S.D. Admin. R. 20:06:55:34

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

Section 20:06:55:34 - Issuer standards and certification criteria

In order to participate in an Exchange, a health insurance issuer must have in effect a certification issued or recognized by the director to demonstrate that each health plan it offers in an Exchange is a qualified health plan. The director may certify a health plan as a qualified health plan if the requirements of § 20:06:55:35 are met or the director determines that making the health plan available is in the interest of the qualified individuals and qualified employers. The director may not exclude a health plan on the following basis:

(1) Such plan is a fee-for-service plan;

(2) Through the imposition of premium price controls; or

(3) That the health plan provides treatments necessary to prevent patients' deaths in circumstances determined to be inappropriate or too costly.

S.D. Admin. R. 20:06:55:34

39 SDR 203, adopted June 10, 2013, effective 1/1/2014.

General Authority: SDCL 58-17-87, 58-18-79.

Law Implemented: SDCL 58-17-87, 58-18-79, 58-18-80.