or rating methodologies.

58-17-74. Provisions for premium rates for individual health benefit plans.

58-17-74.1. Premium rate limitations.

58-17-75. Promulgation of rules for rates charged for individual health benefit plans.

58-17-76. Transfer into or out of class of business.

58-17-77. Temporary suspension of premium rates for individual health insurance--Reasons.

58-17-78. Required disclosure when offering individual health benefit plan.

58-17-79. Documentation of rating methods and practices.

58-17-80. 58-17-80. Repealed by SL 2009, ch 262, § 1.

58-17-81. Availability of information on rating methods and practices of carriers offering individual health benefit plans.

58-17-82. Renewal of individual health benefit plans--Exceptions.

58-17-83. Election not to renew individual health benefit plan--Future business restricted.

58-17-84. Provisions for carriers providing individual coverage other than excepted benefits.

58-17-84.1. (Text of section effective until the first plan year, policy year, or renewal date on or after January 1, 2019) Anesthesia and hospitalization for dental care to be provided certain covered persons.

58-17-85. 58-17-85, 58-17-85.1. Repealed by SL 2015, ch 249, §§ 2, 3.

58-17-86. 58-17-86. Repealed by SL 2003 (SS) ch 1, § 33

58-17-87. Director to promulgate rules for individual health insurance--Scope of rules.

58-17-88. Minimum inpatient care coverage following delivery.

58-17-89. Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.

58-17-90. Notice to policyholders--Disclosures.

58-17-91. 58-17-91 to 58-17-96. Repealed by SL 2000, ch 243, §§ 16 to 21

58-17-97. Provisions covering preexisting conditions.

58-17-98. Health insurance policies to provide coverage for biologically-based mental illnesses.

58-17-99. Application of § 58-17-98--Exemptions.

58-17-100. Definitions.

58-17-101. Insurer may not exclude certain off-label uses of prescription drugs.

58-17-102. Exceptions.

58-17-103. Provisions limited to cancer or life threatening diseases.

58-17-104. Deductibles, copayments, and managed care review not affected.

58-17-105. Drugs used in research trials not covered.

58-17-106. No reduction or limitation of coverage otherwise required by law.

58-17-107. Health insurance policies to provide coverage for prostate cancer screening.

58-17-108. "Disability income insurance" defined.

58-17-109. Exclusion or reduction of benefits.

58-17-110. Commencement of loss.

58-17-111. Minimum standards--Exceptions.

58-17-112. Promulgation of rules regarding disability income policies--Content.

58-17-113. 58-17-113, 58-17-114. Repealed by SL 2015, ch 249, § 36, eff. Jan. 1, 2017.

58-17-115. 58-17-115. Repealed by SL 2015, ch 249, § 5.

58-17-116. 58-17-116. Repealed by SL 2015, ch 249, § 36, eff. Jan. 1, 2017.

58-17-117. 58-17-117, 58-17-118. Repealed by SL 2015, ch 249, §§ 6, 7.

58-17-119. 58-17-119 to 58-17-124. Repealed by SL 2015, ch 249, § 36, eff. Jan. 1, 2017.

58-17-125. 58-17-125. Repealed by SL 2015, ch 249, § 10.

58-17-126. 58-17-126. Repealed by SL 2015, ch 249, § 36, eff. Jan. 1, 2017.

58-17-127. 58-17-127 to 58-17-137. Repealed by SL 2015, ch 249, §§ 12 to 22.

58-17-138. 58-17-138. Repealed by SL 2015, ch 249, § 36, eff. Jan. 1, 2017.

58-17-139. 58-17-139 to 58-17-141. Repealed by SL 2015, ch 249, §§ 24 to 26.

58-17-142. Maximum premium rates for plans issued prior to August 1, 2003--Rate provisions of § 58-17-75 to apply upon carrier's discontinuance of active marketing.

58-17-143. 58-17-143. Repealed by SL 2015, ch 249, § 36, eff. Jan. 1, 2017.

58-17-144. 58-17-144, 58-17-145. Repealed by SL 2015, ch 249, §§ 28, 29.

58-17-145.1. Repealed.

58-17-146. Dental insurers prohibited from setting fees for noncovered service.

