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South Dakota Codified Laws
Insurance
Health Insurance Policies
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Section
58-17-1
Requirements for all health insurance policies delivered in state.
Section
58-17-1.1
Grandfathered plans required to cover low-dose mammography--Extent of coverage.
Section
58-17-1.2
Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.
Section
58-17-1.3
Diabetes coverage not required of certain plans and policies.
Section
58-17-1.4
Policies required to cover occult breast cancer screening.
Section
58-17-2
Persons covered by policy.
Section
58-17-2.1
Health insurance on a franchise plan.
Section
58-17-2.2
Conversion privileges of insured's spouse upon divorce.
Section
58-17-2.3
Dependent coverage termination--Age--Full-time students.
Section
58-17-3
Time of commencement and termination to be set out in policy.
Section
58-17-4
Consideration for policy to be stated.
Section
58-17-4.1
Filing and approval of individual policy premium rates.
Section
58-17-4.2
Premium rates required to be reasonable--Rules to establish minimum standards promulgated by director.
Section
58-17-4.3
58-17-4.3.Transferred to §58-17-74.1 by SL 2005, ch 10, §41.
Section
58-17-5
Identification of forms, riders and endorsements--Form number, location.
Section
58-17-6
Style and arrangement of policy provisions--Printing, size of type.
Section
58-17-7
Documents forming part of policy--Setting forth in full, rates and classifications excepted.
Section
58-17-8
Exceptions and reductions of coverage to be clearly set out.
Section
58-17-9
Renewal of policy at option of insurer--Statement in policy so informing the policyholder.
Section
58-17-10
58-17-10.Repealed by SL 2006, ch 259, §32.
Section
58-17-10.1
Reduction of benefits because of increase in statutory disability benefits prohibited.
Section
58-17-10.2
Individual policy for insured's spouse required in policies covering spouse--Eligibility--Coverage--Waiting periods.
Section
58-17-11
Return of policy by purchaser--Refund of premium paid--Dissatisfaction with terms after examination.
Section
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.
Section
58-17-12
Required provisions--Captions--Substitutes, approval by director.
Section
58-17-13
Omission from policy of inapplicable provision--Approval of director--Modification of inconsistent provision.
Section
58-17-14
Entire contract and change clauses required--Signed acceptance required for endorsements.
Section
58-17-15
Time limit on certain defenses--Application of section.
Section
58-17-16
58-17-16.Repealed by SL 2011, ch 216, §5.
Section
58-17-17
Grace period on premiums required in policy.
Section
58-17-18
Renewal of policy--Restriction on company's right to refuse.
Section
58-17-19
Reinstatement when premium not paid within grace period.
Section
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.
Section
58-17-21
Notice of claim--Provision required in policy.
Section
58-17-22
Notice of claim--Loss of time benefit--Optional provision, insertion by insurer.
Section
58-17-23
Claim forms--Furnishing by insurer.
Section
58-17-24
Proofs of loss--Provision required in policy.
Section
58-17-25
Time of payment of claims--Provision required in policy.
Section
58-17-26
Payment of claims--Persons to whom benefits payable--Provision required in policy.
Section
58-17-27
Payment of claims--Optional provisions, insertion by insurer.
Section
58-17-28
Physical examination of insured--Autopsy in death claims--Provision required in policy.
Section
58-17-29
Action to recover under policy--Time for beginning.
Section
58-17-30
Beneficiary--Changes reserved to insured.
Section
58-17-30.1
Continuation of coverage for child with intellectual or physical disability--Proof of dependency.
Section
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.
Section
58-17-30.3
Premature birth and congenital defects covered--Applicability.
Section
58-17-30.4
Notice of birth or adoption required for continued coverage.
Section
58-17-30.5
Coverage for inpatient alcoholism treatment required.
Section
58-17-30.6
Alcoholism benefits provided--Days of care.
Section
58-17-30.7
Policies excluded from alcoholism coverage requirements.
Section
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.
Section
58-17-30.9
Notice that dependent is no longer eligible for coverage--Premium adjustment.
Section
58-17-31
Optional policy provisions.
Section
58-17-32
Occupational change--Policy provision for adjustment of premium or benefits.
Section
58-17-33
Misstatement of age--Policy provision for adjustment of benefits.
Section
58-17-34
Earnings of insured--Policy provision for adjustment of benefits.
Section
58-17-35
Earnings adjustment clause to be coupled with insured's right to continue policy in force.
