S.D. Codified Laws § 58-41-63 — SD Code / Title 58 / Chapter 41 / Section 58-41-63
General annual report required--Form and contents
Status: in_force

Every health maintenance organization shall annually, on or before March first, file a report verified by at least two principal officers with the director, covering the preceding calendar year. Such report shall be on forms prescribed by the director and shall include:

(1) A financial statement of the organization, including its balance sheet and receipts and disbursements for the preceding year certified by an independent certified public accountant licensed by an appropriate jurisdiction, reflecting at least:

(a) Prepayment and other payments received for health care services rendered;

(b) Expenditures to all providers, by classes or groups of providers, and insurance companies or nonprofit health service plan corporations engaged to fulfill obligations arising out of the health maintenance contract; and

(c) Expenditures for capital improvements, or additions thereto, including but not limited to construction, renovation or purchase of facilities and capital equipment;

(2) Any material changes in the information submitted pursuant to §§ 58-41-6 to 58-41-9 , inclusive;

(3) The number of new enrollees enrolled during the year, the number of enrollees as of the end of the year and the number of enrollees terminated during the year;

(4) A summary of information compiled pursuant to subdivision 58-41-12(3) on such form as may be required by the director;

(5) A report of the names and residence addresses of all persons set forth in subdivision 58-41-6(3), who were associated with the health maintenance organization during the preceding year, and the amount of wages, expense reimbursements, or other payments to such individuals for services to the health maintenance organization, including a full disclosure of all financial arrangements during the preceding year required to be disclosed pursuant to subdivision 58-41-6(3); and

(6) Such other information relating to the performance of the health maintenance organization as is reasonably necessary to enable the director to carry out his duties under this chapter.

Source: SL 1974, ch 321, § 24; SL 2013, ch 256, § 17.
S.D. Codified Laws § 58-33-91 — SD Code / Title 58 / Chapter 33 / Section 58-33-91
Sale of unregistered securities by insurance producer prohibited
Status: in_force

No insurance producer may offer or sell any security in this state unless the security is registered or exempt from registration pursuant to chapter 47-31B .

Source: SL 2001, ch 287, § 2; SL 2004, ch 278, § 68.
S.D. Codified Laws § 58-33-68 — SD Code / Title 58 / Chapter 33 / Section 58-33-68
Factors considered in determining action taken against violator--Failure to remedy situation--Administrative action
Status: in_force

The Division of Insurance, in interpreting and enforcing §§ 58-33-66 and 58-33-67 , shall consider all pertinent facts and circumstances to determine the severity and appropriateness of action to be taken in regard to any violation of §§ 58-33-66 to 58-33-69 , inclusive, including but not limited to, the following:

(1) The magnitude of the harm to the claimant or insured;

(2) Any actions by the insured, claimant, or insurer that mitigate or exacerbate the impact of the violation;

(3) Actions of the claimant or insured which impeded the insurer in processing or settling the claim;

(4) Actions of the insurer which increase the detriment to the claimant or insured. The director need not show a general business practice in taking administrative action for these violations.

However, no administrative action may be taken by the director for a violation of this section unless the insurer has been notified of the violation and refuses to take corrective action to remedy the situation.

Any administrative action taken by the director shall be pursuant to the provisions of chapter 1-26 .

Source: SL 1986, ch 422, § 3.
S.D. Codified Laws § 58-17-36 — SD Code / Title 58 / Chapter 17 / Section 58-17-36
Option of insurer to define "valid loss of time coverage"
Status: in_force

The insurer may, at its option, include in the provision in § 58-17-34 a definition of "valid loss of time coverage," approved as to form by the director, which definition shall be limited in subject matter to coverage provided by governmental agencies or by organizations subject to regulation by insurance law or by insurance authorities of this or any other state of the United States or any province of Canada, or to any other coverage the inclusion of which may be approved by the director or any combination of such coverages. In the absence of such definition such term shall not include any coverage provided for such insured pursuant to any compulsory benefit statute, including any workers' compensation or employer's liability statute, or benefits provided by union welfare plans or by employer or employee benefit organizations.

Source: SL 1966, ch 111, ch 25, § 19 (2).
S.D. Codified Laws § 58-43-16.1 — SD Code / Title 58 / Chapter 43 / Section 58-43-16.1
Applicability of §§58-43-16.2to58-43-16.9
Status: in_force

The provisions of §§ 58-43-16.2 to 58-43-16.9 , inclusive, do not apply to any foreign or alien insurer licensed in this state or any insurer that is a SOX compliant entity or a direct or indirect wholly-owned subsidiary of a SOX compliant entity.

Source: SL 2009, ch 271, § 16.
S.D. Codified Laws § 58-41-24 — SD Code / Title 58 / Chapter 41 / Section 58-41-24
Mechanisms for enrollee participation in policy and operation of governing body
Status: in_force

The governing body shall establish a mechanism to afford the enrollees an opportunity to express their opinions in matters of policy and operation through the establishment of advisory panels, by the use of advisory referenda on major policy decisions, or through the use of other mechanisms as may be prescribed or permitted by the director.

Source: SL 1974, ch 321, § 16; SL 2013, ch 256, § 9.
S.D. Codified Laws § 58-29E-7 — SD Code / Title 58 / Chapter 29E / Section 58-29E-7
Annual audit of pharmacy benefit manager authorized
Status: in_force

A third-party payor that has contracted with a licensed pharmacy benefit manager may audit the pharmacy benefit manager once each calendar year. The audit authorized by this section is in addition to any other statutory or contractual audit rights. As part of the audit, a third-party payor may request:

(1) All reimbursements paid to retail pharmacies, on a claim level, for all customers of the pharmacy benefit manager in this state, including ancillary charges, claw backs, dispensing fees, drug-specific reimbursements, other fees, rebates, and reimbursement adjustments;

(2) Differences in reimbursement amounts paid to affiliated and unaffiliated pharmacies, including differences in dispensing fees and reimbursed ingredient costs;

(3) Historical claims data, including:

(a) Acquisition costs;

(b) Administrative fees associated with claims;

(c) Amounts paid by a covered individual;

(d) Amounts paid by a third-party payor;

(e) Channels, whether mail or retail;

(f) Dispensing fees;

(g) Formulary tiers;

(h) Ingredient costs;

(i) Ingredient quantity;

(j) Sales tax;

(k) Supply availability by the number of days; and

(l) Usual and customary prices; and

(4) Aggregate rebate amounts, received by calendar quarter, directly or indirectly from manufacturers, including rebates from other entities affiliated with or related to the pharmacy benefit manager, if those entities negotiate or contract with manufacturers.

A pharmacy benefit manager shall, within thirty days, provide the information requested in accordance with this section, together with a certification, signed by the chief executive officer or the chief financial officer of the pharmacy benefit manager, attesting to the accuracy and completeness of the information.

Source: SL 2004, ch 311, § 7; SL 2023, ch 166, § 7.
S.D. Codified Laws § 58-38-29 — SD Code / Title 58 / Chapter 38 / Section 58-38-29
Additional chapters applicable to purchasing organization
Status: in_force

Any organization is subject to all applicable provisions of chapter 58-3 and chapter 58-33 .

Source: SL 1994, ch 382, § 5.
S.D. Codified Laws § 58-1-1 — SD Code / Title 58 / Chapter 1 / Section 58-1-1
Citation of title
Status: in_force

This title shall be known as the Insurance Code.

Source: SL 1966, ch 111, § 1.
S.D. Codified Laws § 58-16-18 — SD Code / Title 58 / Chapter 16 / Section 58-16-18
Insurance of employees or members of group against death of dependents
Status: in_force

Any group life policy issued under §§ 58-16-2 to 58-16-17 , inclusive, may be extended to insure the employees or members against loss due to the death of their spouses and minor children, or any class or classes thereof, subject to the requirements of §§ 58-16-19 to 58-16-22 , inclusive.

Source: SL 1966, ch 111, ch 24, § 2.
S.D. Codified Laws § 58-18-25 — SD Code / Title 58 / Chapter 18 / Section 58-18-25
Time for payment of benefits
Status: in_force

Subject to § 58-18-20 , every blanket health insurance policy shall contain a provision that all benefits payable under the policy other than benefits for loss of time will be payable immediately upon receipt of due written proof of such loss, and that, subject to due proof of loss, all accrued benefits payable under the policy for loss of time will be paid not later than at the expiration of each period of thirty days during the continuance of the period for which the insurer is liable, and that any balance remaining unpaid at the termination of such period will be paid immediately upon receipt of such proof.

Source: SL 1966, ch 111, ch 26, § 5 (5).
S.D. Codified Laws § 58-33A-25.2 — SD Code / Title 58 / Chapter 33A / Section 58-33A-25.2
Annuity training course providers--Training requirements of other states
Status: in_force

Each course provider intending to comply with § 58-33A-25.1 shall cover all subjects listed in § 58-33A-25.1 . No provider of such course may present any marketing information or provide training on sales techniques or provide specific information about a particular insurer's products. Additional subjects may be offered in conjunction with and in addition to the required subjects. Each provider of an annuity training course intending to comply with § 58-33A-25.1 shall register as a continuing education provider in this state and shall comply with the rules applicable to producer continuing education courses as set forth in chapter 58-30 .

An annuity training course may be conducted and completed by classroom or self-study methods. Each provider of annuity training shall comply with the reporting requirements and shall issue certificates of completion in accordance with chapter 58-30 . The satisfaction of the training requirements of another state that are substantially similar to the provisions of this section satisfy the training requirements of this section and § 58-33A-25.1 . The satisfaction of the components of the training requirements of any course or courses with components substantially similar to § 58-33A-25.1 are be deemed to satisfy the training requirements.

Source: SL 2012, ch 250, § 12; SL 2022, ch 186, § 26, eff. Jan. 1, 2023.
S.D. Codified Laws § 58-1-38 — SD Code / Title 58 / Chapter 1 / Section 58-1-38
Conditions for posting property and casualty policy or endorsement on insurer's website
Status: in_force

Notwithstanding any other provision of §§ 58-1-27 to 58-1-39 , inclusive, if a standard property and casualty insurance policy or endorsement does not contain personally identifiable information, an insurer may mail, deliver, or post the policy or endorsement on the insurer's website. If the insurer elects to post an insurance policy or endorsement on the insurer's website in lieu of mailing or delivering the document to the insured, the insurer must comply with the following conditions:

(1) The policy and endorsement must be accessible as long as the policy or endorsement is in force;

(2) After the policy expires, the insurer must maintain and archive the policy and endorsement for five years after the expiration of the policy and shall make the documents available to the party on request;

(3) The insurer must post the policy and endorsement in a manner that allows the insured to print and save the policy and endorsement using a program or application that is widely available on the internet and free to use;

(4) The insurer provides the following information in, or simultaneous with each declarations page provided at the time of issuance of the initial policy and any renewals of that policy;

(a) A description of the exact policy and endorsement form purchased by the insured;

(b) A method by which the insured may obtain, upon request and without charge, a paper copy of the policy; and

(c) The internet address where the insured's policy and endorsement is posted; and

(5) The insurer provides notice, in the format preferred by the insured, of any changes to the form or endorsement, the insured's right to obtain, upon request and without charge, a paper copy of a form, and the internet address where the form and endorsement is posted.

Source: SL 2014, ch 230, § 12.
S.D. Codified Laws § 58-4A-3 — SD Code / Title 58 / Chapter 4A / Section 58-4A-3
Powers of insurance fraud prevention unit
Status: in_force

The insurance fraud prevention unit through its investigator or attorney may do the following:

(1) The investigator or attorney may initiate and conduct independent investigations if the unit has cause to believe that a fraudulent insurance act has been or may be committed;

(2) The investigator or attorney may review reports or complaints of alleged fraudulent insurance acts to determine whether such reports require further investigation and to conduct such investigation;

(3) The investigator or attorney may undertake independent studies to determine the extent of fraudulent insurance acts;

(4) The investigator or attorney may promote awareness of insurance fraud through educational seminars and other education programs for the insurance industry and the general public;

(5) The attorney, subject to applicable criminal or civil law and procedure, may prosecute fraudulent insurance acts on behalf of the state through criminal and civil proceedings; and

(6) The investigator or attorney may cooperate with federal, state, and local law enforcement, prosecuting attorneys, and the attorney general in the investigation and prosecution of fraudulent insurance acts.

Source: SL 1999, ch 241, § 3.
S.D. Codified Laws § 58-18-62 — SD Code / Title 58 / Chapter 18 / Section 58-18-62
Promulgation of rules for purchasing organizations
Status: in_force

The director may promulgate rules pursuant to chapter 1-26 to further the provisions of §§ 58-18-52 to 58-18-62 , inclusive, and for purposes of carrying out the provisions of §§ 58-18-1 to 58-18-6 , inclusive, and to ensure that group health insurance coverage is issued to eligible groups and that organizations are formed and operated to further the purpose of providing economical group health insurance for its members. The rules may include:

(1) Definition of terms;

(2) Criteria for determining groups, associations, organizations, and trusts and their eligibility for coverage;

(3) Criteria for determining substantially similar groups or for determining related industries;

(4) Application requirements and procedures;

(5) Reasonable compensation; and

(6) Organizational structure.

Source: SL 1994, ch 382, § 11.
S.D. Codified Laws § 58-32-40 — SD Code / Title 58 / Chapter 32 / Section 58-32-40
Record open to examination by director--Violation as misdemeanor
Status: in_force

The record shall at all times within five years after issuance of the coverage to which it relates be open to examination by the director. A violation of this section is a Class 2 misdemeanor.

Source: SL 1966, ch 111, ch 11, § 16 (2); SL 1978, ch 359, § 2; SL 2015, ch 260, § 11.
S.D. Codified Laws § 58-33-30 — SD Code / Title 58 / Chapter 33 / Section 58-33-30
Provisions not applicable to life or health insurance or annuities
Status: in_force

Sections 58-33-24 to 58-33-27 , inclusive, do not apply to life insurance, health insurance, or annuity contracts.

Source: SL 1966, ch 111, ch 13, §§ 16 (5), 21 (3); SL 1979, ch 341, § 8.
S.D. Codified Laws § 58-30-159 — SD Code / Title 58 / Chapter 30 / Section 58-30-159
Requirements for nonresident insurance producer license
Status: in_force

Unless denied licensure pursuant to § 58-30-167 , a nonresident person is entitled to receive a nonresident insurance producer license if:

(1) The person is currently licensed as a resident insurance producer and in good standing in the person's home state;

(2) The person has submitted the proper request for licensure and has paid the fees required by § 58-2-29 ;

(3) The person has submitted or transmitted to the director the application for licensure that the person submitted to the person's home state or the application required by § 58-30-148 ; and

(4) Except for fees, the person's home state issues nonresident insurance producer licenses to residents of this state on the same basis.

Source: SL 2001, ch 286, § 19.
S.D. Codified Laws § 58-12-25 — SD Code / Title 58 / Chapter 12 / Section 58-12-25
Reimbursement to department for cost of services
Status: in_force

If the Department of Social Services notifies an insurer that the department has paid for services on behalf of an individual who is covered under an individual, group, or blanket health insurance policy or contract that the insurer issued, delivered, entered into, or renewed in the state, to the extent that the insurer is legally liable, it shall reimburse the department for the cost of the services, regardless of any provision in the health insurance policy or contract that requires payment to the policy holder, subscriber, or another payee. If the insurer, after notice from the department, issues payment to any payee other than the department, the insurer remains liable to the department for the amount of benefits paid to the other party.

Source: SL 2005, ch 263, § 4.
S.D. Codified Laws § 58-41-44 — SD Code / Title 58 / Chapter 41 / Section 58-41-44
Charges to enrollees--Fairness--Actuary's certificate
Status: in_force

Charges for comprehensive health maintenance services may be established in accordance with actuarial principles for various categories of enrollees, provided that such charges applicable to an enrollee shall not be individually determined based on the status of his health. However, the charges shall not be excessive, inadequate, or unfairly discriminatory. A certification, by a qualified actuary, to the appropriateness of the charges, based on reasonable assumptions, shall accompany the filing along with adequate supporting information.

Source: SL 1974, ch 321, § 23 (1).
S.D. Codified Laws § 58-5-160 — SD Code / Title 58 / Chapter 5 / Section 58-5-160
Additional exemptions or exemption authority
Status: in_force

The director of the Division of Insurance may promulgate rules, pursuant to chapter 1-26 , to provide any qualified education loan insurer with additional exemptions from the provisions of Title 58 or to provide additional investment authority.

Source: SL 1998, ch 287, § 7.
S.D. Codified Laws § 58-26-60 — SD Code / Title 58 / Chapter 26 / Section 58-26-60
Mortality tables used for group annuity and pure endowment contracts
Status: in_force

The tables that shall be used for group annuity and pure endowment contracts, excluding any disability and accidental death benefits in the policies are: the Group Annuity Mortality Table for 1951, any modification of the table approved by the director or at the option of the company, any of the tables or modifications of tables specified for individual annuity and pure endowment contracts.

Source: SL 1995, ch 284, § 16.
S.D. Codified Laws § 58-17B-5.1 — SD Code / Title 58 / Chapter 17B / Section 58-17B-5.1
Replacement of policy--Waiver of time periods
Status: in_force

If a long - term care policy replaces another long - term care policy issued by the company or by an affiliated company, the insurer shall waive any time period applicable to preexisting conditions, waiting periods, elimination periods, and probationary periods in the new long - term care policy for similar benefits to the extent such time was spent under the original policy.

Source: SL 1990, ch 398, § 2.
S.D. Codified Laws § 58-3-8 — SD Code / Title 58 / Chapter 3 / Section 58-3-8
Examination disclosing inadequate records--Correction of accounts
Status: in_force

If the director finds accounts to be inadequate, or inadequately kept or posted, he may employ experts to rewrite, post, or balance them at the expense of the person being examined if such person has failed to complete or correct such accounting after the director has given him notice and a reasonable opportunity to do so.

Source: SL 1966, ch 111, ch 2, § 18 (3).
S.D. Codified Laws § 58-44-3 — SD Code / Title 58 / Chapter 44 / Section 58-44-3
Application of chapter based on gross written premium on business placed with controlled insurer
Status: in_force

The provisions of this chapter apply if, in any calendar year, the aggregate amount of gross written premium on business placed with a controlled insurer by a controlling broker is equal to or greater than five percent of the admitted assets of the controlled insurer, as reported in the controlled insurers' quarterly statement filed as of September thirtieth of the prior year.

Source: SL 1992, ch 358, § 3.
S.D. Codified Laws § 58-20-33 — SD Code / Title 58 / Chapter 20 / Section 58-20-33
Involuntary termination of membership in self-insurance association
Status: in_force

A member may be involuntarily terminated as a member of the association if the department finds, after due notice and hearing, that the member:

(1) Has failed to pay any contribution or assessment due to the association;

(2) Has failed to comply with §§ 58-20-25 to 58-20-40 , inclusive, or the rules promulgated pursuant to §§ 58-20-25 to 58-20-40 , inclusive; or

(3) Has failed to comply with the bylaws, loss control policies or discharge any other obligation it owes to the association.

A hearing may be initiated by the department on its own initiative or upon the request of the association's board of directors.

Source: SL 1995, ch 282, § 9.
S.D. Codified Laws § 58-18-36 — SD Code / Title 58 / Chapter 18 / Section 58-18-36
Grandfathered plans required to cover low-dose mammography--Extent of coverage
Status: in_force

Each group health insurance policy that covers a female and that is delivered, issued for delivery, or renewed in this state, except for a policy that provides coverage for specified disease or other limited benefit coverage, shall provide coverage for screening by low-dose mammography for the presence of occult breast cancer that is subject to the same dollar limits, deductibles and coinsurance factors as for other radiological examinations. Coverage for the screening shall be provided as follows: ages thirty-five to thirty-nine, one baseline mammography; ages forty to forty-nine, a mammography every other year; and age fifty and older, a mammography every year.