58-17-146.1. Certain contract terms voidable by dentist.

58-17-147. Elective abortion coverage prohibited in qualified health plan offered through health insurance exchange.

58-17-148. Qualified health plan sold through exchange to provide for placement through licensed insurance producer--Commissions.

58-17-149. Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period.

58-17-150. Retrospective payment of clean claims for covered services provided by health care professional during credentialing period--Requirements.

58-17-151. Applications to be credentialed.

58-17-152. Application of §§ 58-17-149 to 58-17-151.

58-17-153. Coverage for treatment of hearing impairment for persons under age nineteen.

58-17-154. Definitions for §§ 58-17-155 to 58-17-162.

58-17-155. Exceptions to application of §§ 58-17-154 to 58-17-162.

58-17-156. Policies, contracts, certificates, and plans subject to §§ 58-17-154 to 58-17-162.

58-17-157. Coverage for applied behavior analysis for treatment of autism spectrum disorders.

58-17-158. Authorization, prior approval, and other care management requirements--Annual maximum benefit.

58-17-159. Qualifications of person performing or supervising applied behavior analysis.

58-17-160. Review of treatment.

58-17-161. Services under individualized service plan, family service plan, or education program.

58-17-162. Effective date of §§ 58-17-154 to 58-17-161.

58-17-163. Dental care insurers to honor assignment of benefits.

58-17-164. Revocation of assignment of dental insurance benefits.

58-17-165. Reimbursement of payment from insured following receipt of payment from insurer.

58-17-166. Scope of benefits not affected--Medical benefits not included.

58-17-167. Definitions pertaining to telehealth coverage.

58-17-168. Coverage for health care services provided through telehealth.

58-17-169. Discrimination between coverage for services provided in person and through telehealth prohibited.

58-17-170. Application of telehealth coverage requirements.

58-17-171. Payment for dental services--Credit card requirement prohibited.

58-17A-1. Definition of terms.

58-17A-2. Regulations to establish specific standards for policy provisions.

58-17A-3. Preexisting conditions--Policy provisions.

58-17A-3.1. Preexisting conditions provision prohibited in replacement policy--Exception.

58-17A-4. Reasonable benefits required--Regulations to establish minimum standard from loss ratios--Policies issued through mail or mass media advertising.

58-17A-4.1. 58-17A-4.1. Repealed by SL 1992, ch 347, § 5

58-17A-5. Outline of coverage delivered at time of application for insurance.

58-17A-6. Informational brochures.

58-17A-7. Health insurance policies--Requirements for information regarding medicare coverage.

58-17A-8. Notice of right to return and right to premium refund printed in medicare supplement policies and certificates--Payment of refund.

58-17A-8.1. Issuance of policies by insurance company, nonprofit hospital service plan, medical service corporation, or fraternal benefit society--Delivery receipts--Certificates of mailing--Term of retention.

58-17A-9. Regulations subject to Administrative Procedures Act.

58-17A-10. Filing requirements--Master policy--Rates, rating schedules, and supporting documentation--Riders or amendments to delete outpatient prescription drug benefits.

58-17A-11. Premiums to be adjusted to produce a loss ratio conforming with minimum standards--Form of adjustments.

58-17A-12. 58-17A-12. Repealed by SL 1990, ch 396, § 3

58-17A-13. Review of advertisements of issuers providing medicare supplement insurance.

58-17A-14. Requirements for replacement of policy.

58-17A-15. Sale of second policy prohibited except as replacement--Liability of issuer.

58-17A-16. Additional penalties for violation of title.

58-17A-17. Conditional or discriminatory policy or certificate prohibited.

58-17B-1. Scope.

58-17B-2. Definition of terms.

58-17B-3. Minimum requirements for individual policy.

58-17B-4. Adoption of rules--Standards for disclosure.

58-17B-5. Grounds for termination and certain provisions prohibited.

58-17B-5.1. Replacement of policy--Waiver of time periods.

58-17B-6. Defining "preexisting conditions"--Requirements--Exclusions for loss or confinement--Extending limitation periods.

58-17B-7. Requirements for long-term care insurance policies--Post-confinement, post-acute care, or recuperative benefits.

