reglab/housing_qa huggingface dataset:
SD Codified L § 58-17-69 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-69 - "Creditable coverage" defined.

58-17-69. Creditable coverage defined.For purposes of §§58-17-66 to 58-17-87, inclusive, the term, creditable coverage, means benefits or coverage provided under:(1)An employer-based health insurance or health benefit arrangement that provides benefits similar to or exceeding benefits provided under the basic health benefit plan or an employee welfare benefit plan as defined in section 3(1) of the Employee Retirement Income Security Act of 1974 as adopted by the director pursuant to chapter 1-26, to the extent that the plan provides directly or through insurance, reimbursement or otherwise to employees or their dependents medical care for the diagnosis, cure, mitigation, treatment, or prevention of disease, or amounts paid for the purpose of affecting any structure or function of the body and amounts paid for the transportation primarily for and essential to medical care;(2)An individual health benefit plan, including coverage issued by any health maintenance organization or pre-paid hospital or medical services plan that provides benefits similar to or exceeding the benefits provided under the basic health benefit plan as approved pursuant to chapter 1-26, but excluding limited benefit plans and dread disease plans;(3)Medicare or medicaid;(4)Chapter 55 of Title 10, United States Code;(5)A medical care program of the Indian Health Service or of a tribal organization;(6)A state health benefits risk pool;(7)A health plan offered under Chapter 89 of Title 5, United States Code;(8)A public health plan;(9)A health benefit plan under section 5(e) of the Peace Corps Act (22 U.S.C. 2504(e));(10)A church plan;(11)A college plan;(12)A short term or limited duration plan; or(13)An individual health benefit plan, including coverage issued by any health maintenance organization or pre-paid hospital or medical services plan that provided benefits less than the benefits provided under the basic health benefit plan as approved pursuant to chapter 1-26, but excluding the following excepted benefits:(a)Coverage only for accident including accidental death and dismemberment;(b)Disability income insurance;(c)Liability insurance including general liability insurance and automobile liability insurance;(d)Coverage issued as a supplement to liability insurance;(e)Workers' compensation or similar insurance;(f)Automobile medical payment insurance;(g)Credit only insurance including mortgage insurance;(h)Coverage for on-site medical clinics; and(i)Limited scope dental and long-term care insurance, if provided under a separate policy, certificate, or contract of insurance, or not otherwise an integral part of a plan. Source: SL 1996, ch 286, §4; SL 1997, ch 289, §2; SL 1998, ch 289, §1; SL 1999, ch 250, §1; SL 2001, ch 275, §1; SL 2004, ch 301, §1.
SD Codified L § 58-17-70 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-70 - Application of 58-17-66 to 58-17-87, inclusive.

58-17-70. Application of 58-17-66 to 58-17-87, inclusive.Sections 58-17-66 to 58-17-87, inclusive, apply to any individual health benefit plan or certificate delivered or issued for delivery in the state. Sections 58-17-66 to 58-17-87, inclusive, apply to any certificate issued to an eligible person that evidences coverage under a policy or contract issued to a trust or association or other similar grouping of persons, regardless of the situs of delivery of the policy or contract, if the eligible person pays the premium and is not being covered under the policy or contract pursuant to continuation of benefit provisions applicable under federal or state law. The following are not subject to the provisions of §§58-17-66 to 58-17-87, inclusive:(1)Any medicare supplement policy;(2)Any long-term care policy;(3)Any contract or certificate marketed on a group basis that is subject to regulation under chapter 58-18B or §§58-18-42 to 58-18-51.1, inclusive;(4)Any certificate issued to an eligible person that evidences coverage under a professional association plan;(5)Any policy or certificate of specified disease, short-term hospital-surgical care of six months or less duration, hospital confinement indemnity, limited benefit health insurance, or other policy or certificate that provide benefits less than as provided for under subdivision 58-17-69(2) if the carrier offering the policy or certificate at the time of filing for policy form approval, submits a statement certifying that policies or certificates described in this section are being offered and marketed as supplemental health insurance or as individual health benefit plans of six-month duration or less and not renewable, and not as a substitute for hospital or medical expense insurance or major medical insurance. For policy forms approved prior to July 1, 1996, the carrier shall submit such a statement with the director. If such a statement certifying that the policies or certificates are being offered as supplemental health insurance and not as a substitute for major medical insurance is either not filed or is withdrawn, the carrier offering such coverage shall, in addition to the policy or certificate providing coverage that is less than major medical, offer and actively market an individual major medical policy to any person who is solicited for coverage for the nonmajor medical products it offers. Source: SL 1996, ch 286, §5; SL 1998, ch 289, §2; SL 2003 (SS), ch 1, §29.
SD Codified L § 58-17-71 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-71 - Separate classes of individual business--Reasons--Number.

