South Dakota

58-18-1. "Group health insurance" defined.

58-18-2. Employee group insurance authorized--"Employees" defined.

58-18-3. Employer association group health insurance authorized--Employees defined.

58-18-4. Industry fund group insurance authorized--"Employees" defined.

58-18-4.1. Restrictions on issuance of group health insurance policy to association.

58-18-4.2. Required duration of participation by employer member in association plan.

58-18-4.3. Association plan covering state residents to comply with state law.

58-18-4.4. Requirements for insurer offering fully insured health benefit plan through association.

58-18-5. Issuance to person or organization to which group life insurance policy may be issued.

58-18-6. Issuance to cover similar group subject to discretion of director.

58-18-6.1. Coverage of proprietors, partners and executive corporate officer employees.

58-18-7. Continuation without evidence of insurability--Application.

58-18-7.1. Coverage for inpatient treatment of alcoholism to be offered in group policies--Treatment within state included.

58-18-7.2. Benefits provided under alcoholism coverage--Maximum treatment periods permitted.

58-18-7.3. Policies not within alcoholism coverage requirement.

58-18-7.4. Coverage upon application by employee or beneficiary with right to convert following notice of termination.

58-18-7.5. Continuation of coverage upon leaving employment or termination of coverage by insurer--Duration.

58-18-7.6. 58-18-7.6 to 58-18-7.10. Repealed by SL 2001, ch 280, §§ 7 to 11

58-18-7.11. Continuation or conversion policy not required under certain circumstances.

58-18-7.12. Conditions for continuation.

58-18-7.13. Premium for conversion policy and continuation policy.

58-18-7.14. Notification of continuation and conversion rights.

58-18-7.15. Group insurance coverage in lieu of converted individual policies.

58-18-7.16. 58-18-7.16. Repealed by SL 2001, ch 280, § 15

58-18-7.17. Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.

58-18-7.18. Continuation coverage to be same as that available to similarly situated beneficiaries--Option to decrease benefits.

58-18-7.19. Probationary period for continuation or conversion coverage prohibited.

58-18-7.20. Construction with chapter 58-18C.

58-18-7.21. Continued coverage--Insurer's use of experience for rating purposes not limited--Options unavailable in market not required.

58-18-8. Representations by applicant not warranties--Written statement required to avoid insurance or reduce benefits.

58-18-9. Summary statement of coverage for delivery to member of insured group.

58-18-10. Additions to group originally insured.

58-18-11. Direct payment for hospital, medical, or surgical services--Option of insurer.

58-18-11.1. Reduction of benefits because of increase in statutory disability benefits prohibited.

58-18-11.2. 58-18-11.2. Repealed by SL 2009, ch 266, § 1.

58-18-12. "Blanket health insurance" defined.

58-18-13. Blanket health insurance for passengers on common carrier.

58-18-14. Blanket health insurance for employees, dependents, or guests with reference to hazardous activities.

58-18-15. Blanket health insurance for institutions of learning, camps, or sponsors.

58-18-16. Blanket health insurance for religious, charitable, recreational, educational, or civic organizations.

58-18-17. Blanket health insurance for sports team or sponsors.

58-18-18. Blanket health insurance for volunteer group or agency.

58-18-19. Blanket health insurance for other risks approved by director.

58-18-20. Authority to issue blanket health insurance--Filing of copy of form--Required provisions.

58-18-21. Policy and application constitute entire contract--Statements by policyholder not warranties--Written statement required for use in defense of claim.

58-18-22. Sickness or injury--Provision for notice to insurer.

58-18-23. Forms for filing proof of loss--Failure of insurer to furnish, submission of written proof.

58-18-24. Claim for loss of time--Time for furnishing proof of loss--Notice of continuance of disability.

58-18-25. Time for payment of benefits.

58-18-26. Physical examination of insured--Autopsy in death claims.

58-18-27. Time for commencement of action to recover under policy.

58-18-28. Individual application and certificate not required under blanket policy.

