S.D. Admin. R. 20:06:39:57
After December 31, 2013, a health insurance issuer that offers health insurance coverage in the individual market in this state must offer to any individual in the state all products that are approved for sale in the applicable market, and must accept any individual that applies for any of those products. Nothing in this section requires an issuer to offer or provide coverage outside its approved service area.
A health insurance issuer offering health insurance coverage in the individual market, other than excepted benefits, must ensure that such coverage includes the essential health benefits package as defined in § 20:06:56:03 effective for plan or policy years beginning after December 31, 2013. Except for catastrophic plans, any plans not providing at least a bronze level of coverage or not providing essential health benefits as defined in § 20:06:56:03 must be issued as a supplement to other health insurance coverage and may not be used to replace essential health benefits coverage, a grandfathered health benefit plan or a catastrophic plan.
An issuer may but is not required to confirm residence of any applicant or insured to confirm eligibility. Nothing requires an issuer to exclude nonresidents or international students or their dependents from coverage on a student health plan.
Nothing in this section applies to long-term care, medicare supplement, short-term major medical, accident only, stand-alone dental, TRICARE, disability income, or other policies providing coverage based upon a disability trigger.
S.D. Admin. R. 20:06:39:57
General Authority: SDCL 58-17-87.
Law Implemented: SDCL 58-17-87.