As used in this section, "low-dose mammography" means the X ray examination of the breast using equipment dedicated specifically for mammography, including the X ray tube, filter, compression device, screens, films, and cassettes, with an average radiation exposure delivery of less than one rad midbreast, with two views for each breast and with interpretation by a qualified radiologist.

The provisions of this section apply only to grandfathered plans pursuant to 75 Fed. Reg. 116 (2010) to be codified at 26 C.F.R. §§ 54 and 602, 29 C.F.R. § 2590, and 45 C.F.R. § 147. (SL 2011, ch 216, § 19 provides: "The provisions of this Act are repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed.")

Source: SL 1990, ch 397, §§ 1, 4; SL 1991, ch 400, § 4; SL 2011, ch 216, § 9.
S.D. Codified Laws § 58-29B-148 — SD Code / Title 58 / Chapter 29B / Section 58-29B-148
Court may appoint ancillary receiver on terms deemed appropriate--Filing--Notice imparted
Status: in_force

The court may issue an order appointing an ancillary receiver in whatever terms it deems appropriate. The filing or recording of the order with the register of deeds in this state imparts the same notice as a deed, bill of sale, or other evidence of title duly filed or recorded with that register of deeds.

Source: SL 1989, ch 436, § 148.
S.D. Codified Laws § 58-17-10.2 — SD Code / Title 58 / Chapter 17 / Section 58-17-10.2
Individual policy for insured's spouse required in policies covering spouse--Eligibility--Coverage--Waiting periods
Status: in_force

No health insurance policy providing coverage of hospital or medical expense which in addition to covering the insured also provides coverage to the spouse of the insured shall be issued without a provision that provides that upon eligibility for medicare or social security disability benefits by one spouse the other spouse shall be entitled to have issued to him or her, without evidence of insurability, upon application to the company within sixty days following the eligibility, and upon payment of the appropriate premium, an individual policy of accident or health insurance. Such policy shall provide the coverage then being issued by the insurer which is most nearly similar to the existing coverages. This obligation can be met by continuation of coverage for spouse under existing policy at the appropriate premium. Any and all probationary or waiting periods set forth in such policy shall be considered as being met to the extent coverage was in force under the prior policy.

Source: SL 1979, ch 343.
S.D. Codified Laws § 58-43-5.1 — SD Code / Title 58 / Chapter 43 / Section 58-43-5.1
Examination of financial statements by accountant
Status: in_force

Financial statements furnished pursuant to § 58-43-4 shall be examined by the independent certified public accountant. The audit of the insurer's financial statements shall be conducted in accordance with generally accepted auditing standards. In accordance with AU Section 319 of the Professional Standards of the AICPA, Consideration of Internal Control in a Financial Statement Audit as of January 1, 2009, the independent certified public accountant should obtain an understanding of internal control sufficient to plan the audit. To the extent required by AU Section 319, for those insurers required to file a Management's Report of Internal Control over Financial Reporting pursuant to § 58-43-16.13 , the independent certified public accountant should consider, as that term is defined in Statement on Auditing Standards (SAS) No. 102, Defining Professional Requirements in Statements on Auditing Standards as of January 1, 2009, the most recently available report in planning and performing the audit of the statutory financial statements. Consideration shall be given to the procedures illustrated in the Financial Condition Examiners Handbook promulgated by the National Association of Insurance Commissioners as adopted by the director by rules promulgated pursuant to chapter 1-26 , as the independent certified public accountant deems necessary.

Source: SL 2009, ch 271, § 14.
S.D. Codified Laws § 58-14-20 — SD Code / Title 58 / Chapter 14 / Section 58-14-20
Disallowal of credit or deduction
Status: in_force

The director may not allow a credit or deduction to the ceding insurer if the director determines the quality, quantity, or diversity of investments in the trust account of a reinsurer or the surplus to policyholders of the reinsurer is hazardous to a ceding insurer or policyholders.

Source: SL 1992, ch 344, § 18.
S.D. Codified Laws § 58-29F-5 — SD Code / Title 58 / Chapter 29F / Section 58-29F-5
Audit terms
Status: in_force

Unless otherwise prohibited by federal statutes or regulations, for any entity conducting a pharmacy audit the following audit items apply:

(1) The period covered by the audit may not exceed twenty-four months from the date that the claim was submitted to or adjudicated by the entity, unless a longer period is required under state or federal law;

(2) If an entity uses random sampling as a method for selecting a set of claims for examination, the sample size shall be appropriate for a statistically reliable sample. Notwithstanding any other provision, the auditing entity shall provide the pharmacy a masked list that provides a prescription number or date range that the auditing entity is seeking to audit;

(3) An on-site audit may not take place during the first five business days of the months of December and January unless the pharmacy consents;

(4) An auditor may not enter any portion of the pharmacy area where patient-specific information is available unless escorted, and to the extent possible shall remain out of sight and hearing range of the pharmacy patients;

(5) Any recoupment may not be deducted against future remittances until final completion of any appeals process and both parties have received the results of the final audit;

(6) A pharmacy benefits manager may not require information to be written on a prescription unless the information is required to be written on the prescription by state or federal law. Recoupment may be assessed for items not written on the prescription if:

(a) Additional information is required in the provider manual; or

(b) The information is required by the Food and Drug Administration; or

(c) The information is required by the drug manufacturer's product safety program; and

(d) The information in subsections (a), (b), or (c) is not readily available for the auditor at the time of the audit;

(7) The auditing company or agent may not receive payment based on a percentage of the amount recovered. This section does not prevent the entity conducting the audit from charging or assessing the responsible party, directly or indirectly, based on amounts recouped if:

(a) The plan sponsor and the entity conducting the audit have a contract that explicitly states the percentage charge or assessment to the plan sponsor; and

(b) A commission to an agent or employee of the entity conducting the audit is not based, directly or indirectly, on amounts recouped.

Source: SL 2013, ch 254, § 5.
S.D. Codified Laws § 58-18-33 — SD Code / Title 58 / Chapter 18 / Section 58-18-33
Premature birth, congenital defects, and birth abnormalities covered--Applicability
Status: in_force

The coverage for a newly born child from the moment of birth or for a newly adopted child, from the beginning of the six-month adoption bonding period, shall consist of coverage of injury or sickness including the necessary care and treatment of premature birth and medically diagnosed congenital defects and birth abnormalities. The coverage required by this section applies to any subsequent health benefit plan that is purchased providing coverage for that newly born or newly adopted child. If there is a break in coverage that exceeds sixty-three days, the health benefit plan may apply preexisting exclusion limitations as permitted by § 58-18-45 . The provisions of §§ 58-18-32 to 58-18-34 , inclusive, apply to any group health benefit plan issued or renewed by any health insurer, health carrier, health maintenance organization, fraternal benefit society, nonprofit medical and surgical plan, nonprofit hospital service plan, or other entity providing coverage through a health benefit plan subject to the provisions of this title.

Source: SL 1974, ch 322; SDCL Supp, § 58-17-30.3 ; SL 1976, ch 313, § 2; SL 1984, ch 327, § 2; SL 2001, ch 274, § 2; SL 2006, ch 258, § 1.
S.D. Codified Laws § 58-18-51.1 — SD Code / Title 58 / Chapter 18 / Section 58-18-51.1
Application of §§58-18-42to58-18-49, inclusive
Status: in_force

The provisions of §§ 58-18-42 to 58-18-49 , inclusive, apply to health benefit plans which provide health coverage on a self - funded basis through nonfederal government employers, college plans issued on a blanket basis, and church plans. Any self - funded nonfederal government employer plan is subject to the provisions of §§ 58-18-42 to 58-18-49 , inclusive, whether or not it is a single employer plan, a pooled arrangement, a cooperative, through a joint powers agreement, or other similar mechanism for providing health coverage.

Source: SL 1997, ch 289, § 24; SL 2000, ch 250, § 2.
S.D. Codified Laws § 58-26-78 — SD Code / Title 58 / Chapter 26 / Section 58-26-78
Standards for calculating reserves for policies and contracts issued prior to July 1, 1995
Status: in_force

Reserves for policies and contracts issued prior to July 1, 1995, may be calculated, at the option of the company, according to any standards which produce greater aggregate reserves for all the policies and contracts than the minimum reserves required by the laws in effect immediately prior to July 1, 1995.

Source: SL 1995, ch 284, § 34; SL 2015, ch 254, § 19.
S.D. Codified Laws § 58-18-7.18 — SD Code / Title 58 / Chapter 18 / Section 58-18-7.18
Continuation coverage to be same as that available to similarly situated beneficiaries--Option to decrease benefits
Status: in_force

Continuation coverage shall be the same coverage as is available to any similarly situated beneficiary under the plan with respect to whom a qualifying event has not occurred. If coverage is modified under the plan for any group of similarly situated beneficiaries who are not under continuation, such coverage shall also be modified for those continuing coverage in the same manner as for all individuals who are qualified beneficiaries under the plan pursuant to the continuation requirements of this chapter in connection with such group.

Any insurer providing continuation coverage pursuant to § 58-18-7.5 or pursuant to any federal requirement applicable to employer group plans shall offer to all beneficiaries who are eligible to elect to continue coverage the option to decrease benefits of the continued coverage. The options shall include, at a minimum, those coverage options available to beneficiaries who initially enroll into the coverage if the options decrease coverage or a carrier may offer a standardized plan to all those eligible for continuation that contains similar benefits to the beneficiaries prior coverage but at a higher deductible or other reduced benefit features.

Source: SL 2001, ch 280, § 3; SL 2008, ch 266, § 1.
S.D. Codified Laws § 58-41-106 — SD Code / Title 58 / Chapter 41 / Section 58-41-106
Rates for group health insurance issued to purchasing organizations
Status: in_force

Any insurer issuing group health insurance pursuant to §§ 58-41-99 to 58-41-109 , inclusive, is subject to all of the provisions of chapter 58-18B relating to rates.

Source: SL 1994, ch 382, § 8.
S.D. Codified Laws § 58-20-20 — SD Code / Title 58 / Chapter 20 / Section 58-20-20
Annual statement--Inclusion of experience schedule
Status: in_force

Each insurer that writes liability or compensation policies shall include in the annual statement required by law a schedule of its experience thereunder in such form as the director may prescribe.

Source: SL 1966, ch 111, ch 29, § 4.
S.D. Codified Laws § 58-11-42 — SD Code / Title 58 / Chapter 11 / Section 58-11-42
Alteration of application for life or health insurance--Written consent of applicant--Insertions by insurer
Status: in_force

No alteration of an application for any life or health insurance policy shall be made by any person other than the applicant without the applicant's written consent. However, insertions may be made by the insurer, for administrative purposes only, in such manner as to indicate that such insertions are not to be ascribed to the applicant. Any change to an application for administrative purposes is an addition to an application made in conjunction with the processing of the application and does not include the altering of coverage amounts, types, options selected by the applicant, or the altering of any other information provided by the applicant.

Source: SL 1966, ch 111, ch 22, § 10; SL 2012, ch 243, § 1.
S.D. Codified Laws § 58-27-51.2 — SD Code / Title 58 / Chapter 27 / Section 58-27-51.2
Additional investment authority--Property and casualty insurers
Status: in_force

In addition to the authority provided under § 58-27-51 , an insurer authorized to write property and casualty insurance may invest a percentage of the amount by which the insurer's total adjusted capital equals or exceeds two hundred percent of its company action level risk - based capital in investments of any kind, in the discretion of the insurer, without regard to any condition of, restriction in, or exclusion prescribed in chapter 58-27 , and regardless of whether the same or a similar type of investment has been included in, or omitted from, any such section, subject to an aggregate limitation equal to the greatest of:

(1) Fifty percent of the excess of total adjusted capital over the risk - based capital threshold if the insurer has total adjusted capital that equals or exceeds two hundred twenty five percent of its company action level risk - based capital;

(2) Seventy-five percent of the excess of total adjusted capital over the risk - based capital threshold if the insurer has total adjusted capital that equals or exceeds two hundred fifty percent of its company action level risk - based capital; or

(3) One hundred percent of the excess of total adjusted capital over the risk - based capital threshold if the insurer has total adjusted capital that equals or exceeds two hundred seventy - five percent of its company action level risk - based capital.

For the purpose of this section, risk - based capital threshold means two hundred percent of an insurer's company action level risk - based capital. The director shall promulgate rules pursuant to chapter 1-26 to define company action level risk - based capital and total adjusted capital.

Source: SL 1997, ch 294, § 12.
S.D. Codified Laws § 58-9-31 — SD Code / Title 58 / Chapter 9 / Section 58-9-31
Surety insurance including performance bonds
Status: in_force

"Surety insurance" includes insurance guaranteeing the performance of contracts, other than insurance policies, and guaranteeing and executing bonds, undertakings, and contracts of suretyship.

Source: SL 1966, ch 111, ch 4, § 7 (3).
S.D. Codified Laws § 58-49-1 — SD Code / Title 58 / Chapter 49 / Section 58-49-1
Interstate Insurance Product Regulation Compact
Status: in_force

The state of South Dakota hereby enacts the Interstate Insurance Product Regulation Compact:

Interstate Insurance Product Regulation Compact

Article I. Purposes

The purposes of this compact are, through means of joint and cooperative action among the compacting states:

(1) To promote and protect the interest of consumers of individual and group annuity, life insurance, disability income and long-term care insurance products;

(2) To develop uniform standards for insurance products covered under the compact;

(3) To establish a central clearinghouse to receive and provide prompt review of insurance products covered under the compact and, in certain cases, advertisements related thereto, submitted by insurers authorized to do business in one or more compacting states;

(4) To give appropriate regulatory approval to those product filings and advertisements satisfying the applicable uniform standard;

(5) To improve coordination of regulatory resources and expertise between state insurance departments regarding the setting of uniform standards and review of insurance products covered under the compact;

(6) To create the Interstate Insurance Product Regulation Commission; and

(7) To perform these and such other related functions as may be consistent with the state regulation of the business of insurance.

Article II. Definitions

For the purposes of this compact:

(1) "Advertisement" means any material designed to create public interest in a product or induce the public to purchase, increase, modify, reinstate, borrow on, surrender, replace, or retain a policy as more specifically defined in the rules and operating procedures of the commission;

(2) "Bylaws" mean those bylaws established by the commission for its governance or for directing or controlling the commission's actions or conduct;

(3) "Commission" means the Interstate Insurance Product Regulation Commission established by this compact;

(4) "Commissioner" means the chief insurance regulatory official of a state including, but not limited to commissioner, superintendent, director, or administrator;

(5) "Compacting state" means any state which has enacted this compact legislation and which has not withdrawn pursuant to article XIV, section 1, or been terminated pursuant to article XIV, section 2;

(6) "Domiciliary state" means the state in which an insurer is incorporated or organized; or, in the case of an alien insurer, its state of entry;

(7) "Insurer" means any entity licensed by a state to issue contracts of insurance for any of the lines of insurance covered by this chapter;

(8) "Member" means the person chosen by a compacting state as its representative to the commission, or his or her designee;

(9) "Non-compacting state" means any state which is not at the time a compacting state;

(10) "Operating procedures" mean procedures promulgated by the commission implementing a rule, uniform standard, or a provision of this compact;

(11) "Product" means the form of a policy or contract, including any application, endorsement, or related form which is attached to and made a part of the policy or contract, and any evidence of coverage or certificate, for an individual or group annuity, life insurance, disability income or long-term care insurance product that an insurer is authorized to issue;

(12) "Rule" means a statement of general or particular applicability and future effect promulgated by the commission, including a uniform standard developed pursuant to article VII of this compact, designed to implement, interpret, or prescribe law or policy or describing the organization, procedure, or practice requirements of the commission, which shall have the force and effect of law in the compacting states;

(13) "State" means any state, district, or territory of the United States of America;

(14) "Third-party filer" means an entity that submits a product filing to the commission on behalf of an insurer; and

(15) "Uniform standard" means a standard adopted by the commission for a product line, pursuant to article VII of this compact, and shall include all of the product requirements in aggregate; provided, that each uniform standard shall be construed, whether express or implied, to prohibit the use of any inconsistent, misleading, or ambiguous provisions in a product and the form of the product made available to the public shall not be unfair, inequitable, or against public policy as determined by the commission.

Article III. Establishment of the Commission and Venue

(1) The compacting states hereby create and establish a joint public agency known as the Interstate Insurance Product Regulation Commission. Pursuant to article IV, the commission will have the power to develop uniform standards for product lines, receive and provide prompt review of products filed therewith, and give approval to those product filings satisfying applicable uniform standards; provided, it is not intended for the commission to be the exclusive entity for receipt and review of insurance product filings. Nothing herein shall prohibit any insurer from filing its product in any state wherein the Insurer is licensed to conduct the business of insurance; and any such filing shall be subject to the laws of the state where filed.

(2) The commission is a body corporate and politic, and an instrumentality of the compacting states.

(3) The commission is solely responsible for its liabilities except as otherwise specifically provided in this compact.

(4) Venue is proper and judicial proceedings by or against the commission shall be brought solely and exclusively in a court of competent jurisdiction where the principal office of the commission is located.

Article IV. Powers of the Commission

The commission shall have the following powers:

(1) To promulgate rules, pursuant to article VII of this compact, which shall have the force and effect of law and shall be binding in the compacting states to the extent and in the manner provided in this compact;

(2) To exercise its rule-making authority and establish reasonable uniform standards for products covered under the compact, and advertisement related thereto, which shall have the force and effect of law and shall be binding in the compacting states, but only for those products filed with the commission, provided that a compacting state shall have the right to opt out of such uniform standard pursuant to article VII, to the extent and in the manner provided in this compact, and, provided further, that any uniform standard established by the commission for long-term care insurance products may provide the same or greater protections for consumers as, but shall not provide less than, those protections set forth in the National Association of Insurance Commissioners' Long-Term Care Insurance Model Act and Long-Term Care Insurance Model Regulation, respectively, adopted as of 2001. The commission shall consider whether any subsequent amendments to the NAIC Long-Term Care Insurance Model Act or Long-Term Care Insurance Model Regulation adopted by the NAIC require amending of the uniform standards established by the commission for long-term care insurance products;

(3) To receive and review in an expeditious manner products filed with the commission, rate filings for disability income and long-term care insurance products, and give approval of those products and rate filings that satisfy the applicable uniform standard, where such approval shall have the force and effect of law and be binding on the compacting states to the extent and in the manner provided in the compact;

(4) To receive and review in an expeditious manner advertisement relating to long-term care insurance products for which uniform standards have been adopted by the commission and give approval to all advertisement that satisfies the applicable uniform standard. For any product covered under this compact, other than long-term care insurance products, the commission shall have the authority to require an insurer to submit all or any part of its advertisement with respect to that product for review or approval prior to use, if the commission determines that the nature of the product is such that an advertisement of the product could have the capacity or tendency to mislead the public. The actions of the commission as provided in this section shall have the force and effect of law and shall be binding in the compacting states to the extent and in the manner provided in the compact;

(5) To exercise its rule-making authority and designate products and advertisement that may be subject to a self-certification process without the need for prior approval by the commission;

(6) To promulgate operating procedures, pursuant to article VII of this compact, which shall be binding in the compacting states to the extent and in the manner provided in this compact;

(7) To bring and prosecute legal proceedings or actions in its name as the commission; provided, that the standing of any state insurance department to sue or be sued under applicable law shall not be affected;

(8) To issue subpoenas requiring the attendance and testimony of witnesses and the production of evidence;

(9) To establish and maintain offices;

(10) To purchase and maintain insurance and bonds;

(11) To borrow, accept, or contract for services of personnel, including, but not limited to, employees of a compacting state;

(12) To hire employees, professionals, or specialists, and elect or appoint officers, and to fix their compensation, define their duties and give them appropriate authority to carry out the purposes of the compact, and determine their qualifications; and to establish the commission's personnel policies and programs relating to, among other things, conflicts of interest, rates of compensation, and qualifications of personnel;

(13) To accept any and all appropriate donations and grants of money, equipment, supplies, materials, and services and to receive, utilize, and dispose of the same, provided that at all times the commission shall strive to avoid any appearance of impropriety;

(14) To lease, purchase, accept appropriate gifts or donations of, or otherwise to own, hold, improve, or use any property, real, personal, or mixed, provided that at all times the commission shall strive to avoid any appearance of impropriety;

(15) To sell, convey, mortgage, pledge, lease, exchange, abandon, or otherwise dispose of any property, real, personal, or mixed;

(16) To remit filing fees to compacting states as may be set forth in the bylaws, rules, or operating procedures;

(17) To enforce compliance by compacting states with rules, uniform standards, operating procedures, and bylaws;

(18) To provide for dispute resolution among compacting states;

(19) To advise compacting states on issues relating to insurers domiciled or doing business in non-compacting jurisdictions, consistent with the purposes of this compact;

(20) To provide advice and training to those personnel in state insurance departments responsible for product review and to be a resource for state insurance departments;

(21) To establish a budget and make expenditures;

(22) To borrow money;

(23) To appoint committees, including advisory committees comprising of members, state insurance regulators, state legislators or their representatives, insurance industry and consumer representatives, and such other interested persons as may be designated in the bylaws;

(24) To provide and receive information from and to cooperate with law enforcement agencies;

(25) To adopt and use a corporate seal; and

(26) To perform such other functions as may be necessary or appropriate to achieve the purposes of this compact consistent with the state regulation of the business of insurance.