58-18-29. Persons to whom benefits payable under blanket health policy.

58-18-30. Chapter inapplicable to prior policies.

58-18-31. Continuation of coverage for child with intellectual or physical disability--Proof of dependency.

58-18-31.1. Dependent coverage termination--Age--Full-time student.

58-18-32. Family coverage to include newborn and newly adopted children.

58-18-33. Premature birth, congenital defects, and birth abnormalities covered--Applicability.

58-18-34. Notice of birth or adoption required for continued coverage.

58-18-35. Notice required for rate increase by group health insurance company.

58-18-36. Grandfathered plans required to cover low-dose mammography--Extent of coverage.

58-18-36.1. Policies required to cover occult breast cancer screening.

58-18-37. Freedom of choice for pharmacy services.

58-18-38. Annual period of enrollment for licensed pharmacies--Actual notice of enrollment period not required.

58-18-39. Provisions denying choice for pharmacy services as void.

58-18-40. Enforcement of provisions permitting choice for pharmacy services.

58-18-41. Coverage for phenylketonuria.

58-18-42. "Health benefit plan" defined.

58-18-43. "Late enrollee" defined.

58-18-44. "Creditable coverage" defined.

58-18-45. Preexisting conditions--Limitation of waiting periods.

58-18-45.1. (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.

58-18-46. Renewability of health benefit plans--Employer's election--Exceptions.

58-18-47. Nonrenewal of health benefit plans by an employer carrier.

58-18-48. Acceptance of new employees for coverage under employer's existing health benefit plan.

58-18-49. Carrier's offer of coverage to employer--Coverage of all eligible employees.

58-18-50. 58-18-50, 58-18-51. Repealed by SL 1997, ch 289, §§ 12, 13

58-18-51.1. Application of §§ 58-18-42 to 58-18-49, inclusive.

58-18-52. Formation of voluntary health insurance purchasing organizations.

58-18-52.1. Political subdivisions permitted to join with health insurance purchasing organizations.

58-18-53. Membership of voluntary health insurance purchasing organizations.

58-18-54. Purchasing organization's responsibility for negotiating terms and conditions.

58-18-55. Purchasing organization's notice of premium charge.

58-18-56. Additional chapters applicable to purchasing organization.

58-18-57. Approval of purchasing organization by Division of Insurance.

58-18-58. Premiums held in trust by purchasing organization.

58-18-59. Rates for group health insurance issued to purchasing organizations.

58-18-60. Reasonable participation requirements for group members of purchasing organizations.

58-18-61. Purchasing organizations exempt from antitrust provisions.

58-18-62. Promulgation of rules for purchasing organizations.

58-18-63. Minimum loss ratio for employer health benefit plans--Application of section.

58-18-64. 58-18-64 to 58-18-75. Repealed by SL 2000, ch 243, §§ 4 to 15

58-18-76. Minimum inpatient care coverage following delivery.

58-18-77. Shorter hospital stay permitted--Follow-up within forty-eight hours required.

58-18-78. Notice to employees or members--Disclosures.

58-18-79. Promulgation of rules to minimally meet federal standards--Additional rules--Scope.

58-18-80. Health insurance policies to provide coverage for biologically-based mental illnesses.

58-18-81. Application--Exemptions.

58-18-82. Carrier to provide annual report--Time frame--Information.

58-18-83. Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.

58-18-84. Diabetes coverage not required of certain plans and policies.

58-18-85. Policies to provide coverage for prostate cancer screening.

58-18-86. Plans subject to § 58-18-45--Exceptions.

58-18-87. Director to promulgate rules governing use of genetic information.

58-18-88. Authorization of self-funded multiple employer trust sponsored by association--Conditions.

58-18-88.1. Request for waiver by association formed in another state.

58-18-89. Promulgation of rules pertaining to multiple employer trusts.

58-18-90. Multiple employer trust not insurance company or association or subject to specified provisions--Exception.

