reglab/housing_qa huggingface dataset:
SD Codified L § 58-18-2 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-2 - Employee group insurance authorized--"Employees" defined.

58-18-2. Employee group insurance authorized--Employees defined.Group health insurance may be under a policy issued to an employer or trustees of a fund established by an employer, who shall be deemed the policyholder, insuring employees of such employer for the benefit of persons other than the employer. The term "employees" as used herein shall be deemed to include the officers, managers, and employees of the employer, the individual proprietor or partner if the employer is an individual proprietor or partnership, the officers, managers, and employees of subsidiary or affiliated corporations, the individual proprietor or partners and employees of individuals and firms, if the business of the employer and such individual or firm is under common control through stock ownership, contract, or otherwise. The term "employees" as used herein may include retired employees. No director of a corporate employer shall be eligible for insurance under the policy unless such person is otherwise eligible as a bona fide employee of the corporation, by performing services other than the usual duties of a director. A policy issued to insure employees of a public body may provide that the term "employees" shall include elected or appointed officials. The policy may provide that the term "employees" shall include the trustees or their employees, or both, if their duties are principally with such trusteeship. Source: SL 1966, ch 111, ch 26, §1 (1).
SD Codified L § 58-18-3 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-3 - Employer association group health insurance authorized--Employees defined.

58-18-3. Employer association group health insurance authorized--Employees defined.Group health insurance may be under a policy issued to a bona fide association of employers, including a labor union, that has a constitution and bylaws and that has been organized and is maintained in good faith with at least one substantial business purpose unrelated to obtaining insurance, insuring members, employees, or employees of members of the association for the benefit of persons other than the association or its officers or trustees. For the purposes of this section, the term, employees, may include retired employees, and the term, employers, includes working owners without employees who qualify as both an employer and employee. Source: SL 1966, ch 111, ch 26, §1 (2); SL 2019, ch 212, §1.
SD Codified L § 58-18-4 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-4 - Industry fund group insurance authorized--"Employees" defined.

58-18-4. Industry fund group insurance authorized--Employees defined.Group health insurance may be under a policy issued to the trustees of a fund established by two or more employers in the same or related industry or by one or more labor unions or by one or more employers and one or more labor unions or by an association as defined in §58-18-3, which trustees shall be deemed the policyholder, to insure employees of the employers or members of the unions or of such association, or employees of members of such association, for the benefit of persons other than the employers or the unions or such association. The term "employees" as used herein may include the officers, managers and employees of the employer, and the individual proprietor or partners if the employer is an individual proprietor or partnership. The term "employees" as used herein may include retired employees. The policy may provide that the term "employees" shall include the trustees or their employees, or both, if their duties are principally connected with such trusteeship. Source: SL 1966, ch 111, ch 26, §1 (3).
SD Codified L § 58-18-4.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-4.1 - Restrictions on issuance of group health insurance policy to association.

58-18-4.1. Restrictions on issuance of group health insurance policy to association.A group health insurance policy may not be issued to an association under §§58-18-3 and 58-18-4 that is formed, owned, or controlled by any of the following, other than to the extent the entities participate in the group or association in their capacity as employer members of the group or association:(1)A health insurance issuer;(2)A subsidiary or affiliate of a health insurance issuer;(3)A health care organization or network provider that is part of the health care delivery system; or(4)An insurance producer, broker, or consultant. Source: SL 2019, ch 212, §2.
SD Codified L § 58-18-4.2 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-4.2 - Required duration of participation by employer member in association plan.

58-18-4.2. Required duration of participation by employer member in association plan.An employer member that participates in an association under §§58-18-3 and 58-18-4 shall participate in the association plan for a period of not less than three consecutive calendar years. Any contract issued to an association shall contain reasonable enforcement provisions including reasonable fees or assessments for early departure or for enrollment in another multiple employer plan during the early departure date. Source: SL 2019, ch 212, §3.
SD Codified L § 58-18-4.3 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-4.3 - Association plan covering state residents to comply with state law.