Article V. Organization of the Commission

(1) Membership, Voting, and Bylaws

(a) Each compacting state shall have and be limited to one member. Each member shall be qualified to serve in that capacity pursuant to applicable law of the compacting state. Any member may be removed or suspended from office as provided by the law of the state from which he or she shall be appointed. Any vacancy occurring in the commission shall be filled in accordance with the laws of the compacting state wherein the vacancy exists. Nothing herein shall be construed to affect the manner in which a compacting state determines the election or appointment and qualification of its own commissioner.

(b) Each member shall be entitled to one vote and shall have an opportunity to participate in the governance of the commission in accordance with the bylaws. Notwithstanding any provision herein to the contrary, no action of the commission with respect to the promulgation of a uniform standard shall be effective unless two-thirds of the members vote in favor thereof.

(c) The commission shall, by a majority of the members, prescribe bylaws to govern its conduct as may be necessary or appropriate to carry out the purposes and exercise the powers of the compact, including, but not limited to:

(i) Establishing the fiscal year of the commission;

(ii) Providing reasonable procedures for appointing and electing members and holding meetings of the management committee;

(iii) Providing reasonable standards and procedures: (i) for the establishment and meetings of other committees and (ii) governing any general or specific delegation of any authority or function of the commission;

(iv) Providing reasonable procedures for calling and conducting meetings of the commission that consists of a majority of commission members, ensuring reasonable advance notice of each such meeting and providing for the right of citizens to attend each such meeting with enumerated exceptions designed to protect the public's interest, the privacy of individuals, and insurers' proprietary information, including trade secrets. The commission may meet in camera only after a majority of the entire membership votes to close a meeting en toto or in part. As soon as practicable, the commission must make public (i) a copy of the vote to close the meeting revealing the vote of each member with no proxy votes allowed, and (ii) votes taken during such meeting;

(v) Establishing the titles, duties, and authority and reasonable procedures for the election of the officers of the commission;

(vi) Providing reasonable standards and procedures for the establishment of the personnel policies and programs of the commission. Notwithstanding any civil service or other similar laws of any compacting state, the bylaws shall exclusively govern the personnel policies and programs of the commission;

(vii) Promulgating a code of ethics to address permissible and prohibited activities of commission members and employees; and

(viii) Providing a mechanism for winding up the operations of the commission and the equitable disposition of any surplus funds that may exist after the termination of the compact after the payment and/or reserving of all of its debts and obligations.

(d) The commission shall publish its bylaws in a convenient form and file a copy thereof and a copy of any amendment thereto with the appropriate agency or officer in each of the compacting states.

(2) Management committee, officers, and personnel

(a) A management committee, comprising of no more than fourteen members shall be established as follows:

(i) One member from each of the six compacting states with the largest premium volume for individual and group annuities, life, disability income and long-term care insurance products determined from the records of the NAIC for the prior year;

(ii) Four members from those compacting states with at least two percent of the market based on the premium volume described above, other than the six compacting states with the largest premium volume, selected on a rotating basis as provided in the bylaws; and

(iii) Four members from those compacting states with less than two percent of the market, based on the premium volume described above, with one selected from each of the four zone regions of the NAIC as provided in the bylaws.

(b) The management committee shall have such authority and duties as may be set forth in the bylaws, including but not limited to:

(i) Managing the affairs of the commission in a manner consistent with the bylaws and purposes of the commission;

(ii) Establishing and overseeing an organizational structure within, and appropriate procedures for, the commission to provide for the creation of uniform standards and other rules, receipt and review of product filings, administrative and technical support functions, review of decisions regarding the disapproval of a product filing, and the review of elections made by a compacting state to opt out of a uniform standard, provided that a uniform standard shall not be submitted to the compacting states for adoption unless approved by two-thirds of the members of the management committee;

(iii) Overseeing the offices of the commission; and

(iv) Planning, implementing, and coordinating communications and activities with other state, federal, and local government organizations in order to advance the goals of the commission.

(c) The commission shall elect annually officers from the management committee, with each having such authority and duties as may be specified in the bylaws.

(d) The management committee may, subject to the approval of the commission, appoint or retain an executive director for such period, upon such terms and conditions and for such compensation as the commission may deem appropriate. The executive director shall serve as secretary to the commission but shall not be a member of the commission. The executive director shall hire and supervise such other staff as may be authorized by the Commission.

(3) Legislative and advisory committees

(a) A legislative committee comprising state legislators or their designees shall be established to monitor the operations of and make recommendations to the commission, including the management committee, provided that the manner of selection and term of any legislative committee member shall be as set forth in the bylaws. Prior to the adoption by the commission of any uniform standard, revision to the bylaws, annual budget or other significant matter as may be provided in the bylaws, the management committee shall consult with and report to the legislative committee.

(b) The commission shall establish two advisory committees, one of which shall comprise consumer representatives independent of the insurance industry and the other comprising of insurance industry representatives.

(c) The commission may establish additional advisory committees as its bylaws may provide for the carrying out of its functions.

(4) Corporate records of the commission

The commission shall maintain its corporate books and records in accordance with the bylaws.

(5) Qualified immunity, defense, and indemnification

(a) The members, officers, executive director, employees, and representatives of the commission shall be immune from suit and liability, either personally or in their official capacity, for any claim for damage to or loss of property or personal injury or other civil liability caused by or arising out of any actual or alleged act, error, or omission that occurred or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities, provided that nothing in this paragraph shall be construed to protect any such person from suit and/or liability for any damage, loss, injury, or liability caused by the intentional or willful and wanton misconduct of that person.

(b) The commission shall defend any member, officer, executive director, employee, or representative of the commission in any civil action seeking to impose liability arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities or that the person against whom the claim is made had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities, provided that nothing herein shall be construed to prohibit that person from retaining his or her own counsel and provided further, that the actual or alleged act, error, or omission did not result from that person's intentional or willful and wanton misconduct.

(c) The commission shall indemnify and hold harmless any member, officer, executive director, employee, or representative of the commission for the amount of any settlement or judgment obtained against that person arising out of any actual or alleged act, error, or omission that occurred within the scope of commission employment, duties, or responsibilities or that such person had a reasonable basis for believing occurred within the scope of commission employment, duties, or responsibilities, provided that the actual or alleged act, error, or omission did not result from the intentional or willful and wanton misconduct of that person.

Article VI. Meetings and Acts of the Commission

(1) The commission shall meet and take such actions as are consistent with the provisions of this compact and the bylaws.

(2) Each member of the commission shall have the right and power to cast a vote to which that compacting state is entitled and to participate in the business and affairs of the commission. A member shall vote in person or by such other means as provided in the bylaws. The bylaws may provide for members' participation in meetings by telephone or other means of communication.

(3) The commission shall meet at least once during each calendar year. Additional meetings shall be held as set forth in the bylaws.

Article VII. Rules and operating procedures: Rulemaking functions of the commission and opting out of uniform standards

(1) Rulemaking authority. The commission shall promulgate reasonable rules, including uniform standards, and operating procedures in order to effectively and efficiently achieve the purposes of this compact. Notwithstanding the foregoing, in the event the commission exercises its rulemaking authority in a manner that is beyond the scope of the purposes of this Act or the powers granted hereunder, then such an action by the commission shall be invalid and have no force and effect.

(2) Rulemaking procedure. Rules and operating procedures shall be made pursuant to a rulemaking process that conforms to the Model State Administrative Procedure Act of 1981 as amended, as may be appropriate to the operations of the commission. Before the commission adopts a uniform standard, the commission shall give written notice to the relevant state legislative committee in each compacting state responsible for insurance issues of its intention to adopt the uniform standard. The commission in adopting a uniform standard shall consider fully all submitted materials and issue a concise explanation of its decision.

(3) Effective date and opt out of a uniform standard. A uniform standard shall become effective ninety days after its promulgation by the commission or such later date as the commission may determine, provided, however, that a compacting state may opt out of a uniform standard as provided in this article. "Opt out" shall be defined as any action by a compacting state to decline to adopt or participate in a promulgated uniform standard. All other rules and operating procedures and amendments thereto shall become effective as of the date specified in each rule, operating procedure, or amendment.

(4) Opt-out procedure.

(a) A compacting state may opt out of a uniform standard, either by legislation or regulation duly promulgated by the insurance department under the compacting state's administrative procedure act. If a compacting state elects to opt out of a uniform standard by regulation, it must (a) give written notice to the commission no later than ten business days after the uniform standard is promulgated or at the time the state becomes a compacting state and (b) find that the uniform standard does not provide reasonable protections to the citizens of the state given the conditions in the state. The commissioner shall make specific findings of fact and conclusions of law, based on a preponderance of the evidence, detailing the conditions in the state which warrant a departure from the uniform standard and determining that the uniform standard would not reasonably protect the citizens of the state. The commissioner must consider and balance the following factors and find that the conditions in the state and needs of the citizens of the state outweigh:

(i) The intent of the legislature to participate in, and the benefits of, an interstate agreement to establish national uniform consumer protections for the products subject to this chapter; and

(ii) The presumption that a uniform standard adopted by the commission provides reasonable protections to consumers of the relevant product.

Notwithstanding the foregoing, a compacting state may, at the time of its enactment of this compact, prospectively opt out of all uniform standards involving long-term care insurance products by expressly providing for such opt out in the enacted compact, and such an opt out shall not be treated as a material variance in the offer or acceptance of any state to participate in this compact. Such an opt out shall be effective at the time of enactment of this compact by the compacting state and shall apply to all existing uniform standards involving long-term care insurance products and those subsequently promulgated.

(b) In accordance with subdivision (a), South Dakota opts out of all existing and prospective uniform standards involving long-term care insurance products in order to preserve South Dakota's statutory requirements governing long-term care insurance products.

(c) In accordance with subdivision (a), South Dakota opts out of all existing uniform standards involving individual and group disability income insurance products in order to preserve South Dakota's statutory requirements governing individual and group disability income insurance products.

(5) Effect of opt out. If a compacting state elects to opt out of a uniform standard, the uniform standard shall remain applicable in the compacting state electing to opt out until such time the opt-out legislation is enacted into law or the regulation opting out becomes effective.

Once the opt out of a uniform standard by a compacting state becomes effective as provided under the laws of that state, the uniform standard shall have no further force and effect in that state unless and until the legislation or regulation implementing the opt out is repealed or otherwise becomes ineffective under the laws of the state. If a compacting state opts out of a uniform Standard after the uniform standard has been made effective in that state, the opt out shall have the same prospective effect as provided under article XIV for withdrawals.

(6) Stay of uniform standard. If a compacting state has formally initiated the process of opting out of a uniform standard by regulation, and while the regulatory opt out is pending, the compacting state may petition the commission, at least fifteen days before the effective date of the uniform standard, to stay the effectiveness of the uniform standard in that state. The commission may grant a stay if it determines the regulatory opt out is being pursued in a reasonable manner, and there is a likelihood of success. If a stay is granted or extended by the commission, the stay or extension thereof may postpone the effective date by up to ninety days unless affirmatively extended by the commission, provided a stay may not be permitted to remain in effect for more than one year unless the compacting state can show extraordinary circumstances which warrant a continuance of the stay, including, but not limited to, the existence of a legal challenge which prevents the compacting state from opting out. A stay may be terminated by the commission upon notice that the rulemaking process has been terminated.

(7) Not later than thirty days after a rule or operating procedure is promulgated, any person may file a petition for judicial review of the rule or operating procedure, provided that the filing of such a petition shall not stay or otherwise prevent the rule or operating procedure from becoming effective unless the court finds that the petitioner has a substantial likelihood of success. The court shall give deference to the actions of the commission consistent with applicable law and shall not find the rule or operating procedure to be unlawful if the rule or operating procedure represents a reasonable exercise of the commission's authority.

Article VIII. Commission records and enforcement

(1) The commission shall promulgate rules establishing conditions and procedures for public inspection and copying of its information and official records, except such information and records involving the privacy of individuals and insurers' trade secrets. The commission may promulgate additional rules under which it may make available to federal and state agencies, including law enforcement agencies, records and information otherwise exempt from disclosure and may enter into agreements with such agencies to receive or exchange information or records subject to nondisclosure and confidentiality provisions.

(2) Except as to privileged records, data, and information, the laws of any compacting state pertaining to confidentiality or nondisclosure shall not relieve any compacting state commissioner of the duty to disclose any relevant records, data, or information to the commission, provided that disclosure to the commission shall not be deemed to waive or otherwise affect any confidentiality requirement and further provided, that, except as otherwise expressly provided in this chapter, the commission shall not be subject to the compacting state's laws pertaining to confidentiality and nondisclosure with respect to records, data, and information in its possession. Confidential information of the commission shall remain confidential after such information is provided to any commissioner.

(3) The commission shall monitor compacting states for compliance with duly adopted bylaws, rules, including uniform standards, and operating procedures. The commission shall notify any non-complying compacting state in writing of its noncompliance with commission bylaws, rules, or operating procedures. If a non-complying compacting state fails to remedy its noncompliance within the time specified in the notice of noncompliance, the compacting state shall be deemed to be in default as set forth in article XIV.

(4) The commissioner of any state in which an insurer is authorized to do business or is conducting the business of insurance shall continue to exercise his or her authority to oversee the market regulation of the activities of the insurer in accordance with the provisions of the state's law. The commissioner's enforcement of compliance with the compact is governed by the following provisions:

(a) With respect to the commissioner's market regulation of a product or advertisement that is approved or certified to the commission, the content of the product or advertisement shall not constitute a violation of the provisions, standards, or requirements of the compact except upon a final order of the commission, issued at the request of a commissioner after prior notice to the insurer and an opportunity for hearing before the commission.

(b) Before a commissioner may bring an action for violation of any provision, standard, or requirement of the compact relating to the content of an advertisement not approved or certified to the commission, the commission or an authorized commission officer or employee must authorize the action. However, authorization pursuant to this paragraph does not require notice to the insurer, opportunity for hearing or disclosure of requests for authorization or records of the commission's action on such requests.

Article IX. Dispute resolution

The commission shall attempt, upon the request of a member, to resolve any disputes or other issues that are subject to this compact and which may arise between two or more compacting states, or between compacting states and non-compacting states, and the commission shall promulgate an operating procedure providing for resolution of such disputes.

Article X. Product filing and approval

(1) Insurers and third-party filers seeking to have a product approved by the commission shall file the product with and pay applicable filing fees to the commission. Nothing in this chapter shall be construed to restrict or otherwise prevent an insurer from filing its product with the insurance department in any state wherein the insurer is licensed to conduct the business of insurance, and such filing shall be subject to the laws of the states where filed.

(2) The commission shall establish appropriate filing and review processes and procedures pursuant to commission rules and operating procedures. Notwithstanding any provision herein to the contrary, the commission shall promulgate rules to establish conditions and procedures under which the commission will provide public access to product filing information. In establishing such rules, the commission shall consider the interests of the public in having access to such information, as well as protection of personal, medical, and financial information and trade secrets, that may be contained in a product filing or supporting information.

(3) Any product approved by the commission may be sold or otherwise issued in those compacting states for which the insurer is legally authorized to do business.

Article XI. Review of commission decisions regarding filings

(1) Not later than thirty days after the commission has given notice of a disapproved product or advertisement filed with the commission, the insurer or third-party filer whose filing was disapproved may appeal the determination to a review panel appointed by the commission. The commission shall promulgate rules to establish procedures for appointing such review panels and provide for notice and hearing. An allegation that the commission, in disapproving a product or advertisement filed with the commission, acted arbitrarily, capriciously, or in a manner that is an abuse of discretion or otherwise not in accordance with the law, is subject to judicial review in accordance with article III, section 4.

(2) The commission shall have authority to monitor, review, and reconsider products and advertisement subsequent to their filing or approval upon a finding that the product does not meet the relevant uniform standard. Where appropriate, the commission may withdraw or modify its approval after proper notice and hearing, subject to the appeal process in section 1 above.

Article XII. Finance

(1) The commission shall pay or provide for the payment of the reasonable expenses of its establishment and organization. To fund the cost of its initial operations, the commission may accept contributions and other forms of funding from the National Association of Insurance Commissioners, compacting states, and other sources. Contributions and other forms of funding from other sources shall be of such a nature that the independence of the commission concerning the performance of its duties shall not be compromised.

(2) The commission shall collect a filing fee from each insurer and third-party filer filing a product with the commission to cover the cost of the operations and activities of the commission and its staff in a total amount sufficient to cover the commission's annual budget.

(3) The commission's budget for a fiscal year shall not be approved until it has been subject to notice and comment as set forth in article VII of this compact.

(4) The commission shall be exempt from all taxation in and by the compacting states.

(5) The commission shall not pledge the credit of any compacting state, except by and with the appropriate legal authority of that compacting state.

(6) The Commission shall keep complete and accurate accounts of all its internal receipts, including grants and donations, and disbursements of all funds under its control. The internal financial accounts of the commission shall be subject to the accounting procedures established under its bylaws. The financial accounts and reports including the system of internal controls and procedures of the commission shall be audited annually by an independent certified public accountant. Upon the determination of the commission, but no less frequently than every three years, the review of the independent auditor shall include a management and performance audit of the commission. The commission shall make an annual report to the Governor and Legislature of the compacting states, which shall include a report of the independent audit. The commission's internal accounts shall not be confidential, and such materials may be shared with the commissioner of any compacting state upon request, provided, however, that any work papers related to any internal or independent audit and any information regarding the privacy of individuals and insurers' proprietary information, including trade secrets, shall remain confidential.

(7) No compacting state shall have any claim to or ownership of any property held by or vested in the commission or to any commission funds held pursuant to the provisions of this compact.

Article XIII. Compacting states, effective date, and amendment

(1) Any state is eligible to become a compacting state.

(2) The compact shall become effective and binding upon legislative enactment of the compact into law by two compacting states, provided the commission shall become effective for purposes of adopting uniform standards, for reviewing and giving approval or disapproval of products filed with the commission that satisfy applicable uniform standards only after twenty-six states are compacting states or, alternatively, by states representing greater than forty percent of the premium volume for life insurance, annuity, and disability income and long-term care insurance products, based on records of the NAIC for the prior year. Thereafter, it shall become effective and binding as to any other compacting state upon enactment of the compact into law by that state.

(3) Amendments to the compact may be proposed by the commission for enactment by the compacting states. No amendment shall become effective and binding upon the commission and the compacting states unless and until all compacting states enact the amendment into law.

Article XIV. Withdrawal, default, and termination

(1) Withdrawal

(a) Once effective, the compact shall continue in force and remain binding upon each and every compacting state, provided that a compacting state may withdraw from the compact ("withdrawing state") by enacting a statute specifically repealing the statute which enacted the compact into law.