58-18-91. Suspension or revocation of authorization of multiple employer trust--Action in lieu of suspension or revocation.

58-18-92. Payment of premium taxes.

58-18-93. Agent licensing requirements.

58-18-94. Application of provisions regarding multiple employer trusts--Inclusion of large and small employers.

58-18-95. Coverage for treatment of hearing impairment for persons under age nineteen.

58-18A-1. 58-18A-1 to 58-18A-7. Repealed by SL 1999, ch 253, §§ 38 to 44

58-18A-8. 58-18A-8. Repealed by SL 2006, ch 259, § 31.

58-18A-9. 58-18A-9 to 58-18A-14. Repealed by SL 1999, ch 253, §§ 45 to 50

58-18A-15. 58-18A-15 to 58-18A-52. Repealed by SL 2006, ch 259, § 31.

58-18A-53. Definitions.

58-18A-54. Allowable expenses defined.

58-18A-55. Expenses that are not allowable.

58-18A-56. Exclusion of certain expenses.

58-18A-57. Plan defined--Types of coverage considered in coordination of benefits to be stated.

58-18A-58. Contracts and coverages included within definition of plan.

58-18A-59. Contracts and coverages not included within definition of plan.

58-18A-60. Application date.

58-18A-61. Promulgation of rules concerning coordination of health plan benefits.

58-18A-62. Prohibited grounds for reduction of benefits.

58-18A-63. Restriction on excess or secondary benefits provisions.

58-18A-64. Closed panel plans.

58-18A-65. Prohibition on reduction of benefits for coverage not qualifying as plan.

58-18A-66. Order of benefit payments.

58-18A-67. Coordination of benefits only available to secondary plans.

58-18A-68. Order of benefits determined under §§ 58-18A-69 to 58-18A-74.

58-18A-69. Plan covering person other than as dependent.

58-18A-70. Plan covering dependent child.

58-18A-71. Plan covering person as active employee.

58-18A-72. Coverage under COBRA or right of continuation.

58-18A-73. Plan covering person for longer period of time.

58-18A-74. Sharing of allowable expenses equally.

58-18A-75. Calculation of amount to be paid by secondary plan.

58-18A-76. Plan providing benefits as services.

58-18A-77. Coordination of benefits of complying and noncomplying plans.

58-18A-78. Noncomplying secondary plan to advance difference covered person would have received if complying plan had been secondary plan.

58-18A-79. Subrogation distinguished.

58-18A-80. Paying of claim where plans disagree on order of benefits.

58-18A-81. Time for bringing existing contract into compliance with statutory requirements.

58-18A-82. Proceedings not subject to statutory requirements.

58-18A-83. Duties, rights accrued, and offenses committed prior to July 1, 2007.

58-18B-1. Definition of terms.

58-18B-2. Chapter applicable to small employer benefit plans.

58-18B-3. Regulations on premium rates.

58-18B-3.1. Base rate increase to be filed with director--Approval or disapproval.

58-18B-4. 58-18B-4, 58-18B-5. Repealed by SL 1994, ch 383, §§ 12, 13

58-18B-6. Disclosure in solicitation and sales materials.

58-18B-7. Information and documentation required--Disclosure.

58-18B-8. Suspension of rate requirements.

58-18B-9. Application of chapter.

58-18B-10. 58-18B-10. Repealed by SL 2002, ch 237, § 1

58-18B-11. Health maintenance organization considered separate carrier.

58-18B-12. Ceding arrangements resulting in less than fifty percent of obligation or risk retained by carrier prohibited.

58-18B-13. Transition period when acquiring additional class of business.

58-18B-14. Rate changes only for small employer business.

58-18B-15. Provisions for premium rates.

58-18B-16. 58-18B-16. Repealed by SL 2004, ch 305, § 1

58-18B-17. Limit on premium rates.

58-18B-18. Promulgation of rules for rating practices.

