reglab/housing_qa huggingface dataset:
SD Codified L § 58-41-63 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-63 - General annual report required--Form and contents.

58-41-63. General annual report required--Form and contents.Every health maintenance organization shall annually, on or before March first, file a report verified by at least two principal officers with the director, covering the preceding calendar year. Such report shall be on forms prescribed by the director and shall include:(1)A financial statement of the organization, including its balance sheet and receipts and disbursements for the preceding year certified by an independent certified public accountant licensed by an appropriate jurisdiction, reflecting at least:(a)Prepayment and other payments received for health care services rendered;(b)Expenditures to all providers, by classes or groups of providers, and insurance companies or nonprofit health service plan corporations engaged to fulfill obligations arising out of the health maintenance contract; and(c)Expenditures for capital improvements, or additions thereto, including but not limited to construction, renovation or purchase of facilities and capital equipment;(2)Any material changes in the information submitted pursuant to §§58-41-6 to 58-41-9, inclusive;(3)The number of new enrollees enrolled during the year, the number of enrollees as of the end of the year and the number of enrollees terminated during the year;(4)A summary of information compiled pursuant to subdivision 58-41-12(3) on such form as may be required by the director;(5)A report of the names and residence addresses of all persons set forth in subdivision 58-41-6(3), who were associated with the health maintenance organization during the preceding year, and the amount of wages, expense reimbursements, or other payments to such individuals for services to the health maintenance organization, including a full disclosure of all financial arrangements during the preceding year required to be disclosed pursuant to subdivision 58-41-6(3); and(6)Such other information relating to the performance of the health maintenance organization as is reasonably necessary to enable the director to carry out his duties under this chapter. Source: SL 1974, ch 321, §24; SL 2013, ch 256, §17.
SD Codified L § 58-41-65 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-65 - Applications, filings and reports as public documents.

58-41-65. Applications, filings and reports as public documents.All applications, filings, and reports required under this chapter are public documents except as provided for by §1-27-30. Source: SL 1974, ch 321, §57; SL 2013, ch 256, §18.
SD Codified L § 58-41-66 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-66 - Annual summary for enrollees required--Contents.

58-41-66. Annual summary for enrollees required--Contents.Every health maintenance organization or its representative shall annually, before April first, provide to its enrollees a summary of:(1)Its most recent annual financial statement, including a balance sheet and statement of receipts and disbursements;(2)A description of the health maintenance organization, its health care plan or plans, its facilities and personnel, and any material changes therein since the last report;(3)The current evidence of coverage; and(4)The health maintenance organization's method for resolving enrollee complaints. Source: SL 1974, ch 321, §25.
SD Codified L § 58-41-67 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-67 - Promulgation of rules.

58-41-67. Promulgation of rules.The director may, pursuant to chapter 1-26, promulgate such reasonable rules as are necessary to carry out the provisions of this chapter. Included among such rules shall be those which provide minimum requirements for the provision of comprehensive health maintenance services, as defined in subdivision 58-41-1(1), and reasonable exclusions therefrom. Source: SL 1974, ch 321, §42; SL 1986, ch 22, §43; SL 2013, ch 256, §19.
SD Codified L § 58-41-73 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-73 - Physician-patient privileges.

58-41-73. Physician-patient privileges.A health maintenance organization shall be entitled to claim any statutory privileges against such disclosure which the provider who furnished such information to the health maintenance organization is entitled to claim. Source: SL 1974, ch 321, §36 (5).
SD Codified L § 58-41-74 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-74 - Confidential data--Exceptions.

58-41-74. Confidential data--Exceptions.Any data or information pertaining to the diagnosis, treatment, or health of any enrollee, or any application obtained from any person, shall be confidential and shall not be disclosed to any person except:(1)To the extent that it may be necessary to carry out the purposes of this chapter;(2)Upon the express consent of the enrollee or applicant;(3)Pursuant to statute or court order for the production of evidence or the discovery thereof; or(4)In the event of a claim or litigation between such person and the provider or health maintenance organization wherein such data or information is pertinent. Source: SL 1974, ch 321, §36 (5).
SD Codified L § 58-41-78 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-78 - Cease and desist orders.

58-41-78. Cease and desist orders.The director may issue an order directing a health maintenance organization or a representative of a health maintenance organization to cease and desist from engaging in any act or practice in violation of the provision of this chapter. Source: SL 1974, ch 321, §47.
SD Codified L § 58-41-79 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-79 - Hearing on cease and desist order--Procedure--Judicial review.

58-41-79. Hearing on cease and desist order--Procedure--Judicial review.Within twenty days after service of the order to cease and desist, the respondent may request a hearing on the question of whether acts or practices in violation of this chapter have occurred. Such hearings shall be conducted pursuant to, and judicial review shall be available as provided by, chapter 1-26. Source: SL 1974, ch 321, §48.
SD Codified L § 58-41-80 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-80 - Injunctive relief against violations--Venue.