(b) The effective date of withdrawal is the effective date of the repealing statute. However, the withdrawal shall not apply to any product filings approved or self-certified or any advertisement of such products on the date the repealing statute becomes effective, except by mutual agreement of the commission and the withdrawing state, unless the approval is rescinded by the withdrawing state as provided in paragraph (e) of this section.

(c) The commissioner of the withdrawing state shall immediately notify the management committee in writing upon the introduction of legislation repealing this compact in the withdrawing state.

(d) The commission shall notify the other compacting states of the introduction of such legislation within ten days after its receipt of notice thereof.

(e) The withdrawing state is responsible for all obligations, duties, and liabilities incurred through the effective date of withdrawal, including any obligations, the performance of which extend beyond the effective date of withdrawal, except to the extent those obligations may have been released or relinquished by mutual agreement of the commission and the withdrawing state. The commission's approval of products and advertisement prior to the effective date of withdrawal shall continue to be effective and be given full force and effect in the withdrawing state, unless formally rescinded by the withdrawing state in the same manner as provided by the laws of the withdrawing state for the prospective disapproval of products or advertisement previously approved under state law.

(f) Reinstatement following withdrawal of any compacting state shall occur upon the effective date of the withdrawing state reenacting the compact.

(2) Default

(a) If the commission determines that any compacting state has at any time defaulted ("defaulting state") in the performance of any of its obligations or responsibilities under this compact, the bylaws, or duly promulgated rules or operating procedures, then, after notice and hearing as set forth in the bylaws, all rights, privileges, and benefits conferred by this compact on the defaulting state shall be suspended from the effective date of default as fixed by the commission. The grounds for default include, but are not limited to, failure of a compacting state to perform its obligations or responsibilities and any other grounds designated in commission rules. The commission shall immediately notify the defaulting state in writing of the defaulting state's suspension pending a cure of the default. The commission shall stipulate the conditions and the time period within which the defaulting state must cure its default. If the defaulting state fails to cure the default within the time period specified by the commission, the defaulting state shall be terminated from the compact and all rights, privileges and benefits conferred by this Compact shall be terminated from the effective date of termination.

(b) Product approvals by the commission, product self-certifications, or any advertisement in connection with such product that are in force on the effective date of termination shall remain in force in the defaulting state in the same manner as if the defaulting state had withdrawn voluntarily pursuant to section 1 of this article.

(c) Reinstatement following termination of any compacting state requires a reenactment of the compact.

(3) Dissolution of compact

(a) The compact dissolves effective upon the date of the withdrawal or default of the compacting state, which reduces membership in the compact to one compacting state.

(b) Upon the dissolution of this compact, the compact becomes null and void and shall be of no further force or effect, and the business and affairs of the commission shall be wound up, and any surplus funds shall be distributed in accordance with the bylaws.

Article XV. Severability and construction

(1) The provisions of this compact shall be severable, and if any phrase, clause, sentence, or provision is deemed unenforceable, the remaining provisions of the compact shall be enforceable.

(2) The provisions of this compact shall be liberally construed to effectuate its purposes.

Article XVI. Binding effect of compact and other laws

(1) Other laws

(a) Nothing herein prevents the enforcement of any other law of a compacting state, except as provided in paragraph (b) of this section.

(b) For any product approved or certified to the commission, the rules, uniform standards, and any other requirements of the commission shall constitute the exclusive provisions applicable to the content, approval, and certification of such products. For advertisement that is subject to the commission's authority, any rule, uniform standard, or other requirement of the commission which governs the content of the advertisement shall constitute the exclusive provision that a commissioner may apply to the content of the advertisement. Notwithstanding the foregoing, no action taken by the commission shall abrogate or restrict:

(i) The access of any person to state courts;

(ii) Remedies available under state law related to breach of contract, tort, or other laws not specifically directed to the content of the product;

(iii) State law relating to the construction of insurance contracts; or

(iv) The authority of the attorney general of the state, including but not limited to maintaining any actions or proceedings as authorized by law.

(c) All insurance products filed with individual states shall be subject to the laws of those states.

(2) Binding effect of this compact

(a) All lawful actions of the commission, including all rules and operating procedures promulgated by the commission, are binding upon the compacting states.

(b) All agreements between the commission and the compacting states are binding in accordance with their terms.

(c) Upon the request of a party to a conflict over the meaning or interpretation of commission actions and upon a majority vote of the compacting states, the commission may issue advisory opinions regarding the meaning or interpretation in dispute.

(d) In the event any provision of this compact exceeds the constitutional limits imposed on the Legislature of any compacting state, the obligations, duties, powers, or jurisdiction sought to be conferred by that provision upon the commission shall be ineffective as to that compacting state, and those obligations, duties, powers, or jurisdiction shall remain in the compacting state and shall be exercised by the agency thereof to which those obligations, duties, powers, or jurisdiction are delegated by law in effect at the time this compact becomes effective.

Source: SL 2024, ch 205, § 1.
S.D. Codified Laws § 58-38-5 — SD Code / Title 58 / Chapter 38 / Section 58-38-5
Board of directors--Minimum number--Qualifications--Selection--Term of office
Status: in_force

The business of a medical and surgical plan corporation shall be managed by a board of directors of at least five persons possessing the same general qualifications as the incorporators and they shall be selected, and their number fixed, in the manner set out in the bylaws for three - year terms. At least a majority of the directors of said corporation must be at all times physicians or surgeons who have contracted, or may contract with such corporation to render to its subscribers medical or surgical service.

Source: SL 1966, ch 111, ch 21, § 4.
S.D. Codified Laws § 58-24-26 — SD Code / Title 58 / Chapter 24 / Section 58-24-26
Excess rate approved for specific risk--Filing application
Status: in_force

Upon written application signed by the insured, stating the reasons therefor, filed with and approved by the director, a rate in excess of that provided by a filing otherwise applicable may be used on any specific risk. The application for approval of this rate shall be filed prior to the effective date of the policy being issued. The director may waive the requirement of prior filing if a special need or circumstance can be demonstrated.

Source: SL 1966, ch 111, ch 15, § 4 (7); SL 1967, ch 133; SL 1990, ch 400, § 2; SL 2009, ch 267, § 1.
S.D. Codified Laws § 58-29B-4 — SD Code / Title 58 / Chapter 29B / Section 58-29B-4
Delinquency proceedings sole and exclusive remedy--Commencement of proceedings by director
Status: in_force

Delinquency proceedings pursuant to this chapter shall constitute the sole and exclusive method of liquidating, rehabilitating, reorganizing, or conserving an insurer, and no court may entertain a petition for the commencement of such proceedings, or any other similar procedure, unless it has been filed in the name of the state on the relation of the director.

Source: SL 1989, ch 436, § 4.
S.D. Codified Laws § 58-18A-70 — SD Code / Title 58 / Chapter 18A / Section 58-18A-70
Plan covering dependent child
Status: in_force

Unless there is a court decree stating otherwise, plans covering a dependent child shall determine the order of benefits as follows:

(1) For a dependent child whose parents are married or are living together, whether or not they have ever been married:

(a) The plan of the parent whose birthday falls earlier in the calendar year is the primary plan; or

(b) If both parents have the same birthday, the plan that has covered the parent longest is the primary plan;

(2) For a dependent child whose parents are divorced or separated or are not living together, whether or not they have ever been married:

(a) If a court decree states that one of the parents is responsible for the dependent child's health care expenses or health care coverage and the plan of that parent has actual knowledge of those terms, that plan is primary. If the parent with responsibility has no health care coverage for the dependent child's health care expenses, but that parent's spouse does, that parent's spouse's plan is the primary plan. This item does not apply with respect to any plan year during which benefits are paid or provided before the entity has actual knowledge of the court decree provision;

(b) If a court decree states that both parents are responsible for the dependent child's health care expenses or health care coverage, the provisions of subdivision (1) of this section shall determine the order of benefits;

(c) If a court decree states that the parents have joint custody without specifying that one parent has responsibility for the health care expenses or health care coverage of the dependent child, the provisions of subdivision (1) of this section shall determine the order of benefits; or

(d) If there is no court decree allocating responsibility for the child's health care expenses or health care coverage, the order of benefits for the child are as follows:

(i) The plan covering the custodial parent;

(ii) The plan covering the custodial parent's spouse;

(iii) The plan covering the noncustodial parent; and then

(iv) The plan covering the noncustodial parent's spouse;

(3) For a dependent child covered under more than one plan of individuals who are not the parents of the child, the order of benefits shall be determined, as applicable, pursuant to subdivision (1) or (2) of this section as if those individuals were parents of the child; and

(4) For a dependent child who has coverage under either or both parents' plans and also has his or her own coverage as a dependent under a spouse's plan, the provisions of § 58-18A-73 apply. If the dependent child's coverage under the spouse's plan began on the same date as the dependent child's coverage under either or both parents' plans, the order of benefits shall be determined, as applicable, pursuant to the provisions of subdivision (1) of this section to the dependent child's parent or parents and the dependent's spouse.

Source: SL 2006, ch 259, § 18; SL 2015, ch 253, § 2.
S.D. Codified Laws § 58-35-67 — SD Code / Title 58 / Chapter 35 / Section 58-35-67
Approval of articles of merger by secretary of state--Endorsement--Filing--Certificate of merger
Status: in_force

Following the delivery of the articles of merger from the director of the Division of Insurance to the secretary of state, the secretary shall, on finding that the articles conform to law, if all required fees have been paid:

(1) Endorse the word "filed" on the original and the copy and the month, day, and year of filing;

(2) File the original in the secretary's office; and

(3) Issue a certificate of merger to which the secretary shall affix the copy.

The certificate of merger, together with a copy, shall be returned to the surviving corporation or its representative.

Source: SL 1995, ch 293, § 8.
S.D. Codified Laws § 58-15-101 — SD Code / Title 58 / Chapter 15 / Section 58-15-101
Beneficiary search
Status: in_force

If the insurer has not been contacted by a beneficiary within one hundred twenty days of an insurer's receipt of information establishing the insurer's knowledge of death, the insurer shall commence a beneficiary search. The beneficiary search shall be completed within one year from the date the insurer received the information.

Source: SL 2018, ch 280, § 8.
S.D. Codified Laws § 58-17-74.1 — SD Code / Title 58 / Chapter 17 / Section 58-17-74.1
Premium rate limitations
Status: in_force

Any health benefit plan issued before July 1, 1996, is subject to the rating limitations provided in this section. For a class of business, the premium rates charged during a rating period to individuals with similar case characteristics for the same or similar coverage, or the rates that could be charged to such individuals under the rating system for that class of business, may not exceed three times the base premium rate after July 1, 2001, two and one-half times the base premium rate after July 1, 2003, and two times the base premium rate after July 1, 2005.

Source: SL 2000, ch 240, § 1; SDCL § 58-17-4.3 ; SL 2005, ch 10, § 41.
S.D. Codified Laws § 58-16-7 — SD Code / Title 58 / Chapter 16 / Section 58-16-7
Labor union group insurance permitted
Status: in_force

A policy of group life insurance may be issued to a labor union, which shall be deemed the policyholder, to insure members of such union for the benefit of persons other than the union or any of its officials, representatives or agents, subject to the requirements of §§ 58-16-8 to 58-16-11 , inclusive.

Source: SL 1966, ch 111, ch 24, § 1 (3).
S.D. Codified Laws § 58-40-15 — SD Code / Title 58 / Chapter 40 / Section 58-40-15
Foreign corporation--Transaction of business in state
Status: in_force

A nonprofit hospital service plan corporation organized under the laws of another state or any territory may with the approval of the director and under the rules as may be promulgated, consistent with the provisions of this chapter, transact and carry on its business in this state; provided it shall first file with the director:

(1) A duly certified copy of its charter or articles of incorporation;

(2) A verified statement of the condition of its affairs for the next preceding calendar year;

(3) A duly certified and authenticated appointment in writing of the director as its true and lawful agent in and for this state, upon whom all lawful process in any action or proceeding against the insurer may be served with the same effect as if a domestic insurer served in this state, such appointment to stipulate that any lawful process against such insurer served on such agent shall be of the same legal force and validity as if served on the insurer, and that the authority shall continue in force as long as any liability remains outstanding against such insurer in this state. Such service may be made on the director in the manner provided by statute for service of process, or may be made by filing a copy of such process in the office of the director. Whenever any such process is served upon the director, he shall forthwith forward a copy thereof by mail, postpaid, directed to the secretary of the insurer; or in case of insurers in foreign countries to the resident manager thereof, in this country, and to its general agent in this state; and

(4) Evidence satisfactory to the director that such corporation has existing contracts for the rendering of hospital service to the subscribers with at least twenty hospitals located within the State of South Dakota, approved for participation by the director.

Any such foreign corporation shall be subject to the laws of this state pertaining to reciprocal relations imposed on foreign insurers transacting or doing business in this state.

Source: SL 1966, ch 111, ch 21, § 23; SL 1986, ch 22, § 42.
S.D. Codified Laws § 58-17H-17 — SD Code / Title 58 / Chapter 17H / Section 58-17H-17
Utilization review program to use documented clinical review criteria--Criteria to be available to authorized agencies upon request
Status: in_force

A utilization review program shall use documented clinical review criteria that are based on sound clinical evidence and are evaluated periodically to assure ongoing efficacy. A health carrier may develop its own clinical review criteria, or it may purchase or license clinical review criteria from qualified vendors. A health carrier shall make available its clinical review criteria upon request to authorized government agencies including the Division of Insurance and the Department of Health.

Source: SL 2011, ch 219, § 42.
S.D. Codified Laws § 58-16-51 — SD Code / Title 58 / Chapter 16 / Section 58-16-51
Discontinuance of group life insurance policies
Status: in_force

If a policy or contract subject to the provisions of §§ 58-16-49 to 58-16-54 , inclusive, provides for automatic discontinuance of the policy or contract after a premium or subscription charge has remained unpaid through the grace period allowed for such payment, the carrier is liable for valid claims for covered losses incurred prior to the end of the grace period.

If the actions of the carrier after the end of the grace period indicate that the carrier considers the policy or contract as continuing in force beyond the end of the grace period, such as, by continuing to recognize claims subsequently incurred, the carrier is liable for valid claims for losses beginning prior to the effective date of the written notice of discontinuance to the policyholder or other entity responsible for making payments or submitting subscription charges to the carrier. The effective date of discontinuance may not be prior to midnight at the end of the third scheduled workday after the date upon which the notice is delivered.

Source: SL 2009, ch 261, § 3.
S.D. Codified Laws § 58-37A-2 — SD Code / Title 58 / Chapter 37A / Section 58-37A-2
Lodge system--Regular meetings--Lodges for children
Status: in_force

A society is operating on the lodge system if it has a supreme governing body and subordinate lodges into which members are elected, initiated, or admitted in accordance with its laws, rules and ritual. Subordinate lodges shall be required by the laws of the society to hold regular meetings at least once in each month in furtherance of the purposes of the society. A society may organize and operate lodges for children under the minimum age for adult membership. No membership and initiation in local lodges may be required of those children, nor may they have a voice or vote in the management of the society.

Source: SL 1990, ch 410, § 2.
S.D. Codified Laws § 58-22-11 — SD Code / Title 58 / Chapter 22 / Section 58-22-11
Refusal, suspension, or cancellation of license for inadequate financial statement
Status: in_force

A license may be refused, suspended, or canceled by the director at any time he determines that the financial statement filed by the applicant or professional bondsman is inadequate to meet the requirements of the director.

Source: SL 1966, ch 111, ch 31, § 24.
S.D. Codified Laws § 58-30-167.3 — SD Code / Title 58 / Chapter 30 / Section 58-30-167.3
Request for hearing
Status: in_force

An order under § 58-30-167.2 must allow sixty days for the producer to request a hearing in writing. If a timely request for hearing is received, the director shall issue a notice of hearing within thirty days. The office of hearing examiners shall hold the hearing, review the director's order with the evidence presented at hearing, and issue a proposed decision. If a producer does not timely request a hearing, the director's order revoking the license becomes the final agency decision pursuant to § 1-26-25 .

Source: SL 2024, ch 204, § 2.
S.D. Codified Laws § 58-25-20 — SD Code / Title 58 / Chapter 25 / Section 58-25-20
Conduct of hearings before director
Status: in_force

Hearings before the director as to matters under this chapter shall be conducted in accordance with chapter 1-26 .

Source: SL 1966, ch 111, ch 14, § 7 (1); SL 1978, ch 359, § 16.
S.D. Codified Laws § 58-17H-4 — SD Code / Title 58 / Chapter 17H / Section 58-17H-4
Applicability of chapter
Status: in_force

The provisions of this chapter apply to any health carrier that provides or performs utilization review services. The requirements of this chapter also apply to any designee of the health carrier or utilization review organization that performs utilization review functions on the carrier's behalf.

Source: SL 2011, ch 219, § 29.
S.D. Codified Laws § 58-5-118 — SD Code / Title 58 / Chapter 5 / Section 58-5-118
Officers and directors permitting new business during impairment of capital or surplus--Liability for losses
Status: in_force

The officers and each director of an insurer who, after knowing that the insurer's capital is impaired, if a stock insurer, or surplus, if a mutual insurer, as provided in § 58-5-114 , permits or assents in the writing of new business by the insurer in this state after the expiration of the period allowed by the director under § 58-5-114 within which to cure the deficiency, shall, together with their respective estates, be severally and jointly liable for the amount of losses which may be incurred by the insured under any such new insurance.

Source: SL 1966, ch 111, ch 16, § 37.
S.D. Codified Laws § 58-22-38 — SD Code / Title 58 / Chapter 22 / Section 58-22-38
Annual list of forfeitures of bonds--Contents
Status: in_force

A professional bondsman shall on or before March first of each year file a sworn statement listing every forfeiture of bonds executed by him during the preceding calendar year giving date of forfeiture, amount of forfeiture and name of court where forfeiture is recorded, and date of payment.

Source: SL 1966, ch 111, ch 31, § 9.
S.D. Codified Laws § 58-20-18 — SD Code / Title 58 / Chapter 20 / Section 58-20-18
Unallocated liability loss expense payments--Distribution schedule included in annual statement
Status: in_force

All unallocated liability loss expense payments made in a given calendar year, subsequent to the first four years in which an insurer has been issuing liability policies, shall be distributed as follows: thirty - five percent shall be charged to the policies written in that year, forty percent to the policies written in the preceding year, ten percent to the policies written in the second year preceding, ten percent to the policies written in the third year preceding, and five percent to the policies written in the fourth year preceding, and such payments made in each of the first four calendar years in which an insurer issues liability policies shall be distributed as follows: In the first calendar year one hundred percent shall be charged to the policies written in that year; in the second calendar year fifty percent shall be charged to the policies written in that year and fifty percent to the policies written in the preceding year; in the third calendar year forty percent shall be charged to the policies written in that year, forty percent to the policies written in the preceding year, and twenty percent to the policies written in the second year preceding; in the fourth calendar year thirty - five percent shall be charged to the policies written in that year, forty percent to the policies written in the preceding year, fifteen percent to the policies written in the second year preceding, and ten percent to the policies written in the third year preceding; and a schedule showing such distribution shall be included in the annual statement.

Source: SL 1966, ch 111, ch 29, § 3.
S.D. Codified Laws § 58-43-4 — SD Code / Title 58 / Chapter 43 / Section 58-43-4
Annual audited financial report--Contents
Status: in_force

The annual audited financial report shall report the financial position of the insurer as of the end of the most recent calendar year and the results of its operations, cash flows, and changes in capital and surplus for the year then ended. The audit shall reflect the statutory accounting practices prescribed, or otherwise permitted, by the division. The report shall include the following:

(1) Report of the accountant;

(2) Balance sheet reporting admitted assets, liabilities, capital, and surplus;

(3) Statement of operations;

(4) Statement of cash flows;

(5) Statement of changes in capital and surplus; and

(6) Notes to financial statements.

Any notes to financial statements shall be prepared in accordance with the Annual Statement Instructions Manual and the Accounting Practices and Procedures Manual prescribed by the National Association of Insurance Commissioners as promulgated by rules by the director pursuant to chapter 1-26 and shall also include a reconciliation of differences, if any, between the audited statutory financial statements and the annual statement filed pursuant to § 58-6-75 with a written description of the nature of these differences.