58-17B-8. Adoption of rules to establish loss ratio standards.

58-17B-9. Policyholder's right to return--Notice.

58-17B-10. Delivery of outline of coverage--Contents.

58-17B-11. Contents of certificate.

58-17B-12. Compliance with chapter prerequisite to advertisement, marketing, offer.

58-17B-13. Endorsement required--Cost-of-living adjustment not required.

58-17B-13.1. Establishment of standards and requirements for cost-of-living adjustment.

58-17B-14. Coverage offered to resident under group policy issued in other state--Requirements.

58-17B-15. Rules in accordance with chapter 1-26.

58-17B-16. Temporary absence from nursing home or assisted living facility--Effect on benefits for long-term care charges and other requirements--Application.

58-17C-1. 58-17C-1 to 58-17C-52. Repealed by SL 2011, ch 219, § 1.

58-17C-53. 58-17C-53. Repealed by SL 2003, ch 250, § 11

58-17C-54. 58-17C-54 to 58-17C-60. Repealed by SL 2011, ch 219, § 1.

58-17C-61. 58-17C-61, 58-17C-62. Repealed by SL 2003, ch 250, §§ 28, 29

58-17C-63. 58-17C-63 to 58-17C-103. Repealed by SL 2011, ch 219, § 1.

58-17C-104. 58-17C-104. Transferred to § 58-17E-9.

58-17C-105. 58-17C-105. Transferred to § 58-17E-39.

58-17C-106. 58-17C-106. Transferred to § 58-17E-41.

58-17C-107. 58-17C-107. Transferred to § 58-17E-45.

58-17C-108. 58-17C-108. Repealed by SL 2006, ch 257, § 19.

58-17D-1. Definitions.

58-17D-2. Certain utilization review organizations exempt from managed health care provisions.

58-17D-3. Property and casualty insurers to use registered utilization review organizations.

58-17D-4. Utilization review to be administered by qualified professional.

58-17D-5. Certain basis for fees prohibited.

58-17D-6. Insurer denying policyholder's claim to provide for reconsideration.

58-17D-7. No cause of action created or abrogated.

58-17E-1. Affiliate defined.

58-17E-2. Discount medical plan defined.

58-17E-3. Discount prescription drug plan defined.

58-17E-4. Discount medical plan organization defined.

58-17E-5. Definitions.

58-17E-6. Application of chapter.

58-17E-7. Registration exception and compliance requirements for otherwise registered health carriers.

58-17E-8. Notification of director required where discount medical plan organization loses registration or is subject to disciplinary proceeding in another state.

58-17E-9. Registration of discount medical plan organization.

58-17E-10. Review of application.

58-17E-11. Internet website to be established.

58-17E-12. Duration of registration--Renewal applications.

58-17E-13. Renewal of registration.

58-17E-14. Nonrenewal, suspension, or revocation of registration.

58-17E-15. Notice of grounds for nonrenewal, suspension, or revocation--Hearing.

58-17E-16. Winding up of affairs.

58-17E-17. Duration of suspension--Conditions for reinstatement.

58-17E-18. Consent orders.

58-17E-19. Registration exception for providers giving discounts to own patients.

58-17E-20. Surety bond.

58-17E-21. Deposit in lieu of surety bond.

58-17E-22. Surety bonds and deposits not subject to levy by claimants.

58-17E-23. Examination or investigation of discount medical organization--Expenses.

58-17E-24. Pro rata reimbursement of charges upon cancellation of membership.

58-17E-25. Written materials on member benefits.

58-17E-26. Services to be provided in accordance with written agreement.

58-17E-27. Contents of provider agreement.

58-17E-28. Contents of provider network agreement.

58-17E-29. Agreements with entity contracting with provider network.

58-17E-30. Copies of agreements to be maintained.

58-17E-31. Internet website requirements.

58-17E-32. Application of provider agreement requirements.

58-17E-33. Marketing of product--Agreement.

58-17E-34. Contents of marketing agreement.

58-17E-35. Liability for conduct of marketer.

58-17E-36. Approval of advertisements and marketing materials.

58-17E-37. Submission of advertising and marketing materials to director.

58-17E-38. Advertisements to be truthful and not misleading.

