§ 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
§ 58-18-7.11 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
§ 58-18-7.17 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
§ 58-18-7.21 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
§ 58-18-12 “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
§ 58-18-52 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
§ 58-18-76 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
§ 58-18-87 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
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Terms Used In South Dakota Codified Laws > Title 58 > Chapter 18 - Group and Blanket Health Insurance Policies

  • Assets: (1) The property comprising the estate of a deceased person, or (2) the property in a trust account.
  • Baseline: Projection of the receipts, outlays, and other budget amounts that would ensue in the future without any change in existing policy. Baseline projections are used to gauge the extent to which proposed legislation, if enacted into law, would alter current spending and revenue levels.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Children: includes children by birth and by adoption. See South Dakota Codified Laws 2-14-2
  • Continuance: Putting off of a hearing ot trial until a later time.
  • Contract: A legal written agreement that becomes binding when signed.
  • Corporation: A legal entity owned by the holders of shares of stock that have been issued, and that can own, receive, and transfer property, and carry on business in its own name.
  • Dependent: A person dependent for support upon another.
  • 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.
  • Fraud: Intentional deception resulting in injury to another.
  • Guardian: A person legally empowered and charged with the duty of taking care of and managing the property of another person who because of age, intellect, or health, is incapable of managing his (her) own affairs.
  • Jurisdiction: (1) The legal authority of a court to hear and decide a case. Concurrent jurisdiction exists when two courts have simultaneous responsibility for the same case. (2) The geographic area over which the court has authority to decide cases.
  • Liabilities: The aggregate of all debts and other legal obligations of a particular person or legal entity.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
  • Person: includes natural persons, partnerships, associations, cooperative corporations, limited liability companies, and corporations. See South Dakota Codified Laws 2-14-2
  • State: when used in context signifying a jurisdiction other than the State of South Dakota, a state, the District of Columbia, a territory, commonwealth, or possession of the United States of America, or a province of the Dominion of Canada. See South Dakota Codified Laws 58-1-2
  • written: include typewriting and typewritten, printing and printed, except in the case of signatures, and where the words are used by way of contrast to typewriting and printing. See South Dakota Codified Laws 2-14-2