reglab/housing_qa huggingface dataset:
SD Codified L § 58-17-42 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-42 - Age limit in policy--Effect of acceptance of premiums or misstatement of age.

58-17-42. Age limit in policy--Effect of acceptance of premiums or misstatement of age.If any policy of health insurance contains a provision establishing, as an age limit or otherwise, a date after which the coverage provided by the policy will not be effective, and if such date falls within a period for which premium is accepted by the insurer or if the insurer accepts a premium after such date, the coverage provided by the policy will continue in force until the end of the period for which premium has been accepted. In the event the age of the insured has been misstated and if, according to the correct age of the insured, the coverage provided by the policy would not have become effective, or would have ceased prior to the acceptance of such premium or premiums, then the liability of the insurer shall be limited to the refund, upon request, of all premiums paid for the period not covered by the policy. Source: SL 1966, ch 111, ch 25, §28.
SD Codified L § 58-17-43 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-43 - Third parties taking policy covering insured.

58-17-43. Third parties taking policy covering insured.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.
SD Codified L § 58-17-44 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-44 - Foreign or alien insurer--Policy provision required by home state.

58-17-44. Foreign or alien insurer--Policy provision required by home state.Any policy of a foreign or alien insurer, when delivered or issued for delivery to any person in this state, may contain any provision which is not less favorable to the insured or the beneficiary than the provisions of this chapter and which is prescribed or required by the law of the state or country under which the insurer is organized. Source: SL 1966, ch 111, ch 25, §26 (1).
SD Codified L § 58-17-45 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-45 - Policy of domestic insurer delivered in other state--Compliance with laws of other state.

58-17-45. Policy of domestic insurer delivered in other state--Compliance with laws of other state.Any policy of a domestic insurer may, when issued for delivery in any other state or country, contain any provision permitted or required by the laws of such other state or country. Source: SL 1966, ch 111, ch 25, §26 (2).
SD Codified L § 58-17-46 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-46 - Policy provisions not subject to chapter--Conforming to statute required.

58-17-46. Policy provisions not subject to chapter--Conforming to statute required.No policy provision which is not subject to this chapter shall make a policy, or any portion thereof, less favorable in any respect to the insured or the beneficiary than the provisions thereof which are subject to this chapter. Source: SL 1966, ch 111, ch 25, §27 (1).
SD Codified L § 58-17-47 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-47 - Nonconforming and conflicting provisions construed in conformity with statute.

58-17-47. Nonconforming and conflicting provisions construed in conformity with statute.A policy delivered or issued for delivery to any person in this state in violation of this chapter shall be held valid but shall be construed as provided in this chapter. When any provision in a policy subject to this chapter is in conflict with any provision of this chapter, the rights, duties, and obligations of the insurer, the insured and the beneficiary shall be governed by the provisions of this chapter. Source: SL 1966, ch 111, ch 25, §27 (2).
SD Codified L § 58-17-48 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-48 - Liability and workers' compensation insurance--Inapplicability of health insurance provisions.

58-17-48. Liability and workers' compensation insurance--Inapplicability of health insurance provisions.Nothing in §§58-17-1 to 58-17-47, inclusive, shall apply to or affect any policy of liability or workers' compensation and employers liability insurance. Source: SL 1966, ch 111, ch 25, §1 (1).
SD Codified L § 58-17-49 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-49 - Health insurance provisions inapplicable to group or blanket policy.

58-17-49. Health insurance provisions inapplicable to group or blanket policy.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).
SD Codified L § 58-17-50 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-50 - Life insurance, endowment or annuity contracts not subject to health insurance provisions.

58-17-50. Life insurance, endowment or annuity contracts not subject to health insurance provisions.Nothing in §§58-17-1 to 58-17-47, inclusive, shall apply to or affect life insurance, endowment, or annuity contracts, or contracts supplemental thereto which contain only such provisions relating to health insurance as:(1)Provide additional benefits in case of dismemberment or loss of sight, or of death by accident or accidental means, or as(2)Operate to safeguard such contracts against lapse, or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract. Source: SL 1966, ch 111, ch 25, §1 (3).
SD Codified L § 58-17-51 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-51 - Health insurance provisions inapplicable to reinsurance.