58-41-80. Injunctive relief against violations--Venue.In the event of any violation of the provisions of this chapter, if the director elects not to issue a cease and desist order, or in the event of noncompliance with a cease and desist order pursuant to §58-41-79, the director may institute a proceeding to obtain injunctive relief or other appropriate relief in the circuit court serving Hughes County. Source: SL 1974, ch 321, §49.
SD Codified L § 58-41-81 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-81 - Suspension or revocation of certificate of authority on findings by director.

58-41-81. Suspension or revocation of certificate of authority on findings by director.The director may suspend or revoke any certificate of authority issued to a health maintenance organization under this chapter if the director finds that any of the following conditions exists:(1)The health maintenance organization is operating significantly in contravention of its basic organizational document, its health maintenance contract, or in a manner contrary to that described in and reasonably inferred from any other information submitted under this chapter, unless amendments to such submissions have been filed with and approved by the director;(2)The health maintenance organization issues evidence of coverage or uses a schedule or charges for health care services which do not comply with the requirements of §§58-41-34 to 58-41-45, inclusive;(3)The health care plan does not provide or arrange for comprehensive health maintenance services;(4)The health maintenance organization is no longer financially responsible and may reasonably be expected to be unable to meet its obligations to enrollees or prospective enrollees;(5)The health maintenance organization has failed to implement a mechanism affording the enrollees an opportunity to participate in matters of policy and operation under the provisions of §§58-41-23 and 58-41-24;(6)The health maintenance organization has failed to implement the complaint system in a manner designed to reasonably resolve valid complaints;(7)The health maintenance organization, or any person acting with its sanction, has advertised or merchandised its services in an untrue, misrepresentative, misleading, deceptive, or unfair manner;(8)The continued operation of the health maintenance organization would be hazardous to its enrollees; or(9)The health maintenance organization has otherwise failed to substantially comply with this chapter, has violated a provision of chapter 58-33 or any other provision of law applicable to health maintenance organizations, or has submitted false information in any report required hereunder. Source: SL 1974, ch 321, §37; SL 2000, ch 235, §3; SL 2013, ch 256, §27.
SD Codified L § 58-41-82 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-82 - Additional grounds for suspension or revocation.

58-41-82. Additional grounds for suspension or revocation.The director may suspend or revoke any certificate of authority issued to a health maintenance organization under this chapter if:(1)The health maintenance organization does not meet the requirements of §58-41-12; or(2)The health maintenance organization is unable to fulfill its obligations to furnish comprehensive health maintenance services as required under its health maintenance contract. Source: SL 1974, ch 321, §37 (4); SL 2013, ch 256, §28.
SD Codified L § 58-41-83 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-83 - Voluntary conference before commencing actions for violation.

58-41-83. Voluntary conference before commencing actions for violation.If the director, for any reason, has cause to believe that any violation of this chapter has occurred or is threatened, the director may, before commencing action under §58-41-81, 58-41-82, 58-41-85, or 58-41-87, give notice to the health maintenance organization and to the representatives, or other persons who appear to be involved in such suspected violations, to arrange a voluntary conference with the alleged violators or their authorized representatives for the purpose of attempting to ascertain the fact that any violation has occurred or is threatened, to arrive at an adequate and effective means of correcting or preventing such violation. Source: SL 1974, ch 321, §45; SL 2013, ch 256, §29.
SD Codified L § 58-41-84 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-84 - Informality in voluntary conferences.

58-41-84. Informality in voluntary conferences.Proceedings under §58-41-83 are not governed by any formal procedural requirements, and may be conducted in such manner as the director finds appropriate under the circumstances. Source: SL 1974, ch 321, §46; SL 2013, ch 256, §30.
SD Codified L § 58-41-85 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-85 - Money penalty in lieu of suspension or revocation.

58-41-85. Money penalty in lieu of suspension or revocation.The director may, in lieu of suspension or revocation of a certificate of authority under 58-41-81 or 58-41-82, levy a money penalty pursuant to §58-4-28.1. Source: SL 1974, ch 321, §44; SL 2000, ch 235, §4.
SD Codified L § 58-41-86 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-86 - Requirements for suspension or revocation.

58-41-86. Requirements for suspension or revocation.A certificate of authority shall be suspended or revoked only after compliance with the requirements of §§58-41-87 to 58-41-91, inclusive. Source: SL 1974, ch 321, §37.
SD Codified L § 58-41-86.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-86.1 - Suspension without notice or hearing.

58-41-86.1. Suspension without notice or hearing.The director of the Division of Insurance may, without advance notice or a hearing thereon, immediately suspend the certificate of authority of a health maintenance organization as to which proceedings for receivership, conservatorship, rehabilitation, or other delinquency proceedings have been commenced in any state by the public supervisory official of such state. Proceedings in such actions shall be conducted in accordance with §§58-6-49 to 58-6-61, inclusive. Source: SL 1985, ch 393, §12.
SD Codified L § 58-41-87 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-87 - Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted.

58-41-87. Notice of grounds for denial, suspension, or revocation of certificate--Time of hearing--Summary proceedings excepted.If the director has cause to believe that grounds for the denial of an application for a certificate of authority exist, or that grounds for the suspension or revocation of a certificate of authority exist, the director shall notify the health maintenance organization in writing specifically stating the grounds for denial, suspension, or revocation and fixing a time of at least twenty days thereafter for a hearing on the matter, except in summary proceedings as provided in §58-41-94. Source: SL 1974, ch 321, §39; SL 2013, ch 256, §31.
SD Codified L § 58-41-88 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-88 - Administrative procedure and rules.

