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U.S. State Codes
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South-Dakota
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Title 58 - Insurance
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Chapter 17 - Health Insurance Policies
Chapter 17 - Health Insurance Policies
§ 58-17-1 Requirements for all health insurance policies delivered in state.
§ 58-17-1.1 Grandfathered plans required to cover low-dose mammography--Extent of coverage.
§ 58-17-1.2 Policies to provide coverage for diabetes supplies, equipment and education--Exceptions--Conditions and limitations.
§ 58-17-1.3 Diabetes coverage not required of certain plans and policies.
§ 58-17-1.4 Policies required to cover occult breast cancer screening.
§ 58-17-2 Persons covered by policy.
§ 58-17-2.1 Health insurance on a franchise plan.
§ 58-17-2.2 Conversion privileges of insured's spouse upon divorce.
§ 58-17-2.3 Dependent coverage termination--Age--Full-time students.
§ 58-17-3 Time of commencement and termination to be set out in policy.
§ 58-17-4 Consideration for policy to be stated.
§ 58-17-4.1 Filing and approval of individual policy premium rates.
§ 58-17-4.2 Premium rates required to be reasonable--Rules to establish minimum standards promulgated by director.
§ 58-17-4.3 Transferred.
§ 58-17-5 Identification of forms, riders and endorsements--Form number, location.
§ 58-17-6 Style and arrangement of policy provisions--Printing, size of type.
§ 58-17-7 Documents forming part of policy--Setting forth in full, rates and classifications excepted.
§ 58-17-8 Exceptions and reductions of coverage to be clearly set out.
§ 58-17-9 Renewal of policy at option of insurer--Statement in policy so informing the policyholder.
§ 58-17-10 Repealed.
§ 58-17-10.1 Reduction of benefits because of increase in statutory disability benefits prohibited.
§ 58-17-10.2 Individual policy for insured's spouse required in policies covering spouse--Eligibility--Coverage--Waiting periods.
§ 58-17-11 Return of policy by purchaser--Refund of premium paid--Dissatisfaction with terms after examination.
§ 58-17-11.1 Issuance of policies by insurance company, nonprofit hospital service plan, medical service corporation, or fraternal benefit society--Delivery receipts--Certificates of mailing--Term of retention.
§ 58-17-12 Required provisions--Captions--Substitutes, approval by director.
§ 58-17-13 Omission from policy of inapplicable provision--Approval of director--Modification of inconsistent provision.
§ 58-17-14 Entire contract and change clauses required--Signed acceptance required for endorsements.
§ 58-17-15 Time limit on certain defenses--Application of section.
§ 58-17-16 Repealed.
§ 58-17-17 Grace period on premiums required in policy.
§ 58-17-18 Renewal of policy--Restriction on company's right to refuse.
§ 58-17-19 Reinstatement when premium not paid within grace period.
§ 58-17-20 Omission of provision as to application of premiums accepted in connection with reinstatement--Right of insured to continue policy in force by payment of premiums.
§ 58-17-21 Notice of claim--Provision required in policy.
§ 58-17-22 Notice of claim--Loss of time benefit--Optional provision, insertion by insurer.
§ 58-17-23 Claim forms--Furnishing by insurer.
§ 58-17-24 Proofs of loss--Provision required in policy.
§ 58-17-25 Time of payment of claims--Provision required in policy.
§ 58-17-26 Payment of claims--Persons to whom benefits payable--Provision required in policy.
§ 58-17-27 Payment of claims--Optional provisions, insertion by insurer.
§ 58-17-28 Physical examination of insured--Autopsy in death claims--Provision required in policy.
§ 58-17-29 Action to recover under policy--Time for beginning.
§ 58-17-30 Beneficiary--Changes reserved to insured.
§ 58-17-30.1 Continuation of coverage for child with intellectual or physical disability--Proof of dependency.
§ 58-17-30.2 Family coverage to include newborn or newly adopted children--Payment of claim not to be withheld during bonding period of adopted child.
§ 58-17-30.3 Premature birth and congenital defects covered--Applicability.
§ 58-17-30.4 Notice of birth or adoption required for continued coverage.
§ 58-17-30.5 Coverage for inpatient alcoholism treatment required.
§ 58-17-30.6 Alcoholism benefits provided--Days of care.
§ 58-17-30.7 Policies excluded from alcoholism coverage requirements.