58-17-71. Separate classes of individual business--Reasons--Number.A carrier may establish a separate class of individual business only to reflect substantial differences in expected claims experience or administrative costs related to the following reasons:(1)The carrier used more than one type of system for the marketing and sale of health benefit plans to individuals; or(2)The carrier has acquired a class of business from another carrier.A carrier may establish up to three separate classes of individual business under this section. Source: SL 1996, ch 286, §6.
SD Codified L § 58-17-72 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-72 - Transitional period when additional class of business acquired.

58-17-72. Transitional period when additional class of business acquired.The director may provide for a period of transition in order for a carrier to come into compliance with §58-17-71 in the instance of acquisition of an additional class of business from another carrier. Source: SL 1996, ch 286, §7.
SD Codified L § 58-17-73 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-73 - Director approval required to establish additional classes of business--Rates or rating methodologies.

58-17-73. Director approval required to establish additional classes of business--Rates or rating methodologies.The director may approve the establishment of additional classes of business upon application to the director and a finding by the director that such action would enhance the efficiency and fairness of the individual marketplace. Nothing in §§58-17-66 to 58-17-87, inclusive, requires a carrier to change any of its rates or rating methodologies for any business other than the individual business subject to the provisions of §§58-17-66 to 58-17-87, inclusive. Source: SL 1996, ch 286, §8.
SD Codified L § 58-17-74 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-74 - Provisions for premium rates for individual health benefit plans.

58-17-74. Provisions for premium rates for individual health benefit plans.Premium rates for individual health benefit plans subject to §§58-17-66 to 58-17-87, inclusive, are subject to the following provisions:(1)Any new policy issued after the effective date of §§58-17-66 to 58-17-87, inclusive, is subject to the provisions of §§58-17-66 to 58-17-87, inclusive;(2)The index rate for a rating period for any class of individual business may not exceed the index rate for any other class of individual business by more than twenty percent;(3)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 vary from the index rate by more than thirty percent of the index rate;(4)An adjustment applied to a single block of business may not exceed the adjustment applied to all blocks of business by more than fifteen percent due to the claim experience or health status of that block of business;(5)Any adjustment in rates for claim experience and duration of coverage may not be charged to specific individual policyholders. Any such adjustment shall be applied uniformly to the rates charged for any person and dependents of the person within each class of business;(6)Premium rates for individual health benefit plans shall comply with the requirements of §§58-17-66 to 58-17-87, inclusive;(7)Each carrier shall apply rating factors consistently with respect to all persons in a class of business. Rating factors shall produce premiums for identical persons which differ only by the amounts attributable to plan design;(8)No carrier may use characteristics other than age, gender, lifestyle, family composition, and geographic area without prior approval of the director. The maximum rating differential based solely on age may not exceed a factor of 5:1; and(9)All rate adjustments based on geographic area shall reflect actual differences in the health care costs of the respective areas.The rating provisions of subdivisions (1), (2), (3), (4), and (6) of this section do not apply to individual health benefit plans issued by a carrier to qualifying individuals on a guaranteed issue basis. However, the rate for any individual covered on a guaranteed issue basis may not exceed two and one half times the base rate of the class of business with the lowest index rate. Source: SL 1996, ch 286, §9; SL 2008, ch 263, §1.
SD Codified L § 58-17-74.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-74.1 - Premium rate limitations.