Section
58-17-36
Option of insurer to define "valid loss of time coverage".
Section
58-17-37
Unpaid premiums--Deduction from benefits.
Section
58-17-38
Conformity with state statutes of insured.
Section
58-17-39
Illegal occupation of insured.
Section
58-17-40
Renewal of policy at option of insurer.
Section
58-17-41
Order of policy provisions.
Section
58-17-42
Age limit in policy--Effect of acceptance of premiums or misstatement of age.
Section
58-17-43
Third parties taking policy covering insured.
Section
58-17-44
Foreign or alien insurer--Policy provision required by home state.
Section
58-17-45
Policy of domestic insurer delivered in other state--Compliance with laws of other state.
Section
58-17-46
Policy provisions not subject to chapter--Conforming to statute required.
Section
58-17-47
Nonconforming and conflicting provisions construed in conformity with statute.
Section
58-17-48
Liability and workers' compensation insurance--Inapplicability of health insurance provisions.
Section
58-17-49
Health insurance provisions inapplicable to group or blanket policy.
Section
58-17-50
Life insurance, endowment or annuity contracts not subject to health insurance provisions.
Section
58-17-51
Health insurance provisions inapplicable to reinsurance.
Section
58-17-52
Prior contracts or policies excepted.
Section
58-17-53
Optometric services--Reimbursement, exceptions.
Section
58-17-54
Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans for public employees--Restrictions on policy limitations.
Section
58-17-54.1
Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services.
Section
58-17-55
Reimbursement provisions applicable to licensed hospitals.
Section
58-17-56
Reimbursement for service rendered or supervised by qualified mental health professional.
Section
58-17-57
"Abuse of health insurance" defined--Violation as misdemeanor.
Section
58-17-58
Waiver of required deductible or co-payment for charitable purposes permitted.
Section
58-17-59
When waiver presumed.
Section
58-17-60
Certain payments exempt.
Section
58-17-61
Assignment of health insurance proceeds to certain hospitals authorized.
Section
58-17-62
Coverage for phenylketonuria.
Section
58-17-63
"Health benefit plan" defined.
Section
58-17-64
Minimum loss ratio for individual health benefit plans.
Section
58-17-65
Individual health insurance plan used in conjunction with managed care plan or utilization review organization.
Section
58-17-66
Definitions for 58-17-66 through 58-17-87.
Section
58-17-67
"Professional association" defined.
Section
58-17-68
"Professional association plan" defined.
Section
58-17-69
"Creditable coverage" defined.
Section
58-17-70
Application of 58-17-66 to 58-17-87, inclusive.
Section
58-17-71
Separate classes of individual business--Reasons--Number.
Section
58-17-72
Transitional period when additional class of business acquired.
Section
58-17-73
Director approval required to establish additional classes of business--Rates or rating methodologies.
Section
58-17-74
Provisions for premium rates for individual health benefit plans.
Section
58-17-74.1
Premium rate limitations.
Section
58-17-75
Promulgation of rules for rates charged for individual health benefit plans.
Section
58-17-76
Transfer into or out of class of business.
Section
58-17-77
Temporary suspension of premium rates for individual health insurance--Reasons.
Section
58-17-78
Required disclosure when offering individual health benefit plan.
Section
58-17-79
Documentation of rating methods and practices.
Section
58-17-80
58-17-80.Repealed by SL 2009, ch 262, §1.
Section
58-17-81
Availability of information on rating methods and practices of carriers offering individual health benefit plans.
Section
58-17-82
Renewal of individual health benefit plans--Exceptions.
Section
58-17-83
Election not to renew individual health benefit plan--Future business restricted.
Section
58-17-84
Provisions for carriers providing individual coverage other than excepted benefits.
Section
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.
Section
58-17-85
58-17-85, 58-17-85.1.Repealed by SL 2015, ch 249, §§2, 3.
Section
58-17-86
58-17-86.Repealed by SL 2003 (SS) ch 1, §33
Section
58-17-87
Director to promulgate rules for individual health insurance--Scope of rules.
Section
58-17-88
Minimum inpatient care coverage following delivery.
Section
58-17-89
Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.
Section
58-17-90
Notice to policyholders--Disclosures.
Section
58-17-91
58-17-91 to 58-17-96.Repealed by SL 2000, ch 243, §§16 to 21
Section
58-17-97
Provisions covering preexisting conditions.
Section
58-17-98
Health insurance policies to provide coverage for biologically-based mental illnesses.