58-18B-19. 58-18B-19. Repealed by SL 1998, ch 289, § 13

58-18B-20. Small employer carrier to issue plan to any small employer--Criteria--Exceptions--Two percent earned premium threshold.

58-18B-21. 58-18B-21, 58-18B-22. Repealed by SL 1998, ch 289, §§ 15, 16

58-18B-23. Uniform application of requirements used to determine eligibility of employers.

58-18B-24. Application of minimum participation and minimum employer contribution requirements.

58-18B-25. Considerations in applying minimum participation requirements--Premium discounts.

58-18B-26. Increase in minimum requirements for employee participation or employer contribution prohibited after acceptance for coverage.

58-18B-27. Modification to exclude certain diseases prohibited.

58-18B-27.1. Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.

58-18B-28. Requirements lifted from small employer carrier in financially impaired condition.

58-18B-29. 58-18B-29. Repealed by SL 2001, ch 279, § 5

58-18B-30. 58-18B-30. Repealed by SL 1998, ch 289, § 18

58-18B-31. 58-18B-31, 58-18B-32. Repealed by SL 2001, ch 279, §§ 6, 7

58-18B-33. 58-18B-33. Repealed by SL 2004, ch 305, § 2

58-18B-34. 58-18B-34. Repealed by SL 2011, ch 220, § 1.

58-18B-35. Director to promulgate rules regulating sale of multiple employer trusts and welfare arrangements--Scope of rules.

58-18B-36. Rules governing implementation and administration of this chapter.

58-18B-37. Marketing health benefit plans--Denial of coverage to employer.

58-18B-38. Prohibited activities of small employer carriers or insurance producers.

58-18B-39. Information regarding restricted network provision of carrier.

58-18B-40. Agent compensation based on characteristics of small employer prohibited--Commission on sale of health insurance plan through exchange.

58-18B-41. Compensation of insurance producer based on percentage of premium.

58-18B-42. 58-18B-42. Repealed by SL 2004, ch 305, § 3

58-18B-43. Status of insurance producer's employment may not be affected by health status, claims experience, occupation, or location of small employer placed with carrier.

58-18B-44. Carrier or agent not to induce or encourage employer to exclude employee from coverage.

58-18B-45. Reasons for denial of coverage to be in writing.

58-18B-46. Rules for additional standards for fair marketing and broad availability of benefit plans to small employers--Penalties.

58-18B-47. Third-party administrator treated as small employer carrier.

58-18B-48. Chapter not applicable to certain group health insurance plans.

58-18B-49. Establishing risk adjusters.

58-18B-50. Minimum inpatient care coverage following delivery.

58-18B-51. Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.

58-18B-52. Notice to employees--Disclosures.

58-18B-53. Health insurance policies to provide coverage for biologically-based mental illnesses.

58-18B-54. Application--Exemptions.

58-18B-55. Supplemental or short term individual health benefit plans exempt from provisions of chapter--Conditions.

58-18B-56. Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.

58-18B-57. Diabetes coverage not required of certain plans.

58-18B-58. Health benefit plans to provide coverage for prostate cancer screening.

58-18B-59. 58-18B-59. Repealed by SL 2019, ch 212, § 12.

58-18B-60. Coverage for treatment of hearing impairment for persons under age nineteen.

58-18C-1. Continuation of coverage after employer ceases operations, fails to pay premiums, or cancels coverage--Persons covered--Time.

58-18C-2. 58-18C-2. Repealed by SL 2005, ch 270, § 7.

58-18C-3. Eligibility requirements.

58-18C-4. Notice of termination required.

58-18C-5. Exercising continuation rights--Option to decrease benefits.

58-18C-6. 58-18C-6. Repealed by SL 2005, ch 270, § 8.

58-18C-7. Continuation policy not required in certain circumstances.

58-18C-8. Premiums for continuation policies.

58-18C-9. Notification of continuation rights.

58-18C-10. 58-18C-10. Repealed by SL 2005, ch 270, § 9.

58-18C-11. Enforceability of chapter under Employee Retirement Income Security Act.