58-17-74.1. Premium rate limitations.Any health benefit plan issued before July1, 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 July1, 2001, two and one-half times the base premium rate after July 1, 2003, and two times the base premium rate after July1, 2005. Source: SL 2000, ch 240, §1; SDCL §58-17-4.3; SL 2005, ch 10, §41.
SD Codified L § 58-17-75 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-75 - Promulgation of rules for rates charged for individual health benefit plans.

58-17-75. Promulgation of rules for rates charged for individual health benefit plans.The director shall promulgate rules pursuant to chapter 1-26 to ensure that rating practices used by carriers are consistent with the purposes of §§58-17-66 to 58-17-87, inclusive, including rules that ensure that differences in rates charged for individual health benefit plans by carriers are reasonable, and reflect objective differences in plan design, age, and gender of the insured. Source: SL 1996, ch 286, §10.
SD Codified L § 58-17-76 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-76 - Transfer into or out of class of business.

58-17-76. Transfer into or out of class of business.No carrier may transfer a person involuntarily into or out of a class of business. No carrier may offer to transfer a person into or out of a class of business unless such an offer is made to transfer all persons in the class of business without regard to claim experience or duration of coverage since issue. Source: SL 1996, ch 286, §11.
SD Codified L § 58-17-77 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-77 - Temporary suspension of premium rates for individual health insurance--Reasons.

58-17-77. Temporary suspension of premium rates for individual health insurance--Reasons.The director may suspend for a specified period the application of subdivision 58-17-74(2) as to the premium rates for one or more rating periods upon a filing by the carrier and a finding by the director either that the suspension is reasonable in light of the financial condition of the carrier or that the suspension would enhance the efficiency and fairness of the marketplace for individual health insurance. Source: SL 1996, ch 286, §12.
SD Codified L § 58-17-78 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-78 - Required disclosure when offering individual health benefit plan.

58-17-78. Required disclosure when offering individual health benefit plan.In connection with the offering for sale of any individual health benefit plan to a person, a carrier shall make a reasonable disclosure, as part of its solicitation and sales materials, of:(1)The extent to which premium rates for a specified person are established or adjusted based upon age and gender;(2)The provisions of the individual health benefit plan concerning the carrier's right to change premium rates and the factors that affect changes in premium rates;(3)The provisions relating to renewability of policies and contracts; and(4)The provisions relating to any preexisting condition provision. Source: SL 1996, ch 286, §13.
SD Codified L § 58-17-79 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-79 - Documentation of rating methods and practices.

58-17-79. Documentation of rating methods and practices.Each carrier shall maintain at its principal place of business a complete and detailed description of its rating practices and renewal underwriting practices, including information and documentation that demonstrate that its rating methods and practices are based upon commonly accepted actuarial assumptions and are in accordance with sound actuarial principles. Source: SL 1996, ch 286, §14.
SD Codified L § 58-17-81 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-81 - Availability of information on rating methods and practices of carriers offering individual health benefit plans.

58-17-81. Availability of information on rating methods and practices of carriers offering individual health benefit plans.A carrier shall make the information and documentation described in §58-17-79 available to the director upon request. Except in cases of violations of §§58-17-66 to 58-17-87, inclusive, the information is proprietary and trade secret information and may not be disclosed by the director to persons outside of the division, except in the case of an administrative proceeding, to the Office of Hearing Examiners or the court in question or except as agreed to by the carrier or as ordered by a court of competent jurisdiction. Source: SL 1996, ch 286, §16.
SD Codified L § 58-17-83 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-83 - Election not to renew individual health benefit plan--Future business restricted.

