S.D. Admin. R. 20:06:57:10

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

Section 20:06:57:10 - Contracts by multiple employer trusts

All contracts issued by a multiple employer trust shall comply with the following:

(1) Each multiple employer trust application for insurance and each policy and certificate issued by a multiple employer trust shall contain in ten-point type on the front page the following notice prominently displayed:

NOTICE

This policy is issued by a multiple employer trust. Multiple employer trusts are not subject to all of the insurance laws and regulations of South Dakota. This policy is not covered by the South Dakota Life and Health Insurance Guaranty Association in the event of plan failure. Your participation in this plan makes you subject to assessments for health plan costs. By accepting coverage, you must participate in this plan for a minimum of three years to avoid penalties for early departure.

(2) A multiple employer trust must offer on a guarantee-issue basis health benefits to all individuals who qualify as members or enrollees of the association;

(3) A multiple employer trust may offer only medical, dental, optical, surgical, hospital, accident and sickness, prescription, or disability benefits;

(4) All contracts or policies issued by a multiple employer trust shall:

(a) Conform to all the provisions of P.L. 104-191, the Health Insurance Portability and Accountability Act of 1996, including guaranteed issue of all products, preexisting condition limitations, renewability, and portability provisions as well as the issuance of prior coverage certificates to enrollees no longer eligible for plan coverage; and

(b) Comply with all coverage mandates that are applicable to group health insurance under this title.

S.D. Admin. R. 20:06:57:10

40 SDR 102, effective 12/3/2013; 45 SDR 158, effective 6/27/2019

General Authority: SDCL 58-18-89.

Law Implemented: SDCL ch 58-15, 58-18-88, 58-18-89.