58-18-4.3. Association plan covering state residents to comply with state law.An association plan based in this state or any other state shall follow all applicable South Dakota laws and administrative rules if the association plan covers South Dakota residents. Source: SL 2019, ch 212, §4.
SD Codified L § 58-18-4.4 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-4.4 - Requirements for insurer offering fully insured health benefit plan through association.

58-18-4.4. Requirements for insurer offering fully insured health benefit plan through association.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.
SD Codified L § 58-18-5 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-5 - Issuance to person or organization to which group life insurance policy may be issued.

58-18-5. Issuance to person or organization to which group life insurance policy may be issued.Group health insurance may be under a policy issued to any person or organization to which a policy of group life insurance may be issued or delivered in this state to insure any class or classes of individuals that could be insured under such group life policy. Source: SL 1966, ch 111, ch 26, §1 (4).
SD Codified L § 58-18-6 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-6 - Issuance to cover similar group subject to discretion of director.

58-18-6. Issuance to cover similar group subject to discretion of director.Group health insurance may be under a policy issued to cover any other substantially similar group which, in the discretion of the director, may be subject to the issuance of a group health policy or contract. Source: SL 1966, ch 111, ch 26, §1 (5).
SD Codified L § 58-18-6.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-6.1 - Coverage of proprietors, partners and executive corporate officer employees.

58-18-6.1. Coverage of proprietors, partners and executive corporate officer employees.Group health insurance, as defined in §58-18-1, is required to offer to extend health insurance coverage to proprietors, partners, and executive corporate officer employees who are participating in such group insurance in their place of employment if such proprietor, partner, or executive officer elects not to be covered under workers' compensation. Source: SL 1981, ch 361.
SD Codified L § 58-18-7 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7 - Continuation without evidence of insurability--Application.

58-18-7. Continuation without evidence of insurability--Application.Any group health policy which contains provisions for the payment by the insurer of benefits for expenses incurred on account of hospital, nursing, medical, or surgical services shall provide for the continuation of benefit provisions, or any part or parts thereof, without evidence of insurability. The provisions of §§58-18-7.4 to 58-18-7.15, inclusive, apply to employers that have fewer than twenty employees employed. Source: SL 1966, ch 111, ch 26, §1 (6); SL 1989, ch 433, §2; SL 2005, ch 270, §1.
SD Codified L § 58-18-7.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.1 - Coverage for inpatient treatment of alcoholism to be offered in group policies--Treatment within state included.

58-18-7.1. Coverage for inpatient treatment of alcoholism to be offered in group policies--Treatment within state included.Any insurer which delivers or issues for delivery in this state group accident and sickness insurance policies which provide coverage on an expense incurred basis shall offer, in writing, to include in such group policies or contracts issued or renewed on or after July 1, 1977, coverage for the inpatient treatment of alcoholism in licensed hospitals and residential primary treatment facilities approved by the State of South Dakota which are carrying out an approved program pursuant to diagnosis and recommendation of a doctor of medicine. However, when coverage for inpatient treatment of alcoholism is included in any group policy, such coverage shall include inpatient treatment at any South Dakota approved inpatient alcoholism treatment facility. Source: SL 1975, ch 314, §1; SL 1976, ch 314, §1; SL 1977, ch 411, §1; SL 1978, ch 362, §1.
SD Codified L § 58-18-7.2 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.2 - Benefits provided under alcoholism coverage--Maximum treatment periods permitted.

58-18-7.2. Benefits provided under alcoholism coverage--Maximum treatment periods permitted.The alcoholism coverage shall provide benefits on the same basis as benefits provided for the treatment of other sicknesses covered under the group policy; provided, however, that the coverage by the insurance carrier need not exceed thirty days' care in any six-month period, and further provided that the total days' care per recipient need not exceed ninety days during the life of the contract. Source: SL 1975, ch 314, §2; SL 1977, ch 411, §2; SL 1978, ch 362, §2.
SD Codified L § 58-18-7.3 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.3 - Policies not within alcoholism coverage requirement.

