reglab/housing_qa huggingface dataset:
SD Codified L § 58-38-11.10 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|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.

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.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.
SD Codified L § 58-38-12 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-12 - Care provided by noncontracting physicians--Contracting physician unavailable.

58-38-12. Care provided by noncontracting physicians--Contracting physician unavailable.If at any time that the subscriber or certificate holder is entitled to medical and surgical service no contracting physician and surgeon is available, the medical and surgical plan corporation shall provide such care by physicians and surgeons who have not contracted with such corporation, to such extent as the subscriber or certificate holder is entitled to under his certificate, and at the same rate and for the same fees as is provided for care by noncontracting physicians and surgeons, but not to exceed the limitation provided for in the certificate. Source: SL 1966, ch 111, ch 21, §5.
SD Codified L § 58-38-13 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-13 - Practice of medicine not authorized by chapter.

58-38-13. Practice of medicine not authorized by chapter.Nothing in this chapter shall authorize any person, association, or corporation to engage, in any manner, in the practice of medicine or surgery. Source: SL 1966, ch 111, ch 21, §5.
SD Codified L § 58-38-14 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-14 - Expenses of acquisition and administration--Control by director.

58-38-14. Expenses of acquisition and administration--Control by director.All acquisition and administrative expenses in connection with such medical and surgical service corporation shall at all times be subject to control by the director. Source: SL 1966, ch 111, ch 21, §9.
SD Codified L § 58-38-15 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-15 - Permitted investments.

58-38-15. Permitted investments.The funds of any corporation subject to the provisions of this chapter shall be invested only in securities permitted by the laws of this state for the investment of assets of life insurance companies. Source: SL 1966, ch 111, ch 21, §10.
SD Codified L § 58-38-16 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-16 - Foreign corporation--Transaction of business in state.

58-38-16. Foreign corporation--Transaction of business in state.A nonprofit medical and surgical 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 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 medical and surgical service to the subscribers with at least twenty physicians and surgeons licensed to practice their profession in 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 upon foreign insurers transacting or doing business in this state. Source: SL 1966, ch 111, ch 21, §11; SL 1986, ch 22, §40.
SD Codified L § 58-38-17 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-17 - Annual statement of financial condition--Filing--Verification--Form and contents.

58-38-17. Annual statement of financial condition--Filing--Verification--Form and contents.Every medical and surgical plan corporation shall annually on or before the first day of March file in the office of the director a statement verified by at least two of the principal officers of said corporation showing its condition on the preceding thirty-first day of December; the statement shall be in such form and shall contain such matters as the director shall prescribe. Source: SL 1966, ch 111, ch 21, §7.
SD Codified L § 58-38-18 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-18 - Investigation and examination by director--Cost borne by corporation.

58-38-18. Investigation and examination by director--Cost borne by corporation.The director may investigate and examine the books and records of any medical and surgical plan corporation, and may summon and examine under oath its officers, representatives, insurance producers, employees, or other persons in relation to the affairs, transactions, and conditions of the corporation.The director shall conduct an examination of each corporation at least every five years pursuant to chapter 58-3, and the cost of the regular or other special examinations shall be borne by the corporation. Source: SL 1966, ch 111, ch 21, §8; SL 1994, ch 389, §1; SL 2001, ch 286, §220.
SD Codified L § 58-38-19 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-19 - Exemption from other insurance laws--Exceptions.

58-38-19. Exemption from other insurance laws--Exceptions.Any medical and surgical plan corporation is exempt from all provisions of the insurance laws of this state other than in this chapter. However, the corporation is subject to the provisions of this title on matters of hearings, appeals, mergers, dissolutions, licensure of insurance producers, and procedures on such matters. The corporation is also subject to §§58-4-39 to 58-4-42, inclusive; 58-6-75; 58-17-17, and 58-17-19 for nongroup policies only; §§58-17-54; 58-17-56; 58-30-124 to 58-30-139, inclusive; and to the fees and taxation as insurers covered by this title; and to chapters 58-3, 58-5A, 58-14, 58-18B, 58-26, 58-27, 58-29B, 58-29D, 58-33, 58-43, and 58-44. Source: SL 1966, ch 111, ch 21, §2; SL 1980, ch 361; SL 1982, ch 367, §1; SL 1991, ch 408, §1; SL 1991, ch 409; SL 1994, ch 386, §2; SL 2001, ch 286, §221.
SD Codified L § 58-38-20 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-20 - Citation of chapter.