58-17E-39. Disclosure that product is not insurance--Advertisements--Rules--Revocation of registration--Agents.

58-17E-40. Prohibited conduct.

58-17E-41. Signature on contract required prior to receipt of consideration--Disclosure of information--Exception.

58-17E-42. Disclosures required for telephone contacts.

58-17E-43. Member to be provided written copy of terms of plan.

58-17E-44. Contents of written materials.

58-17E-45. Consumer's right to return plan or program--Refund.

58-17E-46. Notice to director of change in plan.

58-17E-47. Construction with trade practices statute.

58-17F-1. Definitions.

58-17F-2. Health benefit plan defined.

58-17F-3. Medical director required for managed care plans.

58-17F-4. Health carrier to provide written information to prospective enrollees--Specific information required.

58-17F-5. Health carrier to maintain provider network sufficient to assure services without unreasonable delay--Emergency services--Determination of sufficiency.

58-17F-6. Where provider network is insufficient, covered benefit to be made available at no greater cost.

58-17F-7. Health carrier to ensure provider proximity to covered persons.

58-17F-8. Health carrier to monitor provider ability, capacity, and authority--Financial capability to be monitored in capitated plans.

58-17F-9. Factors to consider in determining network adequacy.

58-17F-10. Access plan required for managed care plans--Annual update--Contents--Exemptions for discounted fee-for-service networks.

58-17F-11. Requirements for health carrier and providers in managed care plans.

58-17F-12. Provisions governing contractual arrangements between health carriers and intermediaries.

58-17F-13. Sample contract forms to be filed with director--Material changes to be submitted--Certain changes not material--Director's inaction within certain time deemed approval--Contract copies to be provided upon request.

58-17F-14. Contract does not relieve health carrier of liability.

58-17F-15. Remedies available to director against health carrier found not in compliance.

58-17F-16. Managed care contractor to register with director.

58-17F-17. Filing changes in registration information.

58-17F-18. Request for information from managed care contractor.

58-17F-19. Activities of nonregistered managed care contractor prohibited.

58-17F-20. Registration fee for managed care contractor.

58-17F-21. Promulgation of rules.

58-17G-1. Definitions.

58-17G-2. Health benefit plan defined.

58-17G-3. Health carrier to develop and maintain systems to measure quality of services--System requirements--Description of quality assessment program to be filed with director.

58-17G-4. Health carrier issuing closed plan to develop quality improvement activities--Minimum requirements of quality improvement activities.

58-17G-5. Carrier may be deemed in compliance if private accrediting body meets requirements.

58-17G-6. Division to monitor complaints regarding managed care policies.

58-17G-7. Promulgation of rules.

58-17H-1. Definitions.

58-17H-2. Health benefit plan defined.

58-17H-3. Urgent care request defined.

58-17H-4. Applicability of chapter.

58-17H-5. Health carrier to provide emergency services coverage without requiring prior authorization--Standards for coverage of emergency services.

58-17H-6. In-network emergency services.

58-17H-7. Cost-sharing requirements for out-of-network emergency services.

58-17H-8. Cost-sharing requirements for covered persons--Payments to out-of-network providers.

58-17H-9. Exceptions for payments by capitated and other plans without negotiated fees.

58-17H-10. Negotiated amounts for in-network providers for a particular emergency service.

58-17H-11. General cost-sharing requirements allowed.

58-17H-12. Access to representative for post-evaluation or post-stabilization services.

58-17H-13. Health carrier may be deemed to meet emergency medical coverage requirements if met by private accrediting body.

58-17H-14. Health carrier responsibility for utilization review activities.

58-17H-15. Director to hold health carrier responsible for utilization review performance of contractor.

58-17H-16. Written utilization review program required--Contents of program document.

58-17H-17. Utilization review program to use documented clinical review criteria--Criteria to be available to authorized agencies upon request.

58-17H-18. Program to be administered by qualified licensed health care professionals.

58-17H-19. Determinations to be issued in timely manner--Process to ensure consistency.

58-17H-20. Effectiveness and efficiency of program to be routinely reviewed.

58-17H-21. Data systems to support program activities and generate management reports.