58-17-51. Health insurance provisions inapplicable to reinsurance.Nothing in §§58-17-1 to 58-17-47, inclusive, shall apply to or affect reinsurance. Source: SL 1966, ch 111, ch 25, §1 (4).
SD Codified L § 58-17-52 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-52 - Prior contracts or policies excepted.

58-17-52. Prior contracts or policies excepted.The provisions of §§58-17-1 to 58-17-51, inclusive, shall not apply to any contracts or policies entered into or issued prior to February 8, 1966, nor to any extensions, renewals, or modifications thereof or amendments thereto whenever made. Source: SL 1966, ch 111, ch 25, §29.
SD Codified L § 58-17-53 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-53 - Optometric services--Reimbursement, exceptions.

58-17-53. Optometric services--Reimbursement, exceptions.If an insurer provides by contract, policy, certificate, or any other means whatever, for a service, or for the partial or total reimbursement, payment, or cost of a service to or on behalf of any of its policyholders, group policyholders, subscribers, or group subscribers, or any other person or groups of persons, which service is within the lawful scope of practice of a licensed optometrist, the person rendering the service or the policyholder, subscriber, or other person is entitled to partial or total reimbursement, payment, or cost of that service, whether the service is performed by a licensed physician or by a licensed optometrist. Unless the contract, policy, certificate, or other means employed otherwise provides, there is no reimbursement of payment for ophthalmic materials, lenses, spectacles, eyeglasses, or appurtenances thereto. Reimbursement may be denied to a policyholder treating himself or any member of his family residing in his household, provided, however, that reimbursement for durable medical equipment, pharmaceuticals, and prosthetic devices may not be denied where within policy coverages. Source: SL 1966, ch 111, ch 32, §8; SL 1982, ch 363, §1.
SD Codified L § 58-17-54 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-54 - Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans for public employees--Restrictions on policy limitations.

58-17-54. Reimbursement provisions applicable to all healing arts licensees--Self-insurance plans for public employees--Restrictions on policy limitations.Notwithstanding any provision of any policy of insurance subject to the general provisions of this title, if a policy or contract provides for reimbursement for any service which may be legally performed by a person licensed in this state for the practice of medicine, surgery, anesthesia by a certified registered nurse anesthetist licensed under chapter 36-9, psychology, dentistry, osteopathy, social work by an independent social worker licensed under §36-26-17, optometry, chiropractic, or podiatry, the reimbursement under that policy or contract may not be denied if the service is rendered by a person so licensed. The provisions of this section apply to all practitioners licensed pursuant to chapters 36-4A and 36-9A after July 1, 1980, and to any plan of self-insurance for public employees. Reimbursement may be denied to a policyholder treating himself or any member of his family residing in his household. However, reimbursement for durable medical equipment, pharmaceuticals, and prosthetic devices may not be denied if within policy coverages.No policy, certificate, or contract may exclude or limit reimbursement for any lawful diagnostic or treatment service by a licensee under chapter 36-5 if the exclusion or limitation is based wholly or in part on any requirement that the service be performed in a place of service not normally used by the licensee.A policy, certificate, or contract may only limit or make optional the reimbursement for any lawful diagnostic or treatment service by a licensee under chapters 36-4 and 36-5 if the limitation is based on a rational basis which is not solely related to the license under, or practices authorized by, chapter 36-5 or is not dependent upon a method of classification, categorization or description based directly or indirectly upon differences in terminology used by different licensees in describing human ailments or in the diagnosis or treatment of human ailments.This section does not require reimbursement for any method or service not necessary, not reasonable or not generally accepted by the peers of the particular licensed health care provider. Source: SL 1970, ch 273; SL 1980, ch 355, §2; SL 1981, ch 24, §6; SL 1982, ch 363, §2; SL 1986, ch 419, §1; SL 1988, ch 402; SL 1989, ch 427; SL 1993, ch 360.
SD Codified L § 58-17-54.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-54.1 - Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services.

58-17-54.1. Copayment or coinsurance amounts for chiropractic, physical therapy, or occupational therapy services.No health insurer may impose any copayment or coinsurance amount on an insured for services rendered by a doctor of chiropractic licensed pursuant to chapter 36-5, an occupational therapist licensed pursuant to chapter 36-31, or a physical therapist licensed pursuant to chapter 36-10 that is greater than the copayment or coinsurance amount imposed on the insured for the services of a primary care physician or practitioner for the same or a similar diagnosed condition even if a different nomenclature is used to describe a condition. Source: SL 2011, ch 217, §1; SL 2012, ch 244, §1.
SD Codified L § 58-17-55 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-55 - Reimbursement provisions applicable to licensed hospitals.