58-18-7.3. Policies not within alcoholism coverage requirement.Sections 58-18-7.1 and 58-18-7.2 do not apply to accident only, or limited or specified disease policies. Source: SL 1975, ch 314, §3; SL 1999, ch 249, §2.
SD Codified L § 58-18-7.4 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.4 - Coverage upon application by employee or beneficiary with right to convert following notice of termination.

58-18-7.4. Coverage upon application by employee or beneficiary with right to convert following notice of termination.An employee or qualified beneficiary who has the right under the group policy to convert the group accident or health insurance plan shall be issued, without evidence of insurability, upon application to the company during the one hundred eighty days prior to expiration of coverage under continuation and upon payment of the appropriate premium, a policy of accident or health insurance. The conversion coverage shall provide the benefits which are available to others qualified for conversion under the policy. Source: SL 1980, ch 354; SL 1989, ch 433, §3; SL 2001, ch 280, §2.
SD Codified L § 58-18-7.5 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.5 - Continuation of coverage upon leaving employment or termination of coverage by insurer--Duration.

58-18-7.5. Continuation of coverage upon leaving employment or termination of coverage by insurer--Duration.Every health benefit program that is self-insured, and every policy of group health insurance providing benefits for hospital or medical expenses delivered or issued for delivery in this state, by a commercial health insurance company, by a nonprofit medical and surgical service plan corporation, by a nonprofit hospital service plan corporation, by a health maintenance organization or by any other similar mechanism shall, in addition to the provisions required by law, include that employees have a right upon leaving employment or the termination of the coverage by the insurer, other than the termination of the policy or contract itself and the replacement thereof by similar coverage, to have the coverage continue for themselves and their eligible dependents for a period of eighteen months for which the employee shall be financially responsible. In the case of a qualified beneficiary who is determined under title II or XVI of the Social Security Act (42 U.S.C. 401) to have been disabled at any time during the first sixty days of continuation coverage, coverage can be continued for twenty-nine months. Nonpayment of the premium by the employer is termination by the employer. Source: SL 1984, ch 326, §1; SL 1988, ch 400, §1; SL 1989, ch 433, §4; SL 2001, ch 280, §6.
SD Codified L § 58-18-7.11 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.11 - Continuation or conversion policy not required under certain circumstances.

58-18-7.11. Continuation or conversion policy not required under certain circumstances.No insurer may be required to offer or renew a continuation or conversion policy covering any person if:(1)The person is covered for similar benefits by another individual or group policy;(2)Similar benefits are provided for or available to such person, by reason of any state or federal law, except any person who becomes entitled to Medicare on or before continuation is elected or who is covered under another group plan on or before continuation is elected;(3)The benefits under sources of the kind referred to in subdivision (1) for such person or benefits provided or available under sources of the kind referred to in subdivision (2) for such person, together with the continued or converted policy's benefits, would result in overinsurance according to the insurer's standards for overinsurance;(4)There has been fraud or material misrepresentation in applying for any benefits under continued or converted policy;(5)The person failed to pay any required contribution;(6)There has been cancellation of all similar insurance policies in the entire state;(7)For cause on the same basis, the plan could terminate the coverage of a similarly situated active employee;(8)The person was terminated from employment for gross misconduct; or(9)The group health insurance policy is terminated by an insurer as a result of the group not meeting an insurer's participation or eligibility requirements. Source: SL 1984, ch 326, §7; SL 1989, ch 433, §9; SL 2001, ch 280, §12; SL 2009, ch 265, §1; SL 2015, ch 249, §31.
SD Codified L § 58-18-7.12 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.12 - Conditions for continuation.