58-17-83. Election not to renew individual health benefit plan--Future business restricted.No carrier that elects not to renew an individual health benefit plan under subdivision 58-17-82(4) may write new business in the individual health benefit plan market in the state for a period of five years from the date of notice to the director. Source: SL 1996, ch 286, §18.
SD Codified L § 58-17-84.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-84.1 - (Text of section effective until the first plan year, policy year, or renewal date on or after January 1, 2019) Anesthesia and hospitalization for dental care to be provided certain covered persons.

58-17-84.1.(Text of section effective until the first plan year, policy year, or renewal date on or after January 1, 2019) Anesthesia and hospitalization for dental care to be provided certain covered persons. Any health benefit plan as defined by §58-17-63 shall cover anesthesia and hospital charges for dental care provided to a covered person who:(1)Is a child under age five; or(2)Is severely disabled or otherwise suffers from a developmental disability as determined by a licensed physician which places such person at serious risk.Such coverage applies regardless of whether the services are provided in a hospital or a dental office. A health carrier may require prior authorization of hospitalization for dental care procedures in the same manner that prior authorization is required for hospitalization for other covered diseases or conditions.(Text of section effective the first plan year, policy year, or renewal date on or after January 1, 2019) Anesthesia and hospital or ambulatory surgery center charges for dental care to be covered for certain persons. Any health benefit plan as defined by §58-17-63 shall cover anesthesia and hospital or ambulatory surgery center charges for dental care provided to a covered person who:(1)Is a child under age five; or(2)If determined by a licensed physician, is severely disabled, has a developmental disability, or otherwise has a medical condition that places the person at serious medical risk.The coverage applies regardless of whether the services are provided in a hospital, ambulatory surgery center, or a dental office. A health carrier may require prior authorization in the same manner that prior authorization is required for other covered diseases or conditions. Source: SL 1999, ch 248, §2; SL 2018, ch 279, §1, eff. Jan. 1, 2019.
SD Codified L § 58-17-87 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-87 - Director to promulgate rules for individual health insurance--Scope of rules.

58-17-87. Director to promulgate rules for individual health insurance--Scope of rules. 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.
SD Codified L § 58-17-88 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-88 - Minimum inpatient care coverage following delivery.

58-17-88. Minimum inpatient care coverage following delivery.If a health insurance policy that is issued or renewed on or after July 1, 1996, provides maternity coverage, the policy shall provide coverage for a minimum of forty-eight hours of inpatient care following a vaginal delivery and a minimum of ninety-six hours of inpatient care following delivery by cesarean section for a mother and her newborn child in a health care facility licensed pursuant to chapter 34-12, except as otherwise provided in §58-17-89. Any policy that provides coverage for complications of pregnancy, and does not provide other maternity benefits, is not required to comply with this section. Source: SL 1996, ch 292, §1; SL 1998, ch 290, §1.
SD Codified L § 58-17-89 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-89 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.

58-17-89. Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.If the treating physician determines that the mother and the newborn meet medical criteria contained in Guidelines for Perinatal Care, Third Edition, of the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists as in effect on January 1, 1996, a health insurance policy may provide coverage for a shorter length of hospital inpatient stay for services related to maternity and newborn care than is required in §58-17-88 if the coverage includes one follow-up visit in the first forty-eight hours after discharge to verify the condition of the mother and newborn. Source: SL 1996, ch 292, §2.
SD Codified L § 58-17-90 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 17 - Health Insurance Policies|Section 58-17-90 - Notice to policyholders--Disclosures.

58-17-90. Notice to policyholders--Disclosures.The health insurer shall provide notice to policyholders regarding the coverage required by §§58-17-88 and 58-17-89 in accordance with rules adopted by the director of the Division of Insurance pursuant to chapter 1-26. The notice shall be in writing and prominently positioned in any literature or correspondence. The notice shall be transmitted to policyholders in the next mailing to policyholders, in the yearly informational packet sent to policyholders, or by January 1, 1997, whichever is earliest. Source: SL 1996, ch 292, §3.