58-17-55. Reimbursement provisions applicable to licensed hospitals.Notwithstanding any provision of any policy of insurance subject to the general provisions of this title, whenever such policy or contract provides for reimbursement for any service which may be legally performed by a hospital licensed in this state which has an organized medical staff with permanent facilities including inpatient beds and which is primarily engaged in providing diagnostic or therapeutic services for medical diagnosis, treatment, or care of injured and disabled, rehabilitation services for the physical rehabilitation of the injured and disabled, either on its premises or in facilities under the supervision of physicians on a pre-arranged basis to inpatients, reimbursement for coverage provided under such policy or contracts shall not be denied. Source: SL 1977, ch 409.
SD Codified L § 58-17-56 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-56 - Reimbursement for service rendered or supervised by qualified mental health professional.

58-17-56. Reimbursement for service rendered or supervised by qualified mental health professional.Notwithstanding any provision of any policy of insurance subject to the general provisions of this title, whenever such policy or contract provides for reimbursement for any service rendered by or directly supervised by a qualified mental health professional as defined in §27A-1-3, which may be legally performed by a mental health center as defined by §27A-1-1, reimbursement for coverage provided under such policy or contracts may not be denied. However, the provisions of this section only apply to the services defined in §58-17-98. Source: SL 1987, ch 377; SL 1991, ch 220, §§1 and 2; SL 2003, ch 152, §2.
SD Codified L § 58-17-57 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-57 - "Abuse of health insurance" defined--Violation as misdemeanor.

58-17-57. Abuse of health insurance as misdemeanor.A person who provides health care commits abuse of health insurance, if, as a regular business practice, he knowingly accepts from any third-party payor, as payment in full for services rendered, the amount the third-party payor covers, or submits a fee to a third-party payor which is higher than the fee he has agreed to accept from the insured with the understanding of waiving the required deductible or co-payment, if the effect of either business practice is to eliminate the need for payment by the insured of any required deductible or co-payment applicable in the insured's health benefit plan. Abuse of health insurance is a Class 1 misdemeanor. Source: SL 1989, ch 429, §1.
SD Codified L § 58-17-58 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-58 - Waiver of required deductible or co-payment for charitable purposes permitted.

58-17-58. Waiver of required deductible or co-payment for charitable purposes permitted.However, a person may waive any required deductible or co-payment for charitable purposes if:(1)The person who provides the health care determines that the services are necessary for the immediate health and welfare of the insured;(2)The waiver is made on a case-by-case basis and the person who provides the health care determines that payment of the deductible or co-payment would create a substantial financial hardship for the insured; and(3)The waiver is not a regular business practice of the person who provides the health care. Source: SL 1989, ch 429, §2.
SD Codified L § 58-17-59 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-59 - When waiver presumed.

58-17-59. When waiver presumed.Any person who provides health care and who waives the deductible or co-payment for more than one-fourth of his patients during any calendar year, excluding waivers under §58-17-58, or who advertises that he will accept from any third-party payor, as payment in full for services rendered, the amount the third-party payor covers, is presumed to be waiving the deductible or co-payment as a regular business practice. Source: SL 1989, ch 429, §3.
SD Codified L § 58-17-60 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-60 - Certain payments exempt.

58-17-60. Certain payments exempt.Payments made pursuant to federal medicare laws or payments made to the health-care provider according to a contract or agreement between an employer and employee which requires a third-party payor to pay the full amount for health-care services are exempt from §§58-17-57 to 58-17-60, inclusive. Source: SL 1989, ch 429, §4.
SD Codified L § 58-17-61 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-61 - Assignment of health insurance proceeds to certain hospitals authorized.

58-17-61. Assignment of health insurance proceeds to certain hospitals authorized.Any person insured by a health insurance company, health maintenance organization, preferred provider organization, individual practice association, or nonprofit hospital service corporation may assign in writing benefits from such policy, contract, or certificate to a hospital licensed pursuant to chapter 34-12. If such assignment is executed and written notice thereof is given, the insurance company, health maintenance organization, preferred provider organization, individual practice association, or nonprofit hospital service corporation shall pay the benefits directly to the hospital.Nothing in this section modifies the scope of coverage or the amount of benefits payable under a health insurance policy, contract, or certificate. Source: SL 1989, ch 430.
SD Codified L § 58-17-62 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-62 - Coverage for phenylketonuria.

