With respect to a child who has not attained age 26, a plan or issuer may not define dependent for purposes of eligibility for dependent coverage of children other than in terms of a relationship between a child and the participant, and in the individual market, the primary subscriber. A plan or issuer may not deny or restrict coverage for a child who has not attained age 26 based on the presence or absence of the child's financial dependency upon the participant, primary subscriber, or with any other person; residency with the participant and in the individual market the primary subscriber, or any other person; student status; marital status; employment; or any combination of those factors. In addition, a plan or issuer may not deny or restrict coverage of a child based on eligibility for other coverage, except as provided in § 20:06:55:10.
S.D. Admin. R. 20:06:55:02
General Authority: SDCL 58-17-87, 58-18-79.
Law Implemented: SDCL 58-17-87, 58-18-79.