58-18-7.12. Conditions for continuation.Subject to the conditions set forth for continuation in §§58-18-7 to 58-18-7.11, inclusive, a qualified beneficiary may continue coverage for a total of thirty-six months under the following conditions:(1)If at the death of the employee or member, the qualified beneficiary's coverage under the group policy terminates by reason of such death;(2)If a qualified beneficiary ceases to be a qualified family member under the group policy, while the employee or member remains insured under the policy;(3)Any medicare ineligible qualified beneficiary of a current employee;(4)The qualified beneficiary of an employee who is eligible for medicare; or(5)Divorce or legal separation of employee. Source: SL 1984, ch 326, §8; SL 1988, ch 400, §2; SL 1989, ch 433, §10; SL 2001, ch 280, §13.
SD Codified L § 58-18-7.13 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.13 - Premium for conversion policy and continuation policy.

58-18-7.13. Premium for conversion policy and continuation policy.The premium for the conversion policy shall be determined in accordance with the insurer's table of premium rates applicable to the age and class of risk for each person to be covered under that policy and to the type and amount of insurance provided. The premium for a continuation policy may not be greater than one hundred two percent of the group rate under which a person is covered. For any month after the eighteenth month, the premium amount may not exceed one hundred fifty percent of the applicable premium. Source: SL 1984, ch 326, §9; SL 1987, ch 378, §1; SL 1988, ch 400, §3; SL 1989, ch 433, §11; SL 2001, ch 280, §14.
SD Codified L § 58-18-7.14 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.14 - Notification of continuation and conversion rights.

58-18-7.14. Notification of continuation and conversion rights.A notification of the continuation and conversion rights shall be included in each certificate of coverage. Source: SL 1984, ch 326, §10.
SD Codified L § 58-18-7.15 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.15 - Group insurance coverage in lieu of converted individual policies.

58-18-7.15. Group insurance coverage in lieu of converted individual policies.The insurer may elect to provide group insurance coverage in lieu of the issuance of a converted individual policy. Source: SL 1984, ch 326, §11; SL 1987, ch 378, §2; SL 1988, ch 400, §4.
SD Codified L § 58-18-7.17 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.17 - Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.

58-18-7.17. Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.A group health insurance policy or certificate 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 health insurer from excluding coverage for an insured for any sickness or injury caused in the commission of a felony. Source: SL 1997, ch 290, §§2, 7.
SD Codified L § 58-18-7.18 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.18 - Continuation coverage to be same as that available to similarly situated beneficiaries--Option to decrease benefits.

58-18-7.18. Continuation coverage to be same as that available to similarly situated beneficiaries--Option to decrease benefits.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.
SD Codified L § 58-18-7.19 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.19 - Probationary period for continuation or conversion coverage prohibited.

58-18-7.19. Probationary period for continuation or conversion coverage prohibited.No new probationary or waiting period may be applied to the continuation or conversion coverage. Source: SL 2001, ch 280, §4.
SD Codified L § 58-18-7.20 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.20 - Construction with chapter 58-18C.

58-18-7.20. Construction with chapter 58-18C.Nothing in §§58-18-7.4, 58-18-7.5, 58-18-7.11, 58-18-7.12, 58-18-7.13, 58-18-7.18, 58-18-7.19, 58-18-7.20, or 58-18-79 applies to or qualifies any person for any continuation or conversion right available in chapter 58-18C. Source: SL 2001, ch 280, §5.
SD Codified L § 58-18-7.21 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18 - Group And Blanket Health Insurance Policies|Section 58-18-7.21 - Continued coverage--Insurer's use of experience for rating purposes not limited--Options unavailable in market not required.

58-18-7.21. Continued coverage--Insurer's use of experience for rating purposes not limited--Options unavailable in market not required.Nothing in §58-18-7.18 or 58-18C-5 may be construed to limit an insurer's ability to use the experience from those persons who have continued coverage pursuant to §58-18-7.18 or 58-18C-5 for rating purposes for the employer group from which coverage was continued. An insurer is not required to offer an option that is not available in the market for the policy form or forms from which continuation is being offered. This section and §§58-18-7.18 and 58-18C-5 apply to any person electing continuation coverage on or after July 1, 2008. Source: SL 2008, ch 266, §3.