S.D. Admin. R. 20:06:22:33
Each plan year or policy year, as applicable, each health insurance issuer shall establish its own index rate for this state based on the total combined claims costs for providing essential health benefits within the single risk pool of this state. Separate single risk pools are required for the individual and small group markets. Each health insurance issuer shall adjust the index rate on a market-wide basis based on the total expected market-wide payments and charges under the risk adjustment and reinsurance program in this state. The premium rate for all the plans the health insurance issuer offers in this state market must use the applicable index rate, as adjusted for total expected market-wide payments and charges under the risk adjustment and reinsurance programs, subject only to the adjustments permitted under § 20:06:22:34.
S.D. Admin. R. 20:06:22:33
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.