§ 58-17-30.8 Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.
§ 58-17-30.9 Notice that dependent is no longer eligible for coverage--Premium adjustment.
§ 58-17-31 Optional policy provisions.
§ 58-17-32 Occupational change--Policy provision for adjustment of premium or benefits.
§ 58-17-33 Misstatement of age--Policy provision for adjustment of benefits.
§ 58-17-34 Earnings of insured--Policy provision for adjustment of benefits.
§ 58-17-35 Earnings adjustment clause to be coupled with insured's right to continue policy in force.
§ 58-17-36 Option of insurer to define "valid loss of time coverage".
§ 58-17-37 Unpaid premiums--Deduction from benefits.
§ 58-17-38 Conformity with state statutes of insured.
§ 58-17-39 Illegal occupation of insured.
§ 58-17-40 Renewal of policy at option of insurer.
§ 58-17-41 Order of policy provisions.
§ 58-17-42 Age limit in policy--Effect of acceptance of premiums or misstatement of age.
§ 58-17-43 Third parties taking policy covering insured.
§ 58-17-44 Foreign or alien insurer--Policy provision required by home state.
§ 58-17-45 Policy of domestic insurer delivered in other state--Compliance with laws of other state.
§ 58-17-46 Policy provisions not subject to chapter--Conforming to statute required.
§ 58-17-47 Nonconforming and conflicting provisions construed in conformity with statute.
§ 58-17-48 Liability and workers' compensation insurance--Inapplicability of health insurance provisions.
§ 58-17-49 Health insurance provisions inapplicable to group or blanket policy.
§ 58-17-50 Life insurance, endowment or annuity contracts not subject to health insurance provisions.
§ 58-17-51 Health insurance provisions inapplicable to reinsurance.
§ 58-17-52 Prior contracts or policies excepted.
§ 58-17-53 Optometric services--Reimbursement, exceptions.
§ 58-17-54 Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans for public employees--Restrictions on policy limitations.
§ 58-17-54.1 Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services.
§ 58-17-55 Reimbursement provisions applicable to licensed hospitals.
§ 58-17-56 Reimbursement for service rendered or supervised by qualified mental health professional.
§ 58-17-57 Abuse of health insurance as misdemeanor.
§ 58-17-58 Waiver of required deductible or co-payment for charitable purposes permitted.
§ 58-17-59 When waiver presumed.
§ 58-17-60 Certain payments exempt.
§ 58-17-61 Assignment of health insurance proceeds to certain hospitals authorized.
§ 58-17-62 Coverage for phenylketonuria.
§ 58-17-63 Health benefit plan defined.
§ 58-17-64 Minimum loss ratio for individual health benefit plans.
§ 58-17-65 Individual health insurance plan used in conjunction with managed care plan or utilization review organization.
§ 58-17-66 Definitions for 58-17-66 to 58-17-87.
§ 58-17-67 Professional association defined.
§ 58-17-68 Professional association plan defined.
§ 58-17-69 Creditable coverage defined.
§ 58-17-70 Application of 58-17-66 to 58-17-87, inclusive.
§ 58-17-71 Separate classes of individual business--Reasons--Number.
§ 58-17-72 Transitional period when additional class of business acquired.
§ 58-17-73 Director approval required to establish additional classes of business--Rates or rating methodologies.
§ 58-17-74 Provisions for premium rates for individual health benefit plans.
§ 58-17-74.1 Premium rate limitations.
§ 58-17-75 Promulgation of rules for rates charged for individual health benefit plans.
§ 58-17-76 Transfer into or out of class of business.
§ 58-17-77 Temporary suspension of premium rates for individual health insurance--Reasons.
§ 58-17-78 Required disclosure when offering individual health benefit plan.
§ 58-17-79 Documentation of rating methods and practices.
§ 58-17-80 Repealed.
§ 58-17-81 Availability of information on rating methods and practices of carriers offering individual health benefit plans.
§ 58-17-82 Renewal of individual health benefit plans--Exceptions.
§ 58-17-83 Election not to renew individual health benefit plan--Future business restricted.
§ 58-17-84 Provisions for carriers providing individual coverage other than excepted benefits .
§ 58-17-84.1 Anesthesia and hospitalization for dental care to be provided certain covered persons (Effective until January 1, 2019).