Source: SL 1992, ch 357, § 4; SL 2003, ch 257, § 1; SL 2009, ch 271, § 5.
S.D. Codified Laws § 58-15-9 — SD Code / Title 58 / Chapter 15 / Section 58-15-9
Effect of misstatement in policy regarding age
Status: in_force

There shall be a provision that if the age of the insured, or of any other person whose age is considered in determining the premium or benefit has been misstated, any amount payable or benefit accruing under the policy shall be such as the premium would have purchased at the correct age or ages.

Source: SL 1966, ch 111, ch 23, § 7.
S.D. Codified Laws § 58-30-73 — SD Code / Title 58 / Chapter 30 / Section 58-30-73
Refusal of temporary license where purpose unlawful
Status: in_force

The director may refuse to issue a temporary license to any applicant, when it appears that the purpose of obtaining such temporary license is part of a program by an insurer to evade the other provisions of this chapter.

Source: SL 1966, ch 111, ch 9, § 23 (3).
S.D. Codified Laws § 58-46-22 — SD Code / Title 58 / Chapter 46 / Section 58-46-22
Rating organization
Status: in_force

No captive insurance company may be required to join a rating organization.

Source: SL 1996, ch 287, § 22.
S.D. Codified Laws § 58-27-84 — SD Code / Title 58 / Chapter 27 / Section 58-27-84
Evidence of investment required in absence of certificate
Status: in_force

If an investment is not evidenced by a certificate, except as provided in § 58-27-82 , adequate evidence of the insurer's investment shall be obtained and retained by the insurer, a custodian bank, or clearing corporation. Adequate evidence, for purposes of this section, means a written receipt or other verification issued by the depository or issuer or a custodian bank which shows that the investment is held for the insurer, or if applicable under § 58-27-111 , limited partnership or joint venture documentation. Transfers of ownership of investments held as described in subdivision 58-27-80(3), §§ 58-27-82 and 58-27-83 may be evidenced by bookkeeping entry on the books of the issuer of the investment or its transfer or recording agent or the clearing corporation without physical delivery of certificates, if any, evidencing the insurer's investment.

Source: SL 1983, ch 377, § 7; SL 1997, ch 294, § 22.
S.D. Codified Laws § 58-29A-109 — SD Code / Title 58 / Chapter 29A / Section 58-29A-109
Citation of chapter
Status: in_force

This chapter shall be known as the South Dakota Insurance Guaranty Association Act.

Source: SL 2000, ch 247, § 56.
S.D. Codified Laws § 58-46-3.1 — SD Code / Title 58 / Chapter 46 / Section 58-46-3.1
Group, sponsored, or special purpose captive insurance company limit of exposure to loss
Status: in_force

A group, sponsored, or special purpose captive insurance company shall limit its exposure to loss on any one risk or hazard to an amount deemed acceptable by the director. The amount shall be determined based on whether the risk or hazard is reinsured through an insurance company that is licensed or accredited in this state, or other safeguards to the group, sponsored, or special purpose captive insurance company's financial solvency and stability are adequate.

Source: SL 2013, ch 257, § 3.
S.D. Codified Laws § 58-17H-46 — SD Code / Title 58 / Chapter 17H / Section 58-17H-46
Concurrent review urgent care requests--Extended care requests--Time for determination and notice
Status: in_force

For concurrent review urgent care requests involving a request by the covered person or the covered person's authorized representative to extend the course of treatment beyond the initial period of time or the number of treatments, if the request is made at least twenty-four hours prior to the expiration of the prescribed period of time or number of treatments, the health carrier shall make a determination with respect to the request and notify the covered person or, if applicable, the covered person's authorized representative, of the determination, whether it is an adverse determination or not, as soon as possible, taking into account the covered person's medical condition but in no event more than twenty-four hours after the date of the health carrier's receipt of the request. If the health carrier's determination is an adverse determination, the health carrier shall provide notice of the adverse determination in accordance with § 58-17H-48 .

Source: SL 2011, ch 219, § 71.
S.D. Codified Laws § 58-33A-25.5 — SD Code / Title 58 / Chapter 33A / Section 58-33A-25.5
Definition of terms--Compliance with Conduct Rules
Status: in_force

The terms used in § 58-33A-25 mean:

(1) "Comparable standards,":

(a) With respect to broker-dealers and registered representatives of broker-dealers, applicable SEC and FINRA rules pertaining to best interest obligations and supervision of annuity recommendations and sales, including 17 C.F.R. § 240.15|-1 (2023);

(b) With respect to investment advisers registered under federal or state securities laws or investment adviser representatives, the fiduciary duties and all other requirements imposed on such investment advisers or investment adviser representatives by contract or under the Investment Advisers Act of 1940 or applicable state securities law, including the Form ADV and interpretations; and

(c) With respect to plan fiduciaries or fiduciaries, the duties, obligations, prohibitions, and all other requirements attendant to such status under Employee Retirement Income Security Act of 1974 (ERISA) or the Internal Revenue Code as of January 1, 2023; and

(2) "Financial professional," a producer that is regulated and acting as:

(a) A broker-dealer registered under federal or state securities laws or a registered representative of a broker-dealer;

(b) An investment adviser registered under federal or state securities laws or an investment adviser representative associated with the federal or state registered investment adviser; or

(c) A plan fiduciary under 29 U.S. Code § 1002(21) (2019) or fiduciary under 26 U.S. Code § 4975(e)(3) (2019).

Source: SL 2022, ch 186, § 23, eff. Jan. 1, 2023.
S.D. Codified Laws § 58-12-19 — SD Code / Title 58 / Chapter 12 / Section 58-12-19
Clean claim defined
Status: in_force

As used in §§ 58-12-19 to 58-12-21 , inclusive, the term, clean claim, means a claim for which there is no need for additional information to determine eligibility or adjudicate the claim. The term, clean claim, does not include a claim for payment of expenses incurred during a period of time for which premiums are delinquent, except to the extent otherwise required by law or a claim for which fraud is suspected.

Source: SL 2001, ch 273, § 1.
S.D. Codified Laws § 58-17-149 — SD Code / Title 58 / Chapter 17 / Section 58-17-149
Definitions regarding retrospective payment of clean claims for covered services provided during credentialing period
Status: in_force

Terms used in §§ 58-17-149 to 58-17-152 , inclusive, mean:

(1) "Application date," the date on which a health insurer or other entity responsible for the credentialing of health care professionals on behalf of the health insurer receives the health care professional's completed application for credentialing or change request;

(2) "Clean claim," as defined in § 58-12-19 ;

(3) "Health care professional," as defined in subdivision 58-17F-1(8);

(4) "Health insurer," as defined in subdivision 58-17-100(2);

(5) "Special Review," a supplemental review of a health care professional's completed application for credentialing or change request by a health insurer or other entity responsible for credentialing of health care professionals necessitated by credible evidence received by a health insurer or other entity responsible for credentialing of health care professionals as it relates to investigation of the following: action taken against the applicant's licensure status, action taken against the applicant's professional society status, verified complaints to facilities, or licensing agency regarding the applicant; the applicant's non-completion of training programs; a criminal proceeding brought against the applicant a malpractice claim brought against the applicant; loss of a Drug Enforcement Administration certificate or state-controlled substance certificate; loss of a Medicare or Medicaid certification status; or involuntary termination of credentialing by a different health insurer.

Source: SL 2014, ch 236, § 1.
S.D. Codified Laws § 58-11-28 — SD Code / Title 58 / Chapter 11 / Section 58-11-28
Underwriters' and combination policies provisions do not apply to cosurety obligations
Status: in_force

Sections 58-11-26 and 58-11-27 shall not apply to cosurety obligations.

Source: SL 1966, ch 111, ch 22, § 21 (3).
S.D. Codified Laws § 58-5A-80 — SD Code / Title 58 / Chapter 5A / Section 58-5A-80
Director's participation in supervisory college with other regulators
Status: in_force

The director may participate in a supervisory college with other regulators charged with supervision of the insurer or its affiliates, including any state, federal, and international regulatory agency to assess the business strategy, financial position, legal and regulatory position, risk exposure, risk management, and governance processes of individual insurers. The director may enter into agreements pursuant to §§ 58-5A-41.2 and 58-5A-41.3 providing for the basis for cooperation between the director and any other regulatory agency, and the activities of the supervisory college. Nothing in this section delegates to the supervisory college the authority of the director to regulate or supervise the insurer or its affiliates within its jurisdiction.

Source: SL 2015, ch 246, § 21.
S.D. Codified Laws § 58-33-67 — SD Code / Title 58 / Chapter 33 / Section 58-33-67
Unfair or deceptive practices in dealing with insured
Status: in_force

In dealing with the insured or representative of the insured, unfair or deceptive acts or practices in the business of insurance include, but are not limited to, the following:

(1) Failing to acknowledge and act within thirty days upon communications with respect to claims arising under insurance policies and to adopt and adhere to reasonable standards for the prompt investigation of such claims;

(2) Making claims payments to any claimant, insured, or beneficiary not accompanied by a statement setting forth the coverage under which the payments are being made;

(3) Failing to promptly provide a reasonable explanation of the basis in the insurance policy in relation to the facts or applicable law for denial of a claim or for the offer of a compromise settlement;

(4) Failing to promptly settle claims, where liability has become reasonably clear under one portion of the insurance policy coverage to influence settlements under other portions of the insurance policy coverage;

(5) Requiring as a condition of payment of a claim that repairs to any damaged vehicle shall be made by a particular contractor or repair shop;

(6) Failing to make a good faith assignment of the degree of contributory negligence in ascertaining the issue of liability;

(7) Unless permitted by law and the insurance policy, refusing to settle a claim of an insured or claimant on the basis that the responsibility should be assumed by others.

Source: SL 1986, ch 422, § 2; SL 1989, ch 439, § 3.
S.D. Codified Laws § 58-22-18 — SD Code / Title 58 / Chapter 22 / Section 58-22-18
Failure of applicant to pass--Subsequent examinations
Status: in_force

The failure of an applicant to pass an examination shall not preclude him from taking subsequent examinations; provided, however, that at least one year must intervene between examinations.

Source: SL 1966, ch 111, ch 31, § 11.
S.D. Codified Laws § 58-29C-47 — SD Code / Title 58 / Chapter 29C / Section 58-29C-47
Construction of chapter
Status: in_force

This chapter shall be construed to effect the purpose under § 58-29C-45 .

Source: SL 2003, ch 252, § 4.
S.D. Codified Laws § 58-47-9 — SD Code / Title 58 / Chapter 47 / Section 58-47-9
Change in policy terms and conditions--Notice
Status: in_force

An insurer may terminate or otherwise change the terms and conditions of a policy of portable electronics insurance only upon providing the vendor policyholder and enrolled customers with at least twenty days notice. If the insurer changes the terms and conditions, then the insurer shall provide the vendor policyholder with a revised policy or endorsement and each enrolled customer with a revised certificate, endorsement, updated brochure, or other evidence indicating a change in the terms and conditions has occurred and a summary of material changes.

Source: SL 2012, ch 251, § 9.
S.D. Codified Laws § 58-12-13 — SD Code / Title 58 / Chapter 12 / Section 58-12-13
Use of claim forms required by federal law excepted
Status: in_force

An insurer, governmental agency, hospital, or other medical or dental provider does not violate § 58-12-12 by using a claim form or explanation of benefit form which the insurer, governmental agency, hospital, or other medical or dental provider has been required to use by federal law.

Source: SL 1994, ch 381, § 6.
S.D. Codified Laws § 58-30-54 — SD Code / Title 58 / Chapter 30 / Section 58-30-54
Information to applicants as to subjects covered and reference sources
Status: in_force

The director shall prepare and make available to applicants for license information as to the general scope of, and principal subjects to be covered by, the examination for a particular license, together with information as to published books and other reference sources which may be studied by the applicant in preparation for the examination; but the director shall not furnish lists of examination questions and answers nor select examination questions from any list thereof furnished applicants.

Source: SL 1966, ch 111, ch 9, § 14 (2).
S.D. Codified Laws § 58-20-40 — SD Code / Title 58 / Chapter 20 / Section 58-20-40
Proceedings or investigations by department
Status: in_force

The provisions of chapter 1-26 govern all proceedings or investigations of the department pursuant to §§ 58-20-25 to 58-20-40 , inclusive.

Source: SL 1995, ch 282, § 16.
S.D. Codified Laws § 58-29A-85 — SD Code / Title 58 / Chapter 29A / Section 58-29A-85
Compliance with plan of operation--Violation as misdemeanor
Status: in_force

All member insurers shall comply with the plan of operation. Violation of this section is a Class 2 misdemeanor.

Source: SL 2000, ch 247, § 32.
S.D. Codified Laws § 58-35-61 — SD Code / Title 58 / Chapter 35 / Section 58-35-61
Policyholders to vote on merger plan--Notice of vote
Status: in_force

Following the adoption of the resolution approving the plan of merger required by § 58-35-60 , a meeting of the policyholders of each of the corporations shall be held to vote upon the proposed merger plan. Written notice of the meeting of the policyholders shall be given to all policyholders, which may be either an annual or special meeting. Written notice shall be given to each policyholder of record whether or not entitled to vote at the meeting, not less than twenty days before the meeting, in the manner provided in §§ 47-1A-701 to 47-1A-747 , inclusive, and §§ 47-1A-1601 to 47-1A-1620 , inclusive, for the giving of notice of meetings of shareholders. Whether the meeting is an annual or special meeting, the notice shall state that the purpose or one of the purposes of the meeting is to consider the proposed plan of merger. A copy of the resolution passed by the board of directors shall be included in or enclosed with the notice.

Source: SL 1995, ch 293, § 2; SL 2005, ch 202, § 26; SL 2021, ch 210, § 21.
S.D. Codified Laws § 58-29B-50 — SD Code / Title 58 / Chapter 29B / Section 58-29B-50
Enumeration in §58-29B-49not exclusive
Status: in_force

The enumeration, in § 58-29B-49 , of the powers and authority of the liquidator may not be construed as a limitation upon him, nor may it exclude in any manner his right to do such other acts not herein specifically enumerated, or otherwise provided for, as may be necessary or appropriate for the accomplishment of or in aid of the purpose of liquidation.

Source: SL 1989, ch 436, § 50.
S.D. Codified Laws § 58-14-19 — SD Code / Title 58 / Chapter 14 / Section 58-14-19
Substantially similar defined
Status: in_force

For the purposes of this chapter, the term, substantially similar, means standards which equal or exceed the standards of this state.

Source: SL 1992, ch 344, § 17.
S.D. Codified Laws § 58-34-7 — SD Code / Title 58 / Chapter 34 / Section 58-34-7
Application for certificate of authority--Execution and filing--Contents
Status: in_force

The proposed attorney shall execute and file with the director an application for a certificate of authority setting forth:

(1) The name of the insurer;

(2) The location of the insurer's principal office, which shall be the same as that of the attorney and shall be maintained within this state;

(3) The kinds of insurance business proposed to be transacted;

(4) The names and addresses of the original subscribers;

(5) The designation and appointment of the proposed attorney and a copy of the power of attorney;

(6) The names and addresses of the officers and directors of the attorney, if a corporation, or its members, if a firm;

(7) The powers of the subscribers' advisory committee; and the names and terms of office of the members thereof;

(8) That all moneys paid to the reciprocal shall, after deducting therefrom any sum payable to the attorney, be held in the name of the insurer and for the purposes specified in the subscribers' agreement;

(9) A copy of the subscribers' agreement;

(10) A statement that each of the original subscribers has in good faith applied for insurance of a kind proposed to be transacted, and that the insurer has received from each such subscriber the full premium or premium deposit required for the policy applied for, for a term of not less than six months at an adequate rate theretofore filed with and approved by the director;

(11) A statement of the financial condition of the insurer, a schedule of its assets, and a statement that the surplus as required by §§ 58-34-14 to 58-34-16 , inclusive, is on hand; and

(12) A copy of each policy, endorsement and application form it then proposes to issue or use.

Such declaration shall be acknowledged by the attorney.

Source: SL 1966, ch 111, ch 19, § 7 (2).
S.D. Codified Laws § 58-29B-142 — SD Code / Title 58 / Chapter 29B / Section 58-29B-142
Director's application to act as receiver--Grounds
Status: in_force

On the same grounds as are specified in § 58-29B-138 , the director may petition any appropriate federal district court to be appointed receiver to liquidate that portion of the insurer's assets and business over which that court will exercise jurisdiction, or any lesser part thereof that the director deems desirable for the protection of the policyholders and creditors in this state.

Source: SL 1989, ch 436, § 142.
S.D. Codified Laws § 58-43-18 — SD Code / Title 58 / Chapter 43 / Section 58-43-18
Workpapers
Status: in_force

Workpapers are the records kept by the accountant of the procedures followed, the tests performed, the information obtained and the conclusions reached pertinent to his examination of the financial statements of an insurer. Workpapers, accordingly, may include audit planning documentation, work programs, analyses, memoranda, letters of confirmation and representation, abstracts of company documents, and schedules or commentaries prepared or obtained by the accountant in the course of his examination of the financial statements of an insurer and which support his opinion.

Source: SL 1992, ch 357, § 18.
S.D. Codified Laws § 58-35-18 — SD Code / Title 58 / Chapter 35 / Section 58-35-18
Issuance of certificate of authority--Continuation--Termination
Status: in_force

Upon application, the director shall issue such a certificate of authority to every insurer qualified therefor under this chapter. The certificate of authority shall continue, unless revoked or otherwise terminated.

Source: SL 1966, ch 111, ch 17, § 12 (1); SL 2004, ch 297, § 2.
S.D. Codified Laws § 58-5-11 — SD Code / Title 58 / Chapter 5 / Section 58-5-11
Amendment of articles of incorporation--Submission and filing
Status: in_force

Amendments to the articles of incorporation shall be submitted and filed in the same manner as articles of incorporation in §§ 58-5-8 to 58-5-10 , inclusive, and shall be in compliance with the provisions of this title, the bylaws of such corporation and the laws of this state.

Source: SL 1966, ch 111, ch 16, § 8 (1).
S.D. Codified Laws § 58-5-46 — SD Code / Title 58 / Chapter 5 / Section 58-5-46
Certified copy of bylaws and amendments of domestic mutual insurer filed with director--Disapproval by director, grounds
Status: in_force

A domestic mutual insurer shall promptly file with the director of the Division of Insurance a certified copy of its bylaws and all amendments thereto. The director at the time of filing or within thirty days thereafter shall disapprove any bylaw provision deemed by him to be unlawful, unreasonable, inadequate, unfair, or detrimental to the proper interests or protection of the insurer's members or any class thereof.

Source: SL 1966, ch 111, ch 16, § 16 (4).
S.D. Codified Laws § 58-33-80 — SD Code / Title 58 / Chapter 33 / Section 58-33-80
Liability of those who supply information or testify as to fraud
Status: in_force

Any person acting without malice who provides information to, cooperates with or testifies pursuant to a subpoena for an authorized agency, an insurer, the National Association of Insurance Commissioners or any not - for - profit organization established to detect and prevent fraudulent insurance claims is not subject to criminal prosecution, civil penalty, or civil liability, except in cases of perjury or insurance fraud.

Source: SL 1993, ch 368, § 6.
S.D. Codified Laws § 58-5B-4 — SD Code / Title 58 / Chapter 5B / Section 58-5B-4
Number of insurance applications required before certificate issued to mutual insurer
Status: in_force

No original certificate of authority shall be issued by the director of insurance until two hundred fifty applications have been received from health care providers other than hospitals, or in the case of hospitals, applications from hospitals representing fifty percent of the beds in the state or states to be affected, and until the director of insurance has satisfied himself that such mutual insurer has bona fide applications representing the number of applicants required.

