S.D. Admin. R. 20:06:46:04

Current through Register Vol. 51, page 67, December 16, 2024
Section 20:06:46:04 - Condition of enrollment or continued enrollment may not require additional premium for similarly situated individuals

A carrier subject to this chapter may not require an individual, as a condition of enrollment or continued enrollment under the plan, to pay a premium or contribution rate that is greater than the premium or contribution rate for a similarly situated individual enrolled in the plan based on any health factor that relates to the individual or a dependent of the individual. In determining an individual's premium or contribution rate, discounts, rebates, payments-in-kind, and any other premium differential mechanisms shall be taken into account.

Nothing in this section restricts the aggregate amount that a carrier subject to this chapter may charge an employer for coverage under a plan, except that a carrier subject to this chapter may not quote or charge an employer a different premium than that quoted or charged an individual in a group of similarly situated individuals based on a health factor unless permitted under SDCL chapter 58-18 B.

S.D. Admin. R. 20:06:46:04

29 SDR 48, effective 10/10/2002.

General Authority: SDCL 58-18-79.

Law Implemented: SDCL 58-18-79.