S.D. Admin. R. 67:46:14:01

Current through Register Vol. 51, page 57, November 12, 2024

Section 67:46:14:01 - Definitions

Terms used in this chapter mean;

(1) "Caretaker," the adult who lives with and provides care and control of a child eligible for services under this chapter. The caretaker may include the child's parent or parents;

(2) "Child," an individual under age nineteen;

(3) "Group health plan," a plan of, or contributed to by, an employer, including a self-employed person, or employee organization to provide health care, directly or otherwise, to the employees, former employees, the employer, others associated or formerly associated with the employer in a business relationship, or their families. A group health plan includes self-insured plans and plans of incorporated or unincorporated organizations that are organized and operated for educational, religious, charitable, or other purposes and that hold funds exclusively for its members and use those funds to meet the health care needs of its members;

(4) "Health insurance," benefits consisting of medical care provided directly, through insurance or reimbursement, or otherwise, under any hospital or medical service policy or certificate, hospital or medical service plan contract, or health maintenance organization contract offered by a health insurance issuer; and

(5) "Health insurance issuer," an insurance company, insurance service, or insurance organization, including a health maintenance organization, that is required to be licensed to engage in the business of insurance in South Dakota. A health insurance issuer does not include a group health plan.

S.D. Admin. R. 67:46:14:01

26 SDR 168, effective 7/1/2000; 41 SDR 7, effective 7/29/2014; 51 SDR 052, effective 11/11/2024

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

Application of modified adjusted gross income (MAGI), 42 C.F.R. § 435.603 (July 15, 2013).