Source: SL 1976, ch 315, § 4.
S.D. Codified Laws § 58-17D-1 — SD Code / Title 58 / Chapter 17D / Section 58-17D-1
Definitions
Status: in_force

Terms used in this chapter mean:

(1) "Utilization review," a review of health care services provided or to be provided to an individual to assist in the determination of the nature of the injury or condition, or the appropriateness of the treatment provided or to be provided;

(2) "Utilization review organization," any entity that provides utilization review services as defined in this chapter.

Source: SL 2002, ch 231, § 1.
S.D. Codified Laws § 58-5A-40 — SD Code / Title 58 / Chapter 5A / Section 58-5A-40
Insurer to pay expense of examination
Status: in_force

Each registered insurer producing for examination records, books, and papers pursuant to § 58-5A-37 shall be liable for and shall pay the expense of such examination.

Source: SL 1972, ch 267, § 34.
S.D. Codified Laws § 58-43-16.18 — SD Code / Title 58 / Chapter 43 / Section 58-43-16.18
Discretion of management as to internal control framework and documentation
Status: in_force

Management has discretion as to the nature of the internal control framework used, and the nature and extent of documentation, in order to make its assertion in a cost effective manner and, as such, may include assembly of or reference to existing documentation.

Source: SL 2009, ch 271, § 33.
S.D. Codified Laws § 58-41-11 — SD Code / Title 58 / Chapter 41 / Section 58-41-11
Surety bond or deposit required--Waiver
Status: in_force

Each health maintenance organization shall furnish a surety bond in an amount satisfactory to the director or deposit with the director cash or securities acceptable to him in at least the same amount as a guarantee that the obligations to the enrollees will be performed. The director may waive this requirement whenever he is satisfied that the assets of the organization or its contracts with insurers, hospital or medical service corporations, governments, or other organizations are sufficient to reasonably assure the performance of its obligations.

Source: SL 1974, ch 321, § 31.
S.D. Codified Laws § 58-7-7 — SD Code / Title 58 / Chapter 7 / Section 58-7-7
Purpose of deposits
Status: in_force

Such deposits shall be held for purposes set forth in §§ 58-7-8 to 58-7-12 , inclusive.

Source: SL 1966, ch 111, ch 7, § 3.
S.D. Codified Laws § 58-34-54 — SD Code / Title 58 / Chapter 34 / Section 58-34-54
Premium deposits as assets
Status: in_force

All premium deposits delinquent less than ninety days shall be allowed as assets.

Source: SL 1966, ch 111, ch 19, § 18 (4).
S.D. Codified Laws § 58-38-31 — SD Code / Title 58 / Chapter 38 / Section 58-38-31
Premiums held in trust by purchasing organization
Status: in_force

The organization shall hold all premiums received in trust and promptly remit premiums to the person entitled thereto.

Source: SL 1994, ch 382, § 7.
S.D. Codified Laws § 58-18-4.4 — SD Code / Title 58 / Chapter 18 / Section 58-18-4.4
Requirements for insurer offering fully insured health benefit plan through association
Status: in_force

A health insurer offering a fully insured health benefit plan through an association shall:

(1) Guarantee acceptance of all eligible individuals under the employer members' association or fully insured multiple employer arrangement and, if coverage is offered to spouses and dependents, to all of the spouses and dependents;

(2) Provide a bronze health plan that has an actuarial value of sixty percent;

(3) Comply with all applicable state mandates; and

(4) Have premium rates that meet a minimum loss ratio of eighty-five percent.

Source: SL 2019, ch 212, § 5.
S.D. Codified Laws § 58-40-32 — SD Code / Title 58 / Chapter 40 / Section 58-40-32
Promulgation of rules for purchasing organizations
Status: in_force

The director may promulgate rules pursuant to chapter 1-26 to further the provisions of §§ 58-40-22 to 58-40-32 , inclusive, and for purposes of carrying out the provisions of §§ 58-18-1 to 58-18-6 , inclusive, and to ensure that group health insurance coverage is issued to eligible groups and that organizations are formed and operated to further the purpose of providing economical group health insurance for its members. The rules may include:

(1) Definition of terms;

(2) Criteria for determining groups, associations, organizations, and trusts and their eligibility for coverage;

(3) Criteria for determining substantially similar groups or for determining related industries;

(4) Application requirements and procedures;

(5) Reasonable compensation; and

(6) Organizational structure.

Source: SL 1994, ch 382, § 11.
S.D. Codified Laws § 58-2-40 — SD Code / Title 58 / Chapter 2 / Section 58-2-40
Promulgation of rules to protect privacy of medical records
Status: in_force

The director of insurance shall promulgate rules pursuant to chapter 1-26 , to protect the privacy of personally identifiable health care and medical information, data, and records. The rules shall cover health care and medical information, data, and records collected, used, or disclosed by any person licensed or registered under Title 58 or any person with whom such licensees or registrants contract, and shall include all health care and medical information, data, and records received by or in the possession of the Division of Insurance. The rules may include the following:

(1) Definition of terms;

(2) Standards for the protection of the privacy and confidentiality of personally identifiable health care information and medical records;

(3) Rules for the collection, use, storage, security, disclosure, release, and disposal of health care and medical information, data, and records in all forms, including printed material, plastic media, audio, video, computerized and electronic transmissions;

(4) Rules regarding the sale and exchange of health care and medical information, data, and records;

(5) Rules to define the responsibilities and limitations of those needing or requiring access to health care and medical information, data, and records;

(6) Rules for procedures and documents required for the release or transfer of health care and medical information, data, and records, including the identity of who may release such information and records and under what conditions and provisions of the law, as needed to protect the privacy of personally identifiable health care and medical information, data, and records;

(7) Rules for the collection, use, storage, security, disclosure, distribution, release, and disposal of health care information and medical records obtained, used, or held in connection with the operation, maintenance, or review of insurance certificates, contracts, policies, and plans, and health maintenance organizations, subject to the jurisdiction of the director of insurance.

Source: SL 2000, ch 234, § 1.
S.D. Codified Laws § 58-15-38 — SD Code / Title 58 / Chapter 15 / Section 58-15-38
Adjusted premiums and present values--Computation
Status: in_force

Except as otherwise provided in §§ 58-15-43.1 to 58-15-43.11 , inclusive, all adjusted premiums and present values referred to in §§ 58-15-31 to 58-15-43 , inclusive, shall for all policies of ordinary insurance be calculated on the basis of the commissioner's 1958 standard ordinary mortality table; provided that for any category of ordinary insurance issued on female risks, adjusted premiums and present values may be calculated according to an age not more than six years younger than the actual age of the insured. Such calculations for all policies of industrial insurance shall be made on the basis of the 1941 standard industrial mortality table. However, any insurer may file with the director of the Division of Insurance a written notice of its election that such adjusted premiums and present values shall be calculated on the basis of the commissioner's 1961 standard industrial mortality table, after a specified date before January 1, 1968. Further, whether or not any election has been made, such commissioner's 1961 standard industrial mortality table shall be the basis for such calculations as to all policies of industrial insurance issued on or after January 1, 1968. All calculations shall be made on the basis of the rate of interest specified in the policy for calculating cash surrender values and paid - up nonforfeiture benefits, which rate of interest may not exceed three and one - half percent per annum except that a rate of interest not exceeding four percent per annum may be used for policies issued on or after July 1, 1973, and prior to July 1, 1978, and a rate of interest not exceeding five and one - half percent per annum may be used for policies issued on or after July 1, 1978, except that for any single premium whole life or endowment insurance policy a rate of interest not exceeding six and one - half percent per annum may be used. However, in calculating the present value of any paid - up term insurance with accompanying pure endowment, if any, offered as a nonforfeiture benefit, the rates of mortality assumed in the case of policies of ordinary insurance, may be not more than those shown in the commissioner's 1958 extended term insurance table, and, in the case of policies of industrial insurance, may be not more than one hundred thirty percent of the rates of mortality according to the 1941 standard industrial mortality table, except that when the commissioner's 1961 standard industrial mortality table becomes applicable, as hereinbefore provided, such rates of mortality assumed may be not more than those shown in the commissioner's 1961 industrial extended term insurance table. Further for insurance issued on a substandard basis, the calculation of any such adjusted premiums and present values may be based on such other table of mortality as may be specified by the insurer and approved by the director.

Source: SL 1966, ch 111, ch 23, § 28 (5); SL 1973, ch 299, § 1; SL 1977, ch 412, § 1; SL 1982, ch 357, § 4.
S.D. Codified Laws § 58-33-15 — SD Code / Title 58 / Chapter 33 / Section 58-33-15
Insurance not to be used to induce purchases of commodities or services--Misdemeanor
Status: in_force

No insurer may, directly or indirectly through its insurance producers or representatives, participate in any plan to offer or effect any kind or kinds of life insurance, health insurance, property insurance, casualty insurance, surety insurance, or annuities in this state as an inducement to, or in combination with, the purchase by the public of any goods, securities, commodities, services, or subscriptions to periodicals, except upon the payment of a bona fide premium by the insured. Any violation of this section is a Class 2 misdemeanor.

Source: SL 1966, ch 111, ch 13, § 14 (1); SL 1967, ch 132; SL 1978, ch 359, § 2; SL 2001, ch 286, § 201.
S.D. Codified Laws § 58-5A-11.1 — SD Code / Title 58 / Chapter 5A / Section 58-5A-11.1
Cost of hearing officer--Retention of various experts at acquiring person's expense
Status: in_force

If the director appoints a hearing officer to preside at the hearing pursuant to § 58-5A-9 , the cost of employing the hearing officer shall be borne entirely by the entity making the filing of the information statement required by § 58-5A-4 .

The director may retain at the acquiring person's expense any attorneys, actuaries, accountants, and other experts not otherwise a part of the director's staff as may be reasonably necessary to assist the director in reviewing the proposed acquisition of control.

Source: SL 1985, ch 388; SL 1992, ch 341, § 6.
S.D. Codified Laws § 58-43-9.7 — SD Code / Title 58 / Chapter 43 / Section 58-43-9.7
Disqualification of accountant due to previous employment of partner or senior manager of insurer--Relief from requirement
Status: in_force

The director may not recognize an independent certified public accountant as qualified for a particular insurer if a member of the board, president, chief executive officer, controller, chief financial officer, chief accounting officer, or any person serving in an equivalent position for that insurer, was employed by the independent certified public accountant and participated in the audit of that insurer during the one-year period preceding the date that the most current statutory opinion is due. This section shall only apply to partners and senior managers involved in the audit.

An insurer may make application to the director for relief from this requirement on the basis of unusual circumstances. The insurer shall file, with the insurer's annual statement filing, the approval for relief with the states that it is licensed in, with the states that it is doing business in, and with the National Association of Insurance Commissioners. If the nondomestic state accepts electronic filing with the National Association of Insurance Commissioners, the insurer shall file the approval in an electronic format acceptable to the National Association of Insurance Commissioners.

Source: SL 2009, ch 271, § 13.
S.D. Codified Laws § 58-18B-43 — SD Code / Title 58 / Chapter 18B / Section 58-18B-43
Status of insurance producer's employment may not be affected by health status, claims experience, occupation, or location of small employer placed with carrier
Status: in_force

No small employer carrier may terminate, fail to renew, or limit its contract or agreement of representation with an insurance producer for any reason related to the health status, claims experience, occupation, or geographic location of the small employers placed by the agent with the small employer carrier.

Source: SL 1995, ch 281, § 38; SL 2001, ch 286, § 128.
S.D. Codified Laws § 58-11A-6 — SD Code / Title 58 / Chapter 11A / Section 58-11A-6
Variation of reading ease requirement--Grounds
Status: in_force

The director of the Division of Insurance may authorize a lower score than the Flesch Reading Ease Score required in § 58-11A-3 whenever, in his sole discretion, he finds that a lower score will provide a more accurate reflection of the readability of a policy form, is warranted by the nature of a particular policy form or type or class of policy forms or is caused by certain policy language which is drafted to conform to the requirements of any state law, regulation, or agency interpretation.

Source: SL 1981, ch 360, § 6.
S.D. Codified Laws § 58-35-33 — SD Code / Title 58 / Chapter 35 / Section 58-35-33
Withdrawal from membership--Surrender of policy for cancellation--Payment of obligations
Status: in_force

Any member of an insurer may withdraw therefrom by surrendering his policy to the insurer for cancellation and paying all obligations then owing by him to the insurer.

Source: SL 1966, ch 111, ch 17, § 17 (1).
S.D. Codified Laws § 58-30-99 — SD Code / Title 58 / Chapter 30 / Section 58-30-99
Director's record of process against nonresident insurance producers
Status: in_force

The director shall keep a record of the day when served with all such legal process.

Source: SL 1966, ch 111, ch 9, § 31 (5); SL 2001, ch 286, § 180.
S.D. Codified Laws § 58-17E-20 — SD Code / Title 58 / Chapter 17E / Section 58-17E-20
Surety bond
Status: in_force

Each registered discount medical plan organization shall maintain in force a surety bond in its own name in an amount not less than twenty thousand dollars and shall be in favor of any person and the director of the Division of Insurance for the benefit of any person who is damaged by any violation of §§ 58-17E-9 , 58-17E-39 , 58-17E-41 , and 58-17E-45 , inclusive, including any violation by the supplier or by any other person that markets, promotes, advertises, or otherwise distributes a discount card on behalf of the supplier. The bond shall cover any violation occurring during the time period during which the bond is in effect. The bond shall be issued by an insurance company licensed to do business in this state. A copy of the bond or a statement identifying the depository, trustee, and account number of the surety account, and thereafter proof of annual renewal of the bond or maintenance of the surety account, shall be filed with the director.

Source: SL 2006, ch 257, § 20.
S.D. Codified Laws § 58-2-2.1 — SD Code / Title 58 / Chapter 2 / Section 58-2-2.1
Appointment of director--Removal
Status: in_force

The director of the Division of Insurance shall be appointed by the secretary and may be removed at the pleasure of the secretary.

Source: SL 1973, ch 2, § 49; SL 1980, ch 370, § 21; SL 1995, ch 2, § 6; SL 2003, ch 272, § 120.
S.D. Codified Laws § 58-17-30.7 — SD Code / Title 58 / Chapter 17 / Section 58-17-30.7
Policies excluded from alcoholism coverage requirements
Status: in_force

Sections 58-17-30.5 and 58-17-30.6 do not apply to accident only, or limited or specified disease policies.

Source: SL 1977, ch 410, § 4; SL 1979, ch 344, § 2; SL 1982, ch 362; SL 1999, ch 249, § 1.
S.D. Codified Laws § 58-17-165 — SD Code / Title 58 / Chapter 17 / Section 58-17-165
Reimbursement of payment from insured following receipt of payment from insurer
Status: in_force

If, under an assignment authorized in § 58-17-163 , a dentist or dental corporation collects payment from a person and subsequently receives payment from the insurer, the dentist or dental corporation shall reimburse the person, less any applicable copayments, deductibles, or coinsurance amounts, within forty-five days.

Source: SL 2017, ch 213, § 3.
S.D. Codified Laws § 58-22-44 — SD Code / Title 58 / Chapter 22 / Section 58-22-44
Undertaking for appearance before a magistrate or court--Time of appearance
Status: in_force

If no day is fixed for the appearance of the defendant, or an impossible day, or a day in vacation, the undertaking, if for his appearance before a magistrate for a hearing, shall bind the defendant to appear in ten days from the receipt of notice so to do by the defendant, his counsel, or any surety on the undertaking; and if for his appearance in a court for trial, shall bind the defendant so to appear on the first day of the next term of the court which shall commence more than three days after the giving of the undertaking.

Source: SL 1966, ch 111, ch 31, § 3.
S.D. Codified Laws § 58-22-20 — SD Code / Title 58 / Chapter 22 / Section 58-22-20
Renewal license--Issuance by director--Fee
Status: in_force

A renewal license shall be issued by the director to a licensee who has continuously maintained a license in effect without further examination, unless deemed necessary by the director, but such license is in all other respects required to comply with and be subject to the provisions of this chapter. After the receipt of such licensee's application for renewal the current license shall continue in effect until the renewal license is issued or denied for cause.

Source: SL 1966, ch 111, ch 31, § 12; SL 1998, ch 296, § 12.
S.D. Codified Laws § 58-17A-3 — SD Code / Title 58 / Chapter 17A / Section 58-17A-3
Preexisting conditions--Policy provisions
Status: in_force

Notwithstanding any other provision of law, a medicare supplement policy or certificate may not exclude or limit benefits for losses incurred more than six months from the effective date of coverage for a preexisting condition. The policy or certificate may not define a preexisting condition more restrictively than a condition for which medical advice was given or treatment was recommended by or received from a physician within six months before the effective date of coverage.

Source: SL 1982, ch 360, § 3; SL 1992, ch 347, § 3.
S.D. Codified Laws § 58-17-43 — SD Code / Title 58 / Chapter 17 / Section 58-17-43
Third parties taking policy covering insured
Status: in_force

The word "insured," as used in this chapter, shall not be construed as preventing a person other than the insured with a proper insurable interest from making application for and owning a policy covering the insured or from being entitled under such a policy to any indemnities, benefits, and rights provided therein.

Source: SL 1966, ch 111, ch 25, § 25.
S.D. Codified Laws § 58-5-5 — SD Code / Title 58 / Chapter 5 / Section 58-5-5
Incorporation of stock and mutual insurers
Status: in_force

Sections 58-5-6 and 58-5-7 apply to both stock and mutual insurers incorporated in this state after June 30, 1966.

Source: SL 1966, ch 111, ch 16, § 6 (1).
S.D. Codified Laws § 58-10-11 — SD Code / Title 58 / Chapter 10 / Section 58-10-11
Change of property interest on death of insured
Status: in_force

A change of interest, by will or succession, on the death of the insured, does not avoid an insurance of property and the insurance passes to the person taking his interest in the thing insured.

Source: SL 1966, ch 111, ch 22, § 7.
S.D. Codified Laws § 58-29E-2 — SD Code / Title 58 / Chapter 29E / Section 58-29E-2
Licensure requirement--Pharmacy benefit manager
Status: in_force

A person may not act as a pharmacy benefit manager in this state without a license to operate as a third party administrator pursuant to chapter 58-29D . Sections 58-29D -26, 58-29D -27, and 58-29D -29 do not apply to pharmacy benefits managers.

Source: SL 2004, ch 311, § 2; SL 2013, ch 253, § 5; SL 2023, ch 166, § 2.
S.D. Codified Laws § 58-2-28 — SD Code / Title 58 / Chapter 2 / Section 58-2-28
Certified copies of records in office of director as evidence
Status: in_force

Copies of records or documents in his office certified to by the director shall be received in evidence in all courts as if they were the originals.

Source: SL 1966, ch 111, ch 2, § 11 (1).
S.D. Codified Laws § 58-40-8 — SD Code / Title 58 / Chapter 40 / Section 58-40-8
Contracts with subscribers
Status: in_force

Any hospital service plan corporation organized under the provisions of this chapter may enter into contracts for the rendering of hospital service to any of its subscribers with licensed hospitals maintained and operated by any corporation, association, individual or any political subdivision of this state.

Source: SL 1966, ch 111, ch 21, § 17.
S.D. Codified Laws § 58-5C-1 — SD Code / Title 58 / Chapter 5C / Section 58-5C-1
Definition of terms
Status: in_force

Terms as used in this chapter, unless the context otherwise requires, mean:

(1) "Director," the director of insurance;

(2) "Legal malpractice insurance," insurance coverage against the legal liability of the insured and against loss, damage, or expense incident to a claim arising out of an error, omission, negligence, or malpractice in the rendering of professional service by any licensed attorney, his agents, or employees.

Source: SL 1977, ch 405, § 1.
S.D. Codified Laws § 58-26-45 — SD Code / Title 58 / Chapter 26 / Section 58-26-45
Valuation of reserve liabilities for policies and contracts issued before operative date of valuation manual--Calculating reserves
Status: in_force

The director shall annually value the reserve liabilities for all outstanding life insurance policies and annuity and pure endowment contracts of every life insurance company doing business in this state issued on or after July 1, 1995, and prior to the operative date of the valuation manual. In calculating the reserves, the director may use group methods and approximate averages for fractions of a year or otherwise. In lieu of the valuation of the reserves required of any foreign or alien company, the director may accept any valuation made by the insurance supervisory official of any state or other jurisdiction if the valuation complies with the minimum standard provided by this chapter.

