reglab/housing_qa huggingface dataset:
SD Codified L § 58-40-20.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-20.1 - Service and indemnity-type contracts required to cover occult breast cancer screening.

58-40-20.1. Service and indemnity-type contracts required to cover occult breast cancer screening.Each service or indemnity-type contract issued by a nonprofit hospital 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 (SL 2011, ch 216, §19 provides: "The provisions of this Act are repealed if the Patient Protection and Affordable Care Act, Pub.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, §16.
SD Codified L § 58-40-21 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-21 - Coverage for phenylketonuria.

58-40-21. Coverage for phenylketonuria.Every service or indemnity-type contract issued by a nonprofit hospital 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, §5.
SD Codified L § 58-40-22 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-22 - Formation of voluntary health insurance purchasing organizations.

58-40-22. 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 §§58-40-22 to 58-40-32, 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, § 23.
SD Codified L § 58-40-23 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-23 - Membership of voluntary health insurance purchasing organizations.

58-40-23. 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 § 58-40-24 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-24 - Purchasing organization's responsibility for negotiating terms and conditions.

58-40-24. 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 § 58-40-25 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-25 - Purchasing organization's notice of premium charge.

58-40-25. 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 § 58-40-26 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-26 - Additional chapters applicable to purchasing organization.

58-40-26. 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 § 58-40-27 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-27 - Approval of purchasing organization by Division of Insurance.

58-40-27. 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 § 58-40-28 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-28 - Premiums held in trust by purchasing organization.

58-40-28. 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 § 58-40-29 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-29 - Rates for group health insurance issued to purchasing organizations.

58-40-29. Rates for group health insurance issued to purchasing organizations.Any insurer issuing group health insurance pursuant to §§58-40-22 to 58-40-32, inclusive, is subject to all of the provisions of chapter 58-18B relating to rates. Source: SL 1994, ch 382, §8.
SD Codified L § 58-40-30 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-30 - Reasonable participation requirements for group members of purchasing organizations.

58-40-30. 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 § 58-40-31 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-31 - Purchasing organizations exempt from antitrust provisions.

58-40-31. Purchasing organizations exempt from antitrust provisions.Any organization formed pursuant to §§58-40-22 to 58-40-32, inclusive, is exempt from the antitrust provisions under chapter 37-1. Source: SL 1994, ch 382, §10.
SD Codified L § 58-40-32 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-32 - Promulgation of rules for purchasing organizations.

58-40-32. Promulgation of rules for purchasing organizations.The director may promulgate rules pursuant to chapter 1-26 to further the provisions of §§58-40-22 to 58-40-32, 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 § 58-40-33 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-33 - Minimum loss ratio for small employer health benefit plans.

58-40-33. Minimum loss ratio for small employer health benefit plans.Premium rates for individual 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 on the specific design of the product or other objective and pertinent criteria. Source: SL 1994, ch 381, §1.
SD Codified L § 58-40-34 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-34 - Minimum inpatient care coverage following delivery.

58-40-34. 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 hospital 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 §58-40-35. 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, §13; SL 1998, ch 290, §5.
SD Codified L § 58-40-35 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-35 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.

58-40-35. 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 hospital 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 §58-40-34 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, §14.
SD Codified L § 58-40-36 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-36 - Notice to subscribers--Disclosure.

58-40-36. Notice to subscribers--Disclosure.The nonprofit hospital service plan corporation shall provide notice to subscribers regarding the coverage required by §58-40-34 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, §15.
SD Codified L § 58-40-37 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-37 - Health insurance policies to provide coverage for biologically-based mental illnesses.

58-40-37. Health insurance policies to provide coverage for biologically-based mental illnesses.Every service or indemnity-type contract issued by a nonprofit hospital 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 provide, in writing, coverage for the treatment and diagnosis of biologically-based mental illnesses with the same dollar limits, deductibles, coinsurance factors, and restrictions as for other covered illnesses.The term, biologically-based mental illness, means schizophrenia and other psychotic disorders, bipolar disorder, major depression, and obsessive-compulsive disorder. Source: SL 1998, ch 291, §5; SL 1999, ch 251, §5.
SD Codified L § 58-40-38 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-38 - Application--Exemptions.

