Filing and Approval of Policies — Required Provisions
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Except as otherwise required by § 56-26-102, no policy of group accident and sickness insurance shall be delivered or issued for delivery in this state, unless the policy form and rates have been filed with and approved by the commissioner; provided, that in the case of experience-rated group insurance, premium rates and classifications of risk need not be filed, but shall be maintained by the insurance company and made available for review by the commissioner upon the commissioner's request; nor shall any such policy, endorsement, rider or application be issued until the earlier of the expiration of thirty (30) days after the form or rates have been filed or the commissioner giving the commissioner's written approval. The commissioner is authorized to promulgate rules necessary to implement the standards set out in this subsection (a).
The policy must contain, in substance, the following provisions:
A provision that the policy, the application of the employer, or executive officer or trustee of any association or labor union, and the individual applications, if any, of the employees, members or employees of members insured shall constitute the entire contract between the parties, and that all statements made in the applications shall, in the absence of fraud, be deemed representations and not warranties, and that no such statement shall be used in defense of a claim under the policy unless it is contained in a written application;
A provision that the insurer will issue to the policyholder for delivering to the persons insured under the policy, an individual certificate setting forth the benefits and the exceptions thereunder and referring to the master policy under which the coverage is provided; and
A provision that to the group or class thereof originally insured there shall be added from time to time all persons becoming newly eligible for and applying for insurance in the group or class.