S.D. Admin. R. 20:06:58:16

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

Section 20:06:58:16 - Financial requirements and quantitative treatment limitations - Determining portion based on plan payments

For purposes of §§ 20:06:58:07 to 20:06:58:25, inclusive, the determination of the portion of medical or surgical benefits in a classification of benefits subject to a financial requirement or quantitative treatment limitation, or subject to any level of a financial requirement or quantitative treatment limitation, is based on the dollar amount of all plan payments for medical or surgical benefits in the classification expected to be paid under the plan for the plan year or for the portion of the plan year after a change in plan benefits that affects the applicability of the financial requirement or quantitative treatment limitation.

S.D. Admin. R. 20:06:58:16

41 SDR 93, effective 12/3/2014.

General Authority: SDCL 58-17-87, 58-18-79, 58-18-79(15).

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