58-38-20. Citation of chapter.This chapter may be cited as the Medical and Surgical Plan Law. Source: SL 1966, ch 111, ch 21, §1.
SD Codified L § 58-38-21 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-21 - Notice required by medical and surgical plan corporation for rate increase.

58-38-21. Notice required by medical and surgical plan corporation for rate increase.Forty-five days before a contract rate increase is effective, the medical and surgical plan corporation shall notify the group employer or association in writing that the contract rate for the medical and surgical plan operated by the corporation will be increased. Source: SL 1989, ch 434, §2.
SD Codified L § 58-38-22 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-22 - Grandfathered service and indemnity-type contracts required to cover low-dose mammography--Extent of coverage.

58-38-22. Grandfathered service and indemnity-type contracts required to cover low-dose mammography--Extent of coverage.Each service or indemnity-type contract issued by a nonprofit medical and surgical service plan corporation that covers a female and that is delivered, issued for delivery, or renewed in this state, except for a contract 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, 5; SL 1991, ch 400, §5; SL 2011, ch 216, §7.
SD Codified L § 58-38-22.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-22.1 - Service and indemnity-type contracts required to cover occult breast cancer screening.

58-38-22.1. Service and indemnity-type contracts required to cover occult breast cancer screening.Each service or indemnity-type contract issued by a nonprofit medical and surgical service plan corporation that covers a female and that is delivered, issued for delivery, or renewed in this state, except for a contract that provides coverage for specified disease or other limited benefit coverage, shall provide coverage for screening for the presence of occult breast cancer.The provisions of this section apply only to plans that are not grandfathered 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 2011, ch 216, §14.
SD Codified L § 58-38-23 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-23 - Coverage for phenylketonuria.

58-38-23. Coverage for phenylketonuria.Every service or indemnity-type contract issued by a nonprofit medical and surgical service plan corporation 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, §4.
SD Codified L § 58-38-24 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-24 - Hospital service plan authorized.

58-38-24. Hospital service plan authorized.A medical and surgical plan corporation licensed under this chapter may establish and operate a nonprofit hospital service plan under the provisions of chapter 58-40. Such plan shall be governed by chapter 58-40, but is exempt from the provisions of §58-40-4. Source: SL 1993, ch 374.
SD Codified L § 58-38-25 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-25 - Formation of voluntary health insurance purchasing organizations.

58-38-25. Formation of voluntary health insurance purchasing organizations. Notwithstanding the provisions of chapter 47-34A and §§ 47-15-2 and 47-22-4, any organization may form for the purposes of purchasing group health insurance on a voluntary basis. For purposes of §§58-38-25 to 58-38-35, inclusive, an organization means any nonprofit organization or nonprofit corporation formed under South Dakota law. Source: SL 1994, ch 382, §1; SL 2021, ch 210, § 22.
SD Codified L § 58-38-26 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-26 - Membership of voluntary health insurance purchasing organizations.

58-38-26. Membership of voluntary health insurance purchasing organizations.Any organization may have a group health insurance policy issued to that organization on behalf of its members who would be insured under such policy. Members may join the organization, for the purpose of obtaining group health insurance, as individuals, employers, labor unions, associations, or substantially similar groups. Source: SL 1994, ch 382, §2.
SD Codified L § 58-38-27 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-27 - Purchasing organization's responsibility for negotiating terms and conditions.

58-38-27. Purchasing organization's responsibility for negotiating terms and conditions.The organization shall be responsible for negotiating the terms and conditions of insurance contracts, collection of premiums, and providing notice to members. Source: SL 1994, ch 382, §3.
SD Codified L § 58-38-28 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-28 - Purchasing organization's notice of premium charge.

58-38-28. Purchasing organization's notice of premium charge.The organization may provide not less than forty-five days advance notice of any benefit or premium change to its members. Source: SL 1994, ch 382, §4.
SD Codified L § 58-38-29 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-29 - Additional chapters applicable to purchasing organization.

