S.D. Admin. R. 20:06:22:32
For the individual market, a health insurance issuer shall consider the claims experience of all individual health plans, other than those enrolled in grandfathered health plans and group plans subject to SDCL 58-17-70, and excepted benefits offered by such issuer in the individual market in a state, including those enrollees who do not enroll in such plans through an Exchange, to be members of a single risk pool.
For the small group market, a health insurance issuer shall consider the claims experience of all enrollees in all health plans, other than grandfathered health plans, subject to SDCL chapter 58-18 B and offered by such issuer in the small group market in a state, including those enrollees who do not enroll in such plans through an Exchange, to be members of a single risk pool.
S.D. Admin. R. 20:06:22:32
General Authority: SDCL 58-17-4.2, 58-17-87, 58-18B-18, 58-18B-36.
Law Implemented: SDCL 58-17-74.1, 58-17-87, 58-18B-18, 58-18B-36.