58-17H-22. Health carrier oversight of delegated activities--Requirements.

58-17H-23. Utilization review to be coordinated with other medical management activity of health carrier.

58-17H-24. Health carrier to provide free access to review staff.

58-17H-25. Only information necessary for review or determination to be collected.

58-17H-26. Independence and impartiality required for utilization review.

58-17H-27. Written procedures required for making determinations--Notification.

58-17H-28. Prospective review determinations--Timing--Notification of requirements--Extension of time.

58-17H-29. Concurrent review determinations--Timing--Notification requirements.

58-17H-30. Retrospective review determinations--Timing--Notification requirements.

58-17H-31. Calculation of time period for determination for prospective and retrospective reviews.

58-17H-32. Notification of adverse determination--Contents.

58-17H-33. Information required to be provided to covered persons and prospective covered persons.

58-17H-34. Health carrier may be deemed to meet utilization review requirements if met by private accrediting body.

58-17H-35. Registration of utilization review organizations--Required information.

58-17H-36. Filing changes in registration information.

58-17H-37. Requests for information from utilization review organizations.

58-17H-38. Activities of nonregistered utilization review organizations prohibited.

58-17H-39. Registration fee for utilization review organizations.

58-17H-40. Urgent care requests--Written procedures required for receipt and determination of requests.

58-17H-41. Insufficient information for determination--Notice and statement of necessary information.

58-17H-42. Insufficient information for determination of prospective urgent care requests.

58-17H-43. Urgent care requests--Timely notification of determination.

58-17H-44. Time within which to submit necessary information.

58-17H-45. Urgent care requests--Notice of determination--Failure to submit necessary information as grounds for denial of certification.

58-17H-46. Concurrent review urgent care requests--Extended care requests--Time for determination and notice.

58-17H-47. Calculation of time periods for determination.

58-17H-48. Notification of adverse determination--Requirements.

58-17H-49. Promulgation of rules.

58-17H-50. Coverage for cancer treatment medication.

58-17H-51. Reclassification of benefits with respect to cancer treatment medications.

58-17H-52. Medical management practices complying with chapter.

58-17H-53. Step therapy protocols.

58-17H-54. Step therapy protocols--Process--Transparency.

58-17H-55. Step therapy override exceptions.

58-17H-56. Limitations.

58-17I-1. Definitions.

58-17I-2. Health benefit plan defined.

58-17I-3. Urgent care request defined.

58-17I-4. Register of grievances required--Information to be compiled--Maintenance.

58-17I-5. Repealed.

58-17I-6. Grievance procedures--Filing--Certificate of compliance--Contact information.

58-17I-7. Review of adverse determination--Time for filing--Designation and notice of reviewers--Scope of review.

58-17I-8. Rights of covered person or authorized representative on review--Access to documentation.

58-17I-9. Time for decision and notice--Calculation of time periods.

58-17I-10. Procedures for providing new or additional evidence.

58-17I-11. Issuance of decision--Required contents.

58-17I-12. Expedited review for adverse determinations involving urgent care requests--Appointment of peers for review.

58-17I-13. Transmission of necessary information for certain expedited reviews.

58-17I-14. Expedited review decision not initial determination for benefits--Notification--Time periods--Continuation of service involving concurrent review urgent care requests.

58-17I-15. Expedited review decision--Notification--Required contents.

58-17I-16. Promulgation of rules.

58-17J-1. Definitions.

58-17J-2. Patient choice--Health care provider participation.

58-17K-1. Definitions.

58-17K-2. Cost-sharing information described--Required disclosure to enrollees.

58-17K-3. Cost-sharing information disclosed--Required internet method and format.

58-17K-4. Cost-sharing information disclosed--Paper or other method on request--Limit on providers per request.

58-17K-5. Prescription drug file--Required public disclosure--Method, format, and updates.

58-17K-6. Cost-sharing information or prescription drug file--Third party contract to provide information--Health insurer responsible.

58-17K-7. Acting in good faith--Error or omission--Reliance on other entity.

58-17K-8. Compliance with applicable laws required.

58-17K-9. Applicability to certain plans.

58-17K-10. Rules and regulations.

58-17K-11. Plan years effective.