58-38-29. Additional chapters applicable to purchasing organization.Any organization is subject to all applicable provisions of chapter 58-3 and chapter 58-33. Source: SL 1994, ch 382, §5.
SD Codified L § 58-38-30 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-30 - Approval of purchasing organization by Division of Insurance.

58-38-30. Approval of purchasing organization by Division of Insurance.Any organization shall, prior to its engaging in the business of insurance, obtain approval from the Division of Insurance. The division may deny approval or withdraw approval of an organization to engage in the business of insurance for any of the following reasons:(1)Any of the grounds specified in §58-6-8;(2)Insufficient membership control of the organization;(3)Unreasonable compensation to officers, directors, or employees of the organization;(4)Misuse of premiums; or(5)Refusal to be examined or to cooperate in an examination. Source: SL 1994, ch 382, §6.
SD Codified L § 58-38-31 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-31 - Premiums held in trust by purchasing organization.

58-38-31. Premiums held in trust by purchasing organization.The organization shall hold all premiums received in trust and promptly remit premiums to the person entitled thereto. Source: SL 1994, ch 382, §7.
SD Codified L § 58-38-32 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-32 - Rates for group health insurance issued to purchasing organizations.

58-38-32. Rates for group health insurance issued to purchasing organizations.Any insurer issuing group health insurance pursuant to §§58-38-25 to 58-38-35, inclusive, is subject to all of the provisions of chapter 58-18B relating to rates. Source: SL 1994, ch 382, §8.
SD Codified L § 58-38-33 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-33 - Reasonable participation requirements for group members of purchasing organizations.

58-38-33. Reasonable participation requirements for group members of purchasing organizations.An insurer may as a condition of offering coverage or continuing coverage require reasonable participation requirements of groups who become members of an organization. Source: SL 1994, ch 382, §9.
SD Codified L § 58-38-34 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-34 - Purchasing organizations exempt from antitrust provisions.

58-38-34. Purchasing organizations exempt from antitrust provisions.Any organization formed pursuant to §§58-38-25 to 58-38-35, inclusive, is exempt from the antitrust provisions under chapter 37-1. Source: SL 1994, ch 382, §10.
SD Codified L § 58-38-35 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-35 - Promulgation of rules for purchasing organizations.

58-38-35. Promulgation of rules for purchasing organizations.The director may promulgate rules pursuant to chapter 1-26 to further the provisions of §§58-38-25 to 58-38-35, 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.
SD Codified L § 58-38-36 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-36 - Minimum loss ratio for small employer health benefit plans.

58-38-36. Minimum loss ratio for small employer health benefit plans.Premium rates for small employer health benefit plans shall produce a minimum lifetime loss ratio of not less than seventy-five percent. The director may promulgate rules pursuant to chapter 1-26 which modify the minimum loss ratio required based upon the specific plan design or other objective and pertinent criteria. Source: SL 1994, ch 381, §1.
SD Codified L § 58-38-37 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-37 - Minimum inpatient care coverage following delivery.

58-38-37. Minimum inpatient care coverage following delivery.If a service or indemnity-type contract issued or renewed on or after July 1, 1996, by a nonprofit medical and surgical service plan corporation provides maternity coverage, the contract 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 §58-38-38. Any individual policy and any policy issued to employers with less than fifteen employees 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, §10; SL 1998, ch 290, §4.
SD Codified L § 58-38-38 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-38 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.

58-38-38. 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 service or indemnity-type contract issued by a nonprofit medical and surgical service plan corporation may provide coverage for a shorter length of hospital inpatient stay for services related to maternity and newborn care than is required in §58-38-37 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, §11.
SD Codified L § 58-38-39 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 38 - Nonprofit Medical And Surgical Plans|Section 58-38-39 - Notice to subscribers--Disclosures.

58-38-39. Notice to subscribers--Disclosures.The nonprofit medical and surgical service plan corporation shall provide notice to subscribers regarding the coverage required by §58-38-37 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 subscribers in the next mailing to subscribers, in the yearly informational packet sent to subscribers, or by January 1, 1997, whichever is earliest. Source: SL 1996, ch 292, §12.