The provisions in §§ 58-26-56 to 58-26-84 , inclusive, apply to all policies and contracts, as appropriate, subject to this chapter issued on or after July 1, 1995, and prior to the operative date of the valuation manual. The provisions set forth in §§ 58-26-91 to 58-26-100 , inclusive, do not apply to any such policies and contracts.

The minimum standard for the valuation of policies and contracts issued prior to July 1, 1995, is that provided by the laws in effect immediately prior to that date.

Source: SL 1995, ch 284, § 1; SL 2015, ch 254, § 2.
S.D. Codified Laws § 58-20-25 — SD Code / Title 58 / Chapter 20 / Section 58-20-25
Terms as used in §§58-20-25to58-20-40
Status: in_force

Terms used in §§ 58-20-25 to 58-20-40 , inclusive, mean:

(1) "Administrator," a person, partnership, limited liability company, or corporation engaged by a workers' compensation self-insurance association to carry out the policies established by the association and to provide management for the association;

(2) "Association," a not-for-profit workers' compensation self-insurance association consisting of two or more employers which are electric utilities, or an electric utility trade association, which enter into agreements to pool their liabilities for workers' compensation benefits in this state;

(3) "Certificate," a workers' compensation self-insurance certificate issued by the department in accordance with §§ 58-20-25 to 58-20-40 , inclusive;

(4) "Department," the South Dakota Department of Labor and Regulation;

(5) "Insolvency," the inability of an association to pay its outstanding lawful obligations as they mature in the regular course of business, as may be shown either by an excess of its required reserves and other liabilities over its assets, or by its not having sufficient assets to reinsure all of its outstanding liabilities after paying all accrued claims owed by it; and

(6) "Workers' compensation liability," liability to which an electric utility company is subject as an employer under the South Dakota workers' compensation law.

Source: SL 1995, ch 282, § 1; SL 2011, ch 1 (Ex. Ord. 11-1 ), § 33, eff. Apr. 12, 2011.
S.D. Codified Laws § 58-43-16.16 — SD Code / Title 58 / Chapter 43 / Section 58-43-16.16
Contents of Management's Report of Internal Control over Financial Reporting
Status: in_force

A Management's Report of Internal Control over Financial Reporting shall include:

(1) A statement that management is responsible for establishing and maintaining adequate internal control over financial reporting;

(2) A statement that management has established internal control over financial reporting and an assertion, to the best of management's knowledge and belief, after diligent inquiry, as to whether its internal control over financial reporting is effective to provide reasonable assurance regarding the reliability of financial statements in accordance with statutory accounting principles;

(3) A statement that briefly describes the approach or processes by which management evaluated the effectiveness of its internal control over financial reporting;

(4) A statement that briefly describes the scope of work that is included and whether any internal controls were excluded;

(5) Disclosure of any unremediated material weaknesses in the internal control over financial reporting identified by management as of December thirty-first for the immediately preceding year. Management is not permitted to conclude that the internal control over financial reporting is effective to provide reasonable assurance regarding the reliability of financial statements in accordance with statutory accounting principles if there is one or more unremediated material weaknesses in its internal control over financial reporting;

(6) A statement regarding the inherent limitations of internal control systems; and

(7) Signatures of the chief executive officer and the chief financial officer (or equivalent position or title).

Source: SL 2009, ch 271, § 31.
S.D. Codified Laws § 58-5A-55 — SD Code / Title 58 / Chapter 5A / Section 58-5A-55
Persons subject to registration to provide complete and accurate information to insurer
Status: in_force

Any person within an insurance holding company system subject to registration shall be required to provide to an insurer complete and accurate information reasonably necessary to enable the insurer to comply with the provisions of this chapter.

Source: SL 1992, ch 341, § 18.
S.D. Codified Laws § 58-17-87 — SD Code / Title 58 / Chapter 17 / Section 58-17-87
Director to promulgate rules for individual health insurance--Scope of rules
Status: in_force

The director shall promulgate rules pursuant to chapter 1-26 to cover:

(1) Terms or renewability;

(2) Conditions of eligibility;

(3) Benefit limitations, exceptions, and reductions;

(4) Definition of terms;

(5) Filing requirements for forms, rates, and rate schedules;

(6) Marketing practices;

(7) Reporting practices;

(8) Compensation arrangements between insurers or other entities and their agents, representatives, or producers;

(9) Suitability and appropriateness of the policy sold;

(10) Certificates of coverage;

(11) Determinations with regard to waiting periods;

(12) College plans;

(13) Creditable coverages;

(14) Breaks in coverage;

(15) The application of waiting periods; and

(16) Risk spreading mechanisms.

The director shall promulgate rules pursuant to chapter 1-26 that specify prohibited policy or certificate provisions not otherwise specifically authorized by statute which, in the opinion of the director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under an individual policy or certificate. The director shall also promulgate rules pursuant to chapter 1-26 assuring public access to rate and form information and establishing procedures for rate and form approvals and disapprovals. If any federal standards are in place which would require additional steps to meet those standards beyond what is required by this chapter, the director shall promulgate rules to require the offering of health insurance plans, the underwriting and coverage criteria that may be utilized for such health insurance plans, and other requirements related to the coverage criteria and availability of health insurance to individuals in this state in order to minimally meet the federal standards.

Source: SL 1996, ch 286, § 22; SL 1997, ch 289, § 6; SL 1998, ch 289, § 4; SL 2021, ch 210, § 11.
S.D. Codified Laws § 58-47-13 — SD Code / Title 58 / Chapter 47 / Section 58-47-13
Notice and correspondence requirements
Status: in_force

If any notice or correspondence with respect to a policy of portable electronics insurance is required, the notice or correspondence shall be in writing and mailed within any notice period specified within the statute or regulation requiring the notice or correspondence. Notwithstanding any other law, any notice or correspondence may be mailed by postal or electronic means. If the notice or correspondence is mailed through any postal service, the notice or correspondence shall be sent to the vendor of portable electronics at the vendor's mailing address specified for that purpose and to its affected enrolled customer's last known mailing address on file with the insurer. Either the insurer or vendor of portable electronics shall maintain proof of mailing in a form authorized or accepted by the United States Postal Service or any other commercial mail delivery service. If the notice or correspondence is mailed by electronic means, the notice or correspondence shall be sent to the vendor of portable electronics at the vendor's electronic mail address specified for that purpose and to its affected enrolled customer's last known electronic mail address as provided by each enrolled customer to the insurer or vendor of portable electronics. An enrolled customer's provision of an electronic mail address to the insurer or vendor of portable electronics is deemed to be consent to receive notice or correspondence by electronic means so long as a disclosure is provided to the customer within a reasonable time following purchase of the portable electronics. The insurer or vendor of portable electronics shall maintain proof that any notice or correspondence was electronically mailed to an enrolled customer. Notice or correspondence may be sent on behalf of any insurer or vendor, by the supervising entity appointed by the insurer.

Source: SL 2012, ch 251, § 13; SL 2017, ch 215, § 2.
S.D. Codified Laws § 58-29A-98 — SD Code / Title 58 / Chapter 29A / Section 58-29A-98
Settlements by association binding on successor of insolvent insurer--Priority of claim and expenses
Status: in_force

The receiver, liquidator, or statutory successor of an insolvent insurer is bound by determinations of covered claim eligibility under this chapter and by settlements of claims made by the association or a similar organization in another state. The court having jurisdiction shall grant such claims priority equal to that which the claimant would have been entitled in the absence of this chapter against the assets of the insolvent insurer. The expenses of the association or similar organization in handling claims shall be accorded the same priority as the liquidator's expenses.

Source: SL 2000, ch 247, § 45.
S.D. Codified Laws § 58-17H-10 — SD Code / Title 58 / Chapter 17H / Section 58-17H-10
Negotiated amounts for in-network providers for a particular emergency service
Status: in_force

If a health benefit plan has more than one negotiated amount for in-network providers for a particular emergency service, the amount in subdivision 58-17H-8 (1) is the median of these negotiated amounts.

Source: SL 2011, ch 219, § 35.
S.D. Codified Laws § 58-19-33 — SD Code / Title 58 / Chapter 19 / Section 58-19-33
Manner of payment of claims
Status: in_force

All claims shall be paid either by draft drawn upon the insurer or by check of the insurer to the order of the claimant to whom payment of the claim is due pursuant to the policy provisions, or upon direction of such claimant to one specified.

Source: SL 1966, ch 111, ch 27, § 10 (2).
S.D. Codified Laws § 58-32-54 — SD Code / Title 58 / Chapter 32 / Section 58-32-54
Provisions on independently procured coverages do not affect unauthorized insurers
Status: in_force

Sections 58-32-47 to 58-32-53 , inclusive, do not abrogate or modify any provision of this title covering unauthorized insurers or suits against unauthorized insurers.

Source: SL 1966, ch 111, ch 11, § 22 (7).
S.D. Codified Laws § 58-38-11.10 — SD Code / Title 58 / Chapter 38 / Section 58-38-11.10
Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony
Status: in_force

A service or indemnity - type contract issued by a nonprofit medical or surgical service plan corporation that is delivered, issued for delivery, or renewed in this state may not exclude the payment of benefits for injuries sustained by an insured person because the insured was under the influence of alcohol or drugs, as defined by § 32-23-1 .

Nothing in this section precludes a hospital or medical service plan from excluding coverage for an insured for any sickness or injury caused in the commission of a felony.

Source: SL 1997, ch 290, §§ 4, 7.
S.D. Codified Laws § 58-17I-4 — SD Code / Title 58 / Chapter 17I / Section 58-17I-4
Register of grievances required--Information to be compiled--Maintenance
Status: in_force

Each health carrier shall maintain in a register written records to document all grievances received including the notices and claims associated with the grievances during a calendar year. A request for a first level review of a grievance involving an adverse determination shall be processed in compliance with §§ 58-17I-7 to 58-17I-11 , inclusive, and is required to be included in the register. For each grievance the register shall contain the following information:

(1) A general description of the reason for the grievance;

(2) The date received;

(3) The date of each review or, if applicable, review meeting;

(4) Resolution at each level of the grievance, if applicable;

(5) Date of resolution at each level, if applicable; and

(6) Name of the covered person for whom the grievance was filed.

The register shall be maintained in a manner that is reasonably clear and accessible to the director. A health carrier shall retain the register compiled for a calendar year for five years.

Source: SL 2011, ch 219, § 76.
S.D. Codified Laws § 58-34-10 — SD Code / Title 58 / Chapter 34 / Section 58-34-10
Advance notice of cancellation of bond
Status: in_force

The bond required by § 58-34-8 shall provide that it is not subject to cancellation unless thirty days' advance notice in writing of cancellation is given to the attorney and the director.

Source: SL 1966, ch 111, ch 19, § 12 (3).
S.D. Codified Laws § 58-3-3.3 — SD Code / Title 58 / Chapter 3 / Section 58-3-3.3
Reimbursement to agents involved with insurance examinations--Insurer reimbursements
Status: in_force

The director may require persons who are not employees of the division who have been retained by the director to conduct or participate in examinations to bill and receive payments directly from the insurance company being examined. An insurer paying the costs of its examination pursuant to § 58-3-15 may receive reimbursements from the insurance examination fund upon completion of the examination.

Source: SL 1997, ch 283, § 3.
S.D. Codified Laws § 58-27-26 — SD Code / Title 58 / Chapter 27 / Section 58-27-26
Investments in stock of majority owned subsidiary corporations
Status: in_force

With the consent of the director of the Division of Insurance, an insurer may invest in the stock of its majority owned subsidiary insurance corporation; or in the stock of any other majority owned corporation.

Source: SL 1966, ch 111, ch 6, § 16; SL 1969, ch 130; SL 1983, ch 376, § 3.
S.D. Codified Laws § 58-33-38 — SD Code / Title 58 / Chapter 33 / Section 58-33-38
Undefined unfair or deceptive practice--Findings by director
Status: in_force

If the director believes that any person engaged in the insurance business is engaging in this state in any method of competition or in any act or practice in the conduct of such business which is not defined in this chapter, but that such method of competition is unfair or that such act or practice is unfair or deceptive and that a proceeding by him in respect thereto would be in the public interest, he shall, after a hearing of which notice of the hearing and of the charges against him are given such person, make a written report of his findings of fact relative to such charges and serve a copy thereof upon such person and any intervener at the hearing.

Source: SL 1966, ch 111, ch 13, § 5 (1).
S.D. Codified Laws § 58-22-54 — SD Code / Title 58 / Chapter 22 / Section 58-22-54
Enforcement of title permitted although license surrendered or lapsed
Status: in_force

The director retains the authority to enforce the provisions of and impose any penalty or remedy authorized by this chapter and title 58 against any person who is under investigation for or charged with any violation of this chapter or title 58 even if the person's license has been surrendered or has lapsed by operation of law.

Source: SL 2016, ch 233, § 2.
S.D. Codified Laws § 58-3-12.2 — SD Code / Title 58 / Chapter 3 / Section 58-3-12.2
Market conduct examination--Draft examination report
Status: in_force

Prior to the completion of a market conduct examination, the director may request that the examiner in charge provide a draft examination report that is not to be filed under oath. The draft examination report does not constitute the conclusion of the examination and does not trigger the provisions of § 58-3-12 until filed with the division under oath. Once the division has received the draft examination report, the director may share the draft examination report with the company examined to facilitate the resolution of the examination. The examiner in charge shall submit the examination report under oath and trigger the provisions of § 58-3-12 within one hundred eighty days of the director sharing the draft examination report pursuant to this section, unless the secretary provides a longer timeframe to allow additional consideration of the draft examination report by the company being examined. Nothing in this section applies to financial examinations.

Source: SL 2014, ch 232, § 1.
S.D. Codified Laws § 58-26-82 — SD Code / Title 58 / Chapter 26 / Section 58-26-82
Application of §§58-26-75and58-26-81to certain life insurance policies issued on or after January 1, 1986
Status: in_force

If for any life insurance policy issued on or after January 1, 1986, for which the gross premium in the first policy year exceeds that of the second year and for which no comparable additional benefit is provided in the first year for the excess and which provides an endowment benefit or a cash surrender value or a combination thereof in an amount greater than the excess premium, the foregoing provisions of § 58-26-81 and this section shall be applied as if the method actually used in calculating the reserve for the policy were the method described in § 58-26-75 , ignoring the second paragraph of § 58-26-75 . The minimum reserve at each policy anniversary of a policy shall be the greater of the minimum reserve calculated in accordance with § 58-26-75 , including the second paragraph of that section, and the minimum reserve calculated in accordance with § 58-26-81 and this section.

Source: SL 1995, ch 284, § 38.
S.D. Codified Laws § 58-33-25 — SD Code / Title 58 / Chapter 33 / Section 58-33-25
Acceptance by insured of rebate, discount or special advantage as misdemeanor
Status: in_force

No insured named in a policy, nor any employee of such insured shall knowingly receive or accept directly or indirectly, any such rebate, discount, abatement, credit or reduction of premium, or any such special favor or advantage or valuable consideration or inducement. Violation of this section is a Class 2 misdemeanor.

Source: SL 1966, ch 111, ch 13, § 16 (2); SL 1978, ch 359, § 2.
S.D. Codified Laws § 58-5A-62 — SD Code / Title 58 / Chapter 5A / Section 58-5A-62
Violations by officers subject to fine--Determining amount of fine
Status: in_force

Every director or officer of an insurance holding company system who knowingly violates, participates in, or assents to, or who knowingly permits any of the officers or agents of the insurer to engage in transactions or make investments which have not been properly reported or submitted pursuant to this chapter shall pay, in their individual capacity, an administrative fine of not more than five thousand dollars per violation. In determining the amount of the fine, the director shall take into account the gravity of the violation, previous violations, and other matters.

Source: SL 1992, ch 341, § 29.
S.D. Codified Laws § 58-17-49 — SD Code / Title 58 / Chapter 17 / Section 58-17-49
Health insurance provisions inapplicable to group or blanket policy
Status: in_force

Nothing in §§ 58-17-1 to 58-17-47 , inclusive, shall apply to or affect any group or blanket policy.

Source: SL 1966, ch 111, ch 25, § 1 (2).
S.D. Codified Laws § 58-5-50 — SD Code / Title 58 / Chapter 5 / Section 58-5-50
Annual meetings of stockholders or members--Election of directors--Reports of officers of insurer as to affairs--Transaction of other business--Notice of meeting
Status: in_force

Each insurer shall hold an annual meeting of its stockholders or members, to fill vacancies existing or occurring in the board of directors, receive and consider reports of the insurer's officers as to its affairs, and transact such other business as may properly be brought before it. Notice shall be given of such meeting in the manner provided in the bylaws.

Source: SL 1966, ch 111, ch 16, § 18 (3).
S.D. Codified Laws § 58-30-191 — SD Code / Title 58 / Chapter 30 / Section 58-30-191
Release of final orders allowed
Status: in_force

Nothing in §§ 58-30-141 to 58-30-195 , inclusive, prohibits the director from releasing final orders, including for cause terminations that are open to public inspection pursuant to Title 58 and chapters 1-26 and 1-27 , to a database or other clearinghouse service maintained by the National Association of Insurance Commissioners, its affiliates, or its subsidiaries.

Source: SL 2001, ch 286, § 51.
S.D. Codified Laws § 58-17H-32 — SD Code / Title 58 / Chapter 17H / Section 58-17H-32
Notification of adverse determination--Contents
Status: in_force

Any notification of an adverse determination under this section shall, in a manner which is designed to be understood by the covered person, set forth:

(1) Information sufficient to identify the benefit request or claim involved, including the date of service, if applicable, the health care provider, the claim amount, if applicable, the diagnosis code and its corresponding meaning, and the treatment code and its corresponding meaning;

(2) The specific reason or reasons for the adverse determination, including the denial code and its corresponding meaning, as well as a description of the health carrier's standard, if any, that was used in denying the benefit request or claim;

(3) A reference to the specific plan provision on which the determination is based;

(4) A description of additional material or information necessary for the covered person to complete the benefit request, including an explanation of why the material or information is necessary to complete the request;

(5) A description of the health carrier's grievance procedures established pursuant to chapter 58-17I , including time limits applicable to those procedures;

(6) If the health carrier relied upon an internal rule, guideline, protocol, or other similar criterion to make the adverse determination, either the specific rule, guideline, protocol, or other similar criterion or a statement that a specific rule, guideline, protocol, or other similar criterion was relied upon to make the adverse determination and that a copy of the rule, guideline, protocol, or other similar criterion will be provided free of charge to the covered person upon request;

(7) If the adverse determination is based on a medical necessity or experimental or investigational treatment or similar exclusion or limit, either an explanation of the scientific or clinical judgment for making the determination, applying the terms of the health benefit plan to the covered person's medical circumstances or a statement that an explanation will be provided to the covered person free of charge upon request;

(8) If applicable, instructions for requesting:

(a) A copy of the rule, guideline, protocol, or other similar criterion relied upon in making the adverse determination, as provided in subdivision (6) of this section; or

(b) The written statement of the scientific or clinical rationale for the adverse determination, as provided in subdivision (7) of this section; and

(9) A statement explaining the availability of and the right of the covered person, as appropriate, to contact the Division of Insurance at any time for assistance or, upon completion of the health carrier's grievance procedure process as provided under chapter 58-17I , to file a civil suit in a court of competent jurisdiction.

If the adverse determination is a rescission, the health carrier shall provide, in addition to any applicable disclosures required under § 58-17H-32 , clear identification of the alleged fraudulent practice or omission or the intentional misrepresentation of material fact, an explanation as to why the act, practice, or omission was fraudulent or was an intentional misrepresentation of a material fact, and the effective date of the rescission.

A health carrier may provide the notice required under this section in writing or electronically.

If the adverse determination is a rescission, the health carrier shall provide advance notice of the rescission determination required by rules promulgated by the director, in addition to any applicable disclosures required under this section.

