S.D. Admin. R. 20:06:46:08

Current through Register Vol. 51, page 67, December 16, 2024

Section 20:06:46:08 - Preexisting condition exclusion requirements

Section 20:06:46:03 does not prohibit a carrier subject to this chapter from imposing a preexisting condition exclusion period if the preexisting exclusion period:

(1) Complies with the requirements for imposing a preexisting condition exclusion period pursuant to §§ 20:06:40:01, 20:06:40:04, 20:06:40:08, 20:06:40:09, 20:06:40:10, 20:06:40:15, and SDCL 58-18-45;

(2) Is applied uniformly to all similarly situated individuals, as those groups are determined under §§ 20:06:46:09 to 20:06:46:12, inclusive; and

(3) Is not directed at individual participants or beneficiaries based on any health factor of the participants or beneficiaries.

For purposes of §§ 20:06:46:06 to 20:06:46:12, inclusive, a plan amendment relating to a preexisting condition exclusion that is applicable to all individuals in one or more groups of similarly situated individuals under the plan and made effective no earlier than the first day of the first plan year after the amendment is adopted is not considered per se to be directed at any individual participants or beneficiaries.

S.D. Admin. R. 20:06:46:08

29 SDR 48, effective 10/10/2002.

General Authority: SDCL 58-18-79.

Law Implemented: SDCL 58-18-79.