58-41-88. Administrative procedure and rules.The provisions of chapter 1-26, including the right of judicial review, apply to proceedings under §§58-41-85 to 58-41-91, inclusive, to the extent those provisions are not in conflict with other provisions of such sections. Source: SL 1974, ch 321, §39 (4); SL 2000, ch 235, §5.
SD Codified L § 58-41-90 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-90 - Action of director after hearing--Written findings.

58-41-90. Action of director after hearing--Written findings.After hearing pursuant to §§58-41-87 and 58-41-88, or upon the failure of the health maintenance organization to appear at such hearing, the director shall take action as is deemed advisable on written findings which shall be mailed to the health maintenance organization. Source: SL 1974, ch 321, §39 (2); SL 2013, ch 256, §33.
SD Codified L § 58-41-91 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-91 - Judicial review.

58-41-91. Judicial review.The action of the director is subject to the court of primary jurisdiction for claims of the nature and magnitude described. The court may, in disposing of the issue before it, modify, affirm, or reverse the order of the director in whole or in part. Source: SL 1974, ch 321, §39 (3); SL 2013, ch 256, §34.
SD Codified L § 58-41-92 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-92 - Activities prohibited during suspension of certificate.

58-41-92. Activities prohibited during suspension of certificate.When the certificate of authority of a health maintenance organization is suspended, the health maintenance organization may not, during the period of such suspension, enroll any additional enrollees except newborn children or other newly acquired dependents of existing enrollees, and may not engage in any advertising or solicitation whatsoever. A health maintenance organization may not enroll such additional enrollees if it is suspended on those grounds in subdivisions 58-41-81(4) and (8) and §58-41-86.1. Source: SL 1974, ch 321, §38; SL 1985, ch 393, §11.
SD Codified L § 58-41-93 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-93 - Winding up after revocation of certificate--Continued operation to protect enrollees.

58-41-93. Winding up after revocation of certificate--Continued operation to protect enrollees.When the certificate of authority of a health maintenance organization is revoked, the organization shall proceed, immediately following the effective date of the order of revocation, to wind up its affairs, and shall conduct no further business except as may be essential to the orderly conclusion of the affairs of the organization. It shall engage in no further advertising or solicitation whatsoever. The director may, by written order, permit further operation of the organization as he may find to be in the best interest of enrollees, to the end that enrollees will be afforded the greatest practical opportunity to obtain continuing health care coverage. Source: SL 1974, ch 321, §38.
SD Codified L § 58-41-94 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-94 - Summary proceeding to reorganize organization--Grounds.

58-41-94. Summary proceeding to reorganize organization--Grounds.The director may apply for an order directing him to rehabilitate, liquidate, or conserve a health maintenance organization upon any one or more of the grounds set out in chapter 58-29B, or when in his opinion the continued operation of the health maintenance organization would be hazardous either to the enrollees or the people of this state. Source: SL 1974, ch 321, §40.
SD Codified L § 58-41-95 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-95 - Rehabilitation, liquidation, or conservation under insurance company laws.

58-41-95. Rehabilitation, liquidation, or conservation under insurance company laws.Any rehabilitation, liquidation, or conservation of a health maintenance organization shall be deemed to be the rehabilitation, liquidation, or conservation of an insurance company and shall be conducted under the supervision of the director pursuant to chapter 58-29B, except to the extent that the nature of health maintenance organizations renders such law clearly inappropriate. Source: SL 1974, ch 321, §40.
SD Codified L § 58-41-96 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-96 - Severability of provisions.

58-41-96. Severability of provisions.If a part of this chapter is invalid, all valid parts that are severable from the invalid part remain in effect. If a part of this chapter is invalid in one or more of its applications, the part remains in effect in all valid applications that are severable from the invalid applications. Source: SL 1974, ch 321, §58.
SD Codified L § 58-41-97 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-97 - Citation of chapter.

58-41-97. Citation of chapter.This chapter may be cited as the "Health Maintenance Organization Act of 1974." Source: SL 1974, ch 321, §1.
SD Codified L § 58-41-98 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-98 - Coverage for phenylketonuria.

58-41-98. Coverage for phenylketonuria.Every health maintenance contract 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, §6.
SD Codified L § 58-41-99 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-99 - Formation of voluntary health insurance purchasing organizations.

58-41-99. 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 §§58-41-99 to 58-41-109, 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, § 24.
SD Codified L § 58-41-100 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-100 - Membership of voluntary health insurance purchasing organizations.

58-41-100. 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 § 58-41-101 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-101 - Purchasing organization's responsibility for negotiating terms and conditions.

58-41-101. 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 § 58-41-102 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-102 - Purchasing organization's notice of premium charge.

58-41-102. 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 § 58-41-103 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-103 - Additional chapters applicable to purchasing organization.

58-41-103. 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 § 58-41-104 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-104 - Approval of purchasing organization by Division of Insurance.

58-41-104. 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.