The health carrier shall provide clear identification of the alleged fraudulent act, practice, or omission or the intentional misrepresentation of material fact.

The health carrier shall provide an explanation as to why the act, practice, or omission was fraudulent or was an intentional misrepresentation of a material fact.

The health carrier shall provide notice that the covered person or the covered person's authorized representative, prior to the date the advance notice of the proposed rescission ends, may immediately file a grievance to request a review of the adverse determination to rescind coverage pursuant to chapter 58-17I .

The health carrier shall provide a description of the health carrier's grievance procedures established pursuant to chapter 58-17I , including any time limits applicable to those procedures.

The health carrier shall provide the date when the advance notice ends and the date back to which the coverage will be retroactively rescinded.

Source: SL 2011, ch 219, § 57.
S.D. Codified Laws § 58-16-30 — SD Code / Title 58 / Chapter 16 / Section 58-16-30
Association groups--Insurance of members--Minimum number of members required
Status: in_force

A policy of group life insurance may be issued to an association, which has been in existence for one or more years, and which has a constitution and bylaws, and which was not formed for the exclusive purpose of procuring insurance, insuring at least one hundred members of the association for the benefit of persons other than the association or its officers.

Source: SL 1966, ch 111, ch 24, § 1 (5).
S.D. Codified Laws § 58-29B-90 — SD Code / Title 58 / Chapter 29B / Section 58-29B-90
Issuance of show cause order upon failure to pay assessment
Status: in_force

After levy of assessment under § 58-29B-89 , the liquidator shall issue an order directing each member who has not paid the assessment pursuant to the order to show cause why the liquidator should not pursue a judgment therefor.

Source: SL 1989, ch 436, § 90.
S.D. Codified Laws § 58-11-49 — SD Code / Title 58 / Chapter 11 / Section 58-11-49
Time for mailing or delivery of notice of cancellation of automobile policy--Provision for statement of reason for cancellation
Status: in_force

No notice of cancellation of an insurance policy specified in § 58-11-46 is effective unless mailed or delivered by the insurer to the named insured at least twenty days before the effective cancellation date. However, if cancellation is for nonpayment of premium the insurer shall mail or deliver notice of cancellation with the reason for cancelling at least twenty days before the effective cancellation date. Unless the reason for cancelling accompanies or is stated in the notice of cancellation, the notice of cancellation shall state or be accompanied by a statement that the insured may receive the reason for cancellation if he mails or delivers a written request to the insurer.

This section does not apply to nonrenewal.

Source: SL 1968, ch 138, § 3; SL 1983, ch 372, § 2.
S.D. Codified Laws § 58-30-126 — SD Code / Title 58 / Chapter 30 / Section 58-30-126
License required--Bond or errors and omissions policy
Status: in_force

No person may act in the capacity of a managing general agent with respect to risks located in this state for an insurer licensed in this state unless the person is a licensed insurance producer in this state. No person may act in the capacity of a managing general agent representing an insurer domiciled in this state with respect to risks located outside this state unless the person is licensed as an insurance producer in this state. The license may be a nonresident license.

The director may require the managing general agent to obtain a bond or an errors and omissions policy in an amount acceptable to the director for the protection of the insurer.

Source: SL 1992, ch 353, § 3; SL 2001, ch 286, § 189.
S.D. Codified Laws § 58-32-6 — SD Code / Title 58 / Chapter 32 / Section 58-32-6
Unauthorized acts constituting misdemeanors--Additional forfeiture
Status: in_force

Unless performed by a licensed surplus line broker, the following acts are Class 2 misdemeanors if done in this state:

(1) Acting as insurance producer for a nonadmitted insurer in the transaction of insurance business in this state;

(2) In any manner advertising a nonadmitted insurer in this state;

(3) In any other manner aiding a nonadmitted insurer to transact insurance business in this state.

In addition to any penalty provided for commission of misdemeanors, a person violating any provision of this section shall forfeit to this state the sum of five hundred dollars, together with one hundred dollars for each month or fraction thereof during which the person continues such violation.

Source: SL 1966, ch 111, ch 11, § 24; SL 1978, ch 359, § 2; SL 2001, ch 286, § 195.
S.D. Codified Laws § 58-15-15.9 — SD Code / Title 58 / Chapter 15 / Section 58-15-15.9
Insurance policy loan--Notice of interest rate to policyholder
Status: in_force

The life insurer shall notify the policyholder at the time a cash loan is made of the initial rate of interest on the loan and shall notify the policyholder with respect to premium loans of the initial rate of interest on the loan as soon as it is reasonably practical to do so after making the initial loan. Notice need not be given to the policyholder when a further premium loan is added, except that the life insurer shall send to policyholders with loans reasonable advance notice of any increase in the rate and shall include in the required notice the substance of the pertinent provisions of §§ 58-15-15.6 and 58-15-15.7 regarding the adjustable maximum interest rate.

Source: SL 1982, ch 358, § 6.
S.D. Codified Laws § 58-26-11 — SD Code / Title 58 / Chapter 26 / Section 58-26-11
Capital stock and liabilities chargeable against assets
Status: in_force

In any determination of the financial condition of an insurer, capital stock and liabilities to be charged against its assets shall include:

(1) The amount of its capital stock outstanding, if any;

(2) The amount, estimated consistently with the provisions of this title, necessary to pay all of its unpaid losses and claims incurred on or prior to the date of statement, whether reported or unreported, together with the expenses of adjustment or settlement thereof;

(3) With reference to life insurance, annuity contracts, and disability and accidental death benefits:

(a) The amount of reserves on life insurance policies and annuity contracts in force, valued according to the tables of mortality, rates of interest, and methods adopted pursuant to this title which are applicable thereto;

(b) Reserves for disability benefits, for both active and disabled lives;

(c) Reserves for accidental death benefits; and

(d) Any additional reserves which may be required by the director consistent with practice formulated or approved by the national association of insurance commissioners, on account of such insurance;

(4) With reference to health insurance, the amount of reserves required pursuant to § 58-26-30 ;

(5) With reference to insurance other than that specified in subdivisions (3) and (4), and other than title insurance, the amount of reserves equal to the unearned portions of the gross premiums charged on policies in force, computed in accordance with this chapter;

(6) Taxes, expenses, and other obligations due or accrued at the date of the statement.

Source: SL 1966, ch 111, ch 5, § 4.
S.D. Codified Laws § 58-13-5 — SD Code / Title 58 / Chapter 13 / Section 58-13-5
Chapter inapplicable when maximum possible loss not ascertainable
Status: in_force

This chapter shall not apply to life or health insurance, annuities, title insurance, insurance of wet marine and transportation risks, workers' compensation insurance, employer's liability coverages, nor to any policy or type of coverage as to which the maximum possible loss to the insurer is not readily ascertainable on issuance of the policy.

Source: SL 1966, ch 111, ch 4, § 11 (6).
S.D. Codified Laws § 58-19-17 — SD Code / Title 58 / Chapter 19 / Section 58-19-17
Issuance of policies
Status: in_force

All policies of credit life insurance and credit health insurance shall be delivered or issued for delivery in this state only by an insurer authorized to do an insurance business therein, and shall be issued only through holders of licenses or authorizations issued by the director.

Source: SL 1966, ch 111, ch 27, § 9.
S.D. Codified Laws § 58-18-94 — SD Code / Title 58 / Chapter 18 / Section 58-18-94
Application of provisions regarding multiple employer trusts--Inclusion of large and small employers
Status: in_force

The provisions of this chapter regarding multiple employer trusts do not apply to any single employer self-funded plan as preempted by Employee Retirement Income Security Act of 1974, 29 U.S.C. § 1144 or any arrangement exempted pursuant to § 1-24-17 . An authorized self-funded multiple employer trust may include as participating employers both small employers and large employers.

Source: SL 2005, ch 272, § 8; SL 2019, ch 212, § 11.
S.D. Codified Laws § 58-6-18 — SD Code / Title 58 / Chapter 6 / Section 58-6-18
Prevention of confusing similarity of names by director
Status: in_force

In case of conflict of names hereafter between two insurers, or a conflict otherwise prohibited under §§ 58-6-14 to 58-6-17 , inclusive, the director may require, as a condition to the issuance of an original certificate of authority to an applicant insurer, the insurer to use in this state such supplementation or modification of its name or such business name as may reasonably be necessary to avoid the conflict. No such name, supplementation, or modification shall contain the principal identifying factor of the name of any other insurer already authorized to transact insurance in this state.

Source: SL 1966, ch 111, ch 3, § 8 (5).
S.D. Codified Laws § 58-18B-7 — SD Code / Title 58 / Chapter 18B / Section 58-18B-7
Information and documentation required--Disclosure
Status: in_force

Each small employer carrier shall maintain at the carrier's principal place of business a complete and detailed description of the carrier's rating practices and renewal underwriting practices, including information and documentation which demonstrate that the carrier's rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles.

A small employer carrier shall make the information and documentation required by this section available to the director upon request. Except in cases of violations of this chapter, the information shall be considered proprietary and trade secret information and is not subject to disclosure by the director to persons outside of the division except as agreed to by the carrier or by order of a court, or if requested by a law enforcement officer or another state insurance agency.

Source: SL 1991, ch 402, § 7; SL 1995, ch 281, § 12; SL 2009, ch 262, § 2.
S.D. Codified Laws § 58-29B-150 — SD Code / Title 58 / Chapter 29B / Section 58-29B-150
Duties and powers of ancillary receivers, conservators, or liquidators when domiciliary liquidator appointed in this state
Status: in_force

When a domiciliary liquidator has been appointed in this state, ancillary receivers, conservators, or liquidators appointed in reciprocal states shall have, as to assets and books, accounts, and other records in their respective states, corresponding rights, duties, and powers to those provided in this chapter for ancillary receivers appointed in this state.

Source: SL 1989, ch 436, § 150; SL 2008, ch 271, § 6.
S.D. Codified Laws § 58-5A-43 — SD Code / Title 58 / Chapter 5A / Section 58-5A-43
Acquisition of subsidiaries--Limitations
Status: in_force

Any domestic insurer, either by itself or in cooperation with one or more persons, may organize or acquire one or more subsidiaries with the approval of the director and within those acquisitions allowed by this title as long as the aggregate investment by the insurer and its subsidiaries acquired or organized do not exceed the limitations applicable to the investment.

Source: SL 1992, ch 341, § 2.
S.D. Codified Laws § 58-33-122 — SD Code / Title 58 / Chapter 33 / Section 58-33-122
Life insurance solicitation practices on military installation considered false, misleading, deceptive, or unfair
Status: in_force

The following acts or practices, if committed on a military installation by an insurer or insurance producer with respect to the in-person, face-to-face solicitation of life insurance, are declared to be false, misleading, deceptive, or unfair:

(1) Knowingly soliciting the purchase of any life insurance product door to door or without first establishing a specific appointment for each meeting with the prospective purchaser;

(2) Soliciting service members in a group or mass audience or in a captive audience where attendance is not voluntary;

(3) Knowingly making appointments with or soliciting service members during their normally scheduled duty hours;

(4) Making appointments with or soliciting service members in barracks, day rooms, unit areas, or transient personnel housing or other areas where the installation commander has prohibited solicitation;

(5) Soliciting the sale of life insurance without first obtaining permission from the installation commander or the commander's designee;

(6) Posting unauthorized bulletins, notices, or advertisements;

(7) Failing to present DD Form 2885, Personal Commercial Solicitation Evaluation as of January 1, 2008, to service members solicited or encouraging service members solicited not to complete or submit the form; or

(8) Knowingly accepting an application for life insurance or issuing a policy of life insurance on the life of an enlisted member of the armed forces of the United States without first obtaining for the insurer's files a completed copy of any required form which confirms that the applicant has received counseling or fulfilled any other similar requirement for the sale of life insurance established by regulations, directives, or rules of the Department of Defense or any branch of the armed forces of the United States.

Source: SL 2008, ch 272, § 6.
S.D. Codified Laws § 58-6-46 — SD Code / Title 58 / Chapter 6 / Section 58-6-46
Grounds for refusal to renew, suspension, or revocation of certificate
Status: in_force

The director may refuse to renew or may suspend or revoke an insurer's certificate of authority if the director finds after a hearing thereon that the insurer has violated or failed to comply with any lawful order of the director, any laws of this state relevant to the business of insurance, or any provision of this title other than those for which suspension or revocation is mandatory.

Source: SL 1966, ch 111, ch 3, § 19 (1); SL 2013, ch 246, § 1.
S.D. Codified Laws § 58-30-211 — SD Code / Title 58 / Chapter 30 / Section 58-30-211
Conditions for offering and disseminating travel insurance under business entity license
Status: in_force

A travel retailer may offer and disseminate travel insurance under a limited lines travel insurance producer business entity license only if the entity meets the following conditions:

(1) The limited lines travel insurance producer or travel retailer provides to purchasers of travel insurance:

(a) A description of the material terms or the actual material terms of the insurance coverage;

(b) A description of the process for filing a claim;

(c) A description of the review or cancellation process for the travel insurance policy; and

(d) The identity and contact information of the insurer and limited lines producer;

(2) At the time of licensure, the limited lines travel insurance producer shall establish and maintain a register on a form prescribed by the director of each travel retailer that offers travel insurance on the limited lines producer's behalf. The limited lines travel insurance producer shall maintain and update the register annually and shall include the name, address, and contact information of the travel retailer and an officer or person who directs or controls the travel retailer's operations, and the travel retailer's federal tax identification number. The limited lines travel insurance producer shall submit such register to the division of insurance upon reasonable request. The limited lines producer shall certify that the travel retailer registered complies with 18 U.S.C. 1033;

(3) The limited lines travel insurance producer shall designate an employee who is a licensed individual producer as a designated responsible producer, or DRP. The DRP is responsible for the limited lines travel insurance producer's compliance with the travel insurance laws and rules of this state;

(4) The limited lines travel insurance producer pays all applicable insurance producer licensing fees;

(5) The limited lines travel insurance producer requires each employee and authorized representative of the travel retailer whose duties include offering and disseminating travel insurance to receive a program of instruction or training, which is subject to review by the director. The training material shall, at a minimum, contain instructions on the types of insurance offered, ethical sales practices, and required disclosures to prospective customers; and

(6) Limited lines travel insurance producers, and those registered under its license, are exempt from any examination and continuing education requirements under this chapter.

Source: SL 2014, ch 241, § 7.
S.D. Codified Laws § 58-30-6 — SD Code / Title 58 / Chapter 30 / Section 58-30-6
Appointment of insurance producer by insurer--Filing with director--Statement of kinds of insurance to be transacted--Payment of fee--Reasons for denying appointment
Status: in_force

The director may deny an appointment or withhold processing an appointment for reasons of protection of the public health, welfare, or safety including the following:

(1) The insurance producer to be appointed is not properly licensed; or

(2) A notice of hearing from the Division of Insurance seeking revocation or suspension of the insurance producer or insurer has been issued.

Source: SL 1966, ch 111, ch 9, § 20 (1); SL 1995, ch 289, § 1; SL 2001, ch 286, § 156.
S.D. Codified Laws § 58-17A-16 — SD Code / Title 58 / Chapter 17A / Section 58-17A-16
Additional penalties for violation of title
Status: in_force

In addition to any other applicable penalties or other administrative remedies for violations of this title, the director may require issuers violating any provision of this chapter or rules promulgated pursuant to this chapter to cease marketing any medicare supplement policy or certificate in this state which is related directly or indirectly to a violation, or may require such issuer to take such actions as are necessary to comply with the provisions of this chapter, or both.

Source: SL 1992, ch 347, § 16.
S.D. Codified Laws § 58-33-76 — SD Code / Title 58 / Chapter 33 / Section 58-33-76
Notification of suspected fraud
Status: in_force

An insurer, or any person authorized to act on its behalf, which reasonably believes that a false or fraudulent claim, statement, or representation has occurred, may notify an authorized agency and provide it with all relevant information in its possession.

Source: SL 1993, ch 368, § 2.
S.D. Codified Laws § 58-27-34 — SD Code / Title 58 / Chapter 27 / Section 58-27-34
Interests and restrictions not constituting encumbrances upon improved real property
Status: in_force

Real property shall not be deemed to be encumbered within the meaning of § 58-27-32 by reason of the existence of instruments reserving mineral, oil, timber, or similar rights, rights - of - way, sewer rights, rights in walls, nor by reason of any liens for taxes or assessments not yet due, or on account of liens not delinquent for community recreational facilities, or for the maintenance of community facilities, nor by reason of building restrictions or other restrictive covenants common to the community in which the property is located, nor by liens for service and maintenance of water rights where not delinquent, nor when such real property is subject to lease under which rents or profits are reserved to the owner if in any event the security for the loan or investment is a first lien upon the real property.

Source: SL 1966, ch 111, ch 6, § 28 (1).
S.D. Codified Laws § 58-24-1 — SD Code / Title 58 / Chapter 24 / Section 58-24-1
Purpose of chapter
Status: in_force

The purpose of this chapter is to promote the public welfare by regulating insurance rates to the end that they shall not be excessive, inadequate or unfairly discriminatory, and to authorize and regulate cooperative action among insurers in rate - making and in other matters within the scope of this chapter. Nothing in this chapter is intended to prohibit or discourage reasonable competition, or to prohibit or encourage, except to the extent necessary to accomplish the aforementioned purpose, uniformity in insurance rates, rating systems, rating plans, or practices. This chapter shall be liberally interpreted to carry into effect the provisions hereof.

Source: SL 1966, ch 111, ch 15, § 1.
S.D. Codified Laws § 58-48-1 — SD Code / Title 58 / Chapter 48 / Section 58-48-1
Definitions
Status: in_force

Terms used in this chapter mean:

(1) "Applicant," a person applying for an insurance innovation waiver;

(2) "Consumer," a person that purchases or otherwise enters into a transaction or agreement to receive an innovative insurance product or service that is being tested by a participant;

(3) "Innovation," the use or incorporation of a new or emerging technology or a new use of existing technology, including blockchain technology, to address a problem, provide a benefit, or otherwise offer a product, service, business model, or delivery mechanism that is not known by the division to have a comparable widespread offering in the state;

(4) "Innovative insurance product or service," an insurance product or service that includes an innovation;

(5) "Insurance product or service," an insurance product or insurance service that requires state licensure, registration, or other authorization under this title, including an insurance product or insurance service that includes a business model, delivery mechanism, or element that requires a license, registration, or other authorization to do insurance business, act as an insurance producer, or otherwise requires division approval;

(6) "Insurance innovation waiver" or "waiver," a document issued pursuant to this chapter that allows a person to temporarily test an innovative insurance product or service on a limited basis without otherwise being licensed or authorized to act under the laws of the state or in full compliance with the provisions of this title;

(7) "Participant," an applicant whose application for a waiver is granted in accordance with this chapter; and

(8) "Test," to provide an innovative insurance product or service in accordance with a granted waiver.

Source: SL 2021, ch 214, § 1.
S.D. Codified Laws § 58-20-38 — SD Code / Title 58 / Chapter 20 / Section 58-20-38
Revocation of self-insurance association's certificate
Status: in_force

If an association fails to make up a deficiency or to make the required assessment of its members pursuant to § 58-20-37 within thirty days after the department orders it to do so, or if the deficiency is not fully made up within sixty days after the date on which the assessment is made, or within a longer period of time as may be specified by the department, the department shall revoke the association's certificate.

Source: SL 1995, ch 282, § 14.
S.D. Codified Laws § 58-27-85 — SD Code / Title 58 / Chapter 27 / Section 58-27-85
Banking business authorized--Acquisition of banks--Regulation of such banking business
Status: in_force

Any insurance company, directly or through subsidiaries, may engage in all facets of the banking business. Any such insurance company may acquire all or substantially all of the shares of an existing bank which is established under the laws of this state or any other state. Any such banking business is subject to the same laws and regulations and the application thereof by the Division of Banking as are applicable to the operation of banks which are unaffiliated with insurance companies.

Source: SL 1983, ch 376, § 10.