Section
58-17-99
Application of § 58-17-98--Exemptions.
Section
58-17-100
Definitions.
Section
58-17-101
Insurer may not exclude certain off-label uses of prescription drugs.
Section
58-17-102
Exceptions.
Section
58-17-103
Provisions limited to cancer or life threatening diseases.
Section
58-17-104
Deductibles, copayments, and managed care review not affected.
Section
58-17-105
Drugs used in research trials not covered.
Section
58-17-106
No reduction or limitation of coverage otherwise required by law.
Section
58-17-107
Health insurance policies to provide coverage for prostate cancer screening.
Section
58-17-108
"Disability income insurance" defined.
Section
58-17-109
Exclusion or reduction of benefits.
Section
58-17-110
Commencement of loss.
Section
58-17-111
Minimum standards--Exceptions.
Section
58-17-112
Promulgation of rules regarding disability income policies--Content.
Section
58-17-113
58-17-113, 58-17-114.Repealed by SL 2015, ch 249, §36, eff. Jan. 1, 2017.
Section
58-17-115
58-17-115.Repealed by SL 2015, ch 249, §5.
Section
58-17-116
58-17-116.Repealed by SL 2015, ch 249, §36, eff. Jan. 1, 2017.
Section
58-17-117
58-17-117, 58-17-118.Repealed by SL 2015, ch 249, §§6, 7.
Section
58-17-119
58-17-119 to 58-17-124.Repealed by SL 2015, ch 249, §36, eff. Jan. 1, 2017.
Section
58-17-125
58-17-125.Repealed by SL 2015, ch 249, §10.
Section
58-17-126
58-17-126.Repealed by SL 2015, ch 249, §36, eff. Jan. 1, 2017.
Section
58-17-127
58-17-127 to 58-17-137.Repealed by SL 2015, ch 249, §§12 to 22.
Section
58-17-138
58-17-138.Repealed by SL 2015, ch 249, §36, eff. Jan. 1, 2017.
Section
58-17-139
58-17-139 to 58-17-141.Repealed by SL 2015, ch 249, §§24 to 26.
Section
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.
Section
58-17-143
58-17-143.Repealed by SL 2015, ch 249, §36, eff. Jan. 1, 2017.
Section
58-17-144
58-17-144, 58-17-145.Repealed by SL 2015, ch 249, §§28, 29.
Section
58-17-145.1
Deadline for submission of health claim under risk pool.
Section
58-17-146
Dental insurers prohibited from setting fees for noncovered service.
Section
58-17-146.1
Certain contract terms voidable by dentist.
Section
58-17-147
Elective abortion coverage prohibited in qualified health plan offered through health insurance exchange.
Section
58-17-148
Qualified health plan sold through exchange to provide for placement through licensed insurance producer--Commissions.
Section
58-17-149
Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period.
Section
58-17-150
Retrospective payment of clean claims for covered services provided by health care professional during credentialing period--Requirements.
Section
58-17-151
Applications to be credentialed.
Section
58-17-152
Application of §§ 58-17-149 to 58-17-151.
Section
58-17-153
Coverage for treatment of hearing impairment for persons under age nineteen.
Section
58-17-154
Definitions for §§ 58-17-155 to 58-17-162.
Section
58-17-155
Exceptions to application of §§ 58-17-154 to 58-17-162.
Section
58-17-156
Policies, contracts, certificates, and plans subject to §§ 58-17-154 to 58-17-162.
Section
58-17-157
Coverage for applied behavior analysis for treatment of autism spectrum disorders.
Section
58-17-158
Authorization, prior approval, and other care management requirements--Annual maximum benefit.
Section
58-17-159
Qualifications of person performing or supervising applied behavior analysis.
Section
58-17-160
Review of treatment.
Section
58-17-161
Services under individualized service plan, family service plan, or education program.
Section
58-17-162
Effective date of §§ 58-17-154 to 58-17-161.
Section
58-17-163
Dental care insurers to honor assignment of benefits.
Section
58-17-164
Revocation of assignment of dental insurance benefits.
Section
58-17-165
Reimbursement of payment from insured following receipt of payment from insurer.
Section
58-17-166
Scope of benefits not affected--Medical benefits not included .
Section
58-17-167
Definitions pertaining to telehealth coverage.
Section
58-17-168
Coverage for health care services provided through telehealth.
Section
58-17-169
Discrimination between coverage for services provided in person and through telehealth prohibited.
Section
58-17-170
Application of telehealth coverage requirements.