§ 58-33-103 Due diligence investigation required of insurance producer before submitting stop loss policy application for health benefit plan.

SD Codified L § 58-33-103 (2019) (N/A)

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58-33-103. Due diligence investigation required of insurance producer before submitting stop loss policy application for health benefit plan. An insurance producer, prior to submitting an application for a stop loss policy to an insurer for a health benefit plan offered to employees, employee dependents, or a person located in this state, shall carry out appropriate due diligence to establish that the health benefit plan is not unauthorized health insurance, including measures reasonably appropriate to establish:

(1) For any health benefit plan that is represented as established or maintained pursuant to a collective bargaining agreement, the health benefit plan is established or maintained under or pursuant to a collective bargaining agreement under the criteria provided under 29 CFR 2510.3-40 as of January 1, 2007;

(2) The health benefit plan that is not offered by an employee leasing arrangement or professional employer organization to client employers; or

(3) For any health benefit plan that is represented as established by a single employer, that the health benefit plan is covering solely employees, and dependents of employees, of the employer and the employer controls and directs the work of the employee.Source: SL 2007, ch 292, § 11.

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§ 58-33-102 Due diligence investigation required of insurance producer before offering health benefit plan.

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§ 58-33-104 Due diligence investigation required of third party administrator before entering into any administrative contract for health benefit plan.