58-17-62. Coverage for phenylketonuria.Every policy of health insurance that is delivered, issued for delivery or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall offer coverage for testing, diagnosis, and treatment of phenylketonuria including dietary management, formulas, case management, intake and screening, assessment, comprehensive care planning, and service referral. Source: SL 1992, ch 348, §1.
SD Codified L § 58-17-63 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-63 - "Health benefit plan" defined.

58-17-63. Health benefit plan defined.For the purposes of §§58-17-64, 58-18-63, 58-38-36, and 58-40-33, a health benefit plan is any hospital or medical policy or certificate, hospital or medical service plan, or health maintenance organization subscriber contract. The term does not include specified disease, hospital indemnity, fixed indemnity, fixed duration of one year or less, accident-only, credit, dental, vision, medicare supplement, long-term care, or disability income insurance, coverage issued as a supplement to liability insurance, workers' compensation or similar insurance, or automobile medical payment insurance. Source: SL 1994, ch 381, §3.
SD Codified L § 58-17-64 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-64 - Minimum loss ratio for individual health benefit plans.

58-17-64. Minimum loss ratio for individual health benefit plans.Premium rates for individual health benefit plans shall produce a minimum lifetime loss ratio of not less than sixty-five percent. The director may promulgate rules pursuant to chapter 1-26 which modify the minimum loss ratio required based on the specific design of the product or other objective and pertinent criteria. Source: SL 1994, ch 381, §4.
SD Codified L § 58-17-65 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-65 - Individual health insurance plan used in conjunction with managed care plan or utilization review organization.

58-17-65. Individual health insurance plan used in conjunction with managed care plan or utilization review organization. If a managed care plan or utilization review organization is used in conjunction with an individual health insurance plan, the managed care plan or utilization review organization shall establish a written utilization review program, registering a utilization review organization, and requesting information in the same manner as a managed care plan or utilization review organization subject to chapter 58-17H. Source: SL 1996, ch 296, §7; SL 2021, ch 210, § 10.
SD Codified L § 58-17-67 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-67 - "Professional association" defined.

58-17-67. Professional association defined.For purposes of §§58-17-66 to 58-17-87, inclusive, the term, professional association, means any association that meets all of the following criteria:(1)Serves a single profession that requires a significant amount of education, training, or experience or a license or certificate from a state authority to practice the profession;(2)Has been actively in existence for five years;(3)Has a constitution and by-laws or other analogous governing documents;(4)Has been formed and maintained in good faith for purposes other than obtaining insurance;(5)Is not owned or controlled by a carrier or affiliated with a carrier;(6)Does not condition membership in the association on health status of claims experience;(7)Has at least one thousand members if it is a national association; five hundred members if it is a state association; or two hundred members if it is a local association;(8)All members and dependents of members are eligible for coverage regardless of health status or claims experience;(9)Is governed by a board of directors and sponsors annual meetings of its members; and(10)Does not allow producers to market association memberships, accept applications for memberships, or sign up members. Source: SL 1996, ch 286, §2.
SD Codified L § 58-17-68 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-68 - "Professional association plan" defined.

58-17-68. Professional association plan defined.For purposes of §§58-17-66 to 58-17-87, inclusive, the term, professional association plan, means a health benefit plan offered through a professional association that covers members of a professional association and their dependents, and not others, in this state regardless of the situs of delivery of the policy or contract and which meets all the following criteria:(1)Conforms with all the provisions of the rate requirements of §§58-17-66 to 58-17-87, inclusive;(2)Provides renewability of coverage for the members and dependents of members of the professional association that meets the renewability requirements of §§58-17-66 to 58-17-87, inclusive;(3)Provides availability of coverage for the members and dependents of members of the professional association without regard to health status; and(4)Is offered by a carrier that offers health benefit plan coverage to any professional association seeking health benefit plan coverage from the carrier. Source: SL 1996, ch 286, §3; SL 2003 (SS), ch 1, §28.