South Dakota Codified Laws 58-41-35. Contents required in evidence of coverage
An evidence of coverage shall contain a clear, concise, and complete statement of:
(1) The health care services and the insurance or other benefits, if any, to which the enrollee is entitled under the health care plan;
Terms Used In South Dakota Codified Laws 58-41-35
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
(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;
(3) Where and in what manner information is available as to how service, including emergency and out–of–area services, may be obtained;
(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
(5) A description of the health maintenance organization’s method for resolving enrollee complaints.
Source: SL 1974, ch 321, § 19 (2).