§ 58-17-84.1 Anesthesia and hospital or ambulatory surgery center charges for dental care to be covered for certain persons (Effective January 1, 2019).
§ 58-17-85 , 58-17-85.1. Repealed.
§ 58-17-86 Repealed.
§ 58-17-87 Director to promulgate rules for individual health insurance--Scope of rules.
§ 58-17-88 Minimum inpatient care coverage following delivery.
§ 58-17-89 Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.
§ 58-17-90 Notice to policyholders--Disclosures.
§ 58-17-91 to 58-17-96. Repealed.
§ 58-17-97 Provisions covering preexisting conditions.
§ 58-17-98 Health insurance policies to provide coverage for biologically-based mental illnesses.
§ 58-17-99 Application of § 58-17-98--Exemptions.
§ 58-17-100 Definitions.
§ 58-17-101 Insurer may not exclude certain off-label uses of prescription drugs.
§ 58-17-102 Exceptions.
§ 58-17-103 Provisions limited to cancer or life threatening diseases.
§ 58-17-104 Deductibles, copayments, and managed care review not affected.
§ 58-17-105 Drugs used in research trials not covered.
§ 58-17-106 No reduction or limitation of coverage otherwise required by law.
§ 58-17-107 Health insurance policies to provide coverage for prostate cancer screening.
§ 58-17-108 Disability income insurance defined.
§ 58-17-109 Exclusion or reduction of benefits.
§ 58-17-110 Commencement of loss.
§ 58-17-111 Minimum standards--Exceptions.
§ 58-17-112 Promulgation of rules regarding disability income policies--Content.
§ 58-17-113 , 58-17-114. Repealed .
§ 58-17-115 Repealed.
§ 58-17-116 Repealed.
§ 58-17-117 , 58-17-118. Repealed.
§ 58-17-119 to 58-17-124. Repealed .
§ 58-17-125 Repealed.
§ 58-17-126 Repealed.
§ 58-17-127 to 58-17-137. Repealed.
§ 58-17-138 Repealed.
§ 58-17-139 to 58-17-141. Repealed.
§ 58-17-142 Maximum premium rates for plans issued prior to August 1, 2003--Rate provisions of § 58-17-75 to apply upon carrier's discontinuance of active marketing.
§ 58-17-143 Repealed.
§ 58-17-144 , 58-17-145. Repealed.
§ 58-17-145.1 Deadline for submission of health claim under risk pool.
§ 58-17-146 Dental insurers prohibited from setting fees for noncovered service.
§ 58-17-147 Elective abortion coverage prohibited in qualified health plan offered through health insurance exchange.
§ 58-17-148 Qualified health plan sold through exchange to provide for placement through licensed insurance producer--Commissions.
§ 58-17-149 Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period.
§ 58-17-150 Retrospective payment of clean claims for covered services provided by health care professional during credentialing period--Requirements.
§ 58-17-151 Applications to be credentialed.
§ 58-17-152 Application of §§ 58-17-149 to 58-17-151.
§ 58-17-153 Coverage for treatment of hearing impairment for persons under age nineteen.
§ 58-17-154 Definitions for §§ 58-17-155 to 58-17-162.
§ 58-17-155 Exceptions to application of §§ 58-17-154 to 58-17-162.
§ 58-17-156 Policies, contracts, certificates, and plans subject to §§ 58-17-154 to 58-17-162.
§ 58-17-157 Coverage for applied behavior analysis for treatment of autism spectrum disorders.
§ 58-17-158 Authorization, prior approval, and other care management requirements--Annual maximum benefit .
§ 58-17-159 Qualifications of person performing or supervising applied behavior analysis .
§ 58-17-160 Review of treatment.
§ 58-17-161 Services under individualized service plan, family service plan, or education program.
§ 58-17-162 Effective date of §§ 58-17-154 to 58-17-161.
§ 58-17-163 Dental care insurers to honor assignment of benefits.
§ 58-17-164 Revocation of assignment of dental insurance benefits.
§ 58-17-165 Reimbursement of payment from insured following receipt of payment from insurer.
§ 58-17-166 Scope of benefits not affected--Medical benefits not included.
§ 58-17-167 Definitions pertaining to telehealth coverage.
§ 58-17-168 Coverage for health care services provided through telehealth.
§ 58-17-169 Discrimination between coverage for services provided in person and through telehealth prohibited.
§ 58-17-170 Application of telehealth coverage requirements.