58-40-38. Application--Exemptions.The provisions of §58-40-37 do not apply to any plan, policy, or contract that provides coverage only for:(1)Specified disease;(2)Hospital indemnity;(3)Fixed indemnity;(4)Accident-only;(5)Credit;(6)Dental;(7)Vision;(8)Prescription drug;(9)Medicare supplement;(10)Long-term care;(11)Disability income insurance;(12)Coverage issued as a supplement to liability insurance;(13)Workers' compensation or similar insurance;(14)Automobile medical payment insurance; or(15)Individual health benefit plans of six-months duration or less that are not renewable. Source: SL 1998, ch 291, §7.
SD Codified L § 58-40-39 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-39 - Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations.

58-40-39. Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations.Every service or indemnity-type contract issued by a nonprofit hospital service plan corporation delivered, issued for delivery, or renewed in this state, except for policies that provide coverage for specified disease or other limited benefit coverage, shall provide, in writing, coverage for equipment, supplies, and self-management training and education, including medical nutrition therapy, for treatment of persons diagnosed with diabetes if prescribed by a physician or other licensed health care provider legally authorized to prescribe such treatment. Medical nutrition therapy does not include any food items or nonprescription drugs.Coverage for medically necessary equipment and supplies shall include blood glucose monitors, blood glucose monitors for the legally blind, test strips for glucose monitors, urine testing strips, insulin, injection aids, lancets, lancet devices, syringes, insulin pumps and all supplies for the pump, insulin infusion devices, prescribed oral agents for controlling blood sugars, glucose agents, glucagon kits, insulin measurement and administration aids for the visually impaired, and other medical devices for treatment of diabetes.Diabetes self-management training and education shall be covered if: (a) the service is provided by a physician, nurse, dietitian, pharmacist, or other licensed health care provider who satisfies the current academic eligibility requirements of the National Certification Board for Diabetic Educators and has completed a course in diabetes education and training or has been certified as a diabetes educator; and (b) the training and education is based upon a diabetes program recognized by the American Diabetes Association or a diabetes program with a curriculum approved by the American Diabetes Association or the South Dakota Department of Health.Coverage of diabetes self-management training is limited to (a) persons who are newly diagnosed with diabetes or have received no prior diabetes education; (b) persons who require a change in current therapy; (c) persons who have a co-morbid condition such as heart disease or renal failure; or (d) persons whose diabetes condition is unstable. Under these circumstances, no more than two comprehensive education programs per lifetime and up to eight follow-up visits per year need be covered. Coverage is limited to the closest available qualified education program that provides the necessary management training to accomplish the prescribed treatment.The benefits provided in this section are subject to the same dollar limits, deductibles, coinsurance, and other restrictions established for all other benefits covered in the contract. Source: SL 1999, ch 252, §9.
SD Codified L § 58-40-40 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-40 - Diabetes coverage not required of certain plans and policies.

58-40-40. Diabetes coverage not required of certain plans and policies.The provisions of §58-40-39 do not apply to any plan, policy, or contract that provides coverage only for:(1)Specified disease;(2)Hospital indemnity;(3)Fixed indemnity;(4)Accident-only;(5)Credit;(6)Dental;(7)Vision;(8)Prescription drug;(9)Medicare supplement;(10)Long-term care;(11)Disability income insurance;(12)Coverage issued as a supplement to liability insurance;(13)Workers' compensation or similar insurance;(14)Automobile medical payment insurance;(15)Individual health benefit plans of six-months duration or less that are not renewable; or(16)Individual nonmajor medical insurance. Source: SL 1999, ch 252, §10.
SD Codified L § 58-40-41 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 40 - Nonprofit Hospital Service Plans|Section 58-40-41 - Contracts to provide coverage for prostate cancer screening.

58-40-41. Contracts to provide coverage for prostate cancer screening.Every service or indemnity-type contract issued by a nonprofit hospital service plan or organization that covers a male and 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 provide the following coverage for diagnostic screening for prostate cancer:(1)An annual medically recognized diagnostic examination, including a digital rectal examination and a prostate-specific antigen test, as follows:(a)For asymptomatic men aged fifty and over; and(b)For men aged forty-five and over at high risk for prostate cancer; and(2)For males of any age who have a prior history of prostate cancer, medically indicated diagnostic testing at intervals recommended by a physician, including the digital rectal examination, prostate-specific antigen test, and bone scan. Source: SL 2001, ch 277, §5.
SD Codified L § 58-41-1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-1 - Definition of terms.

58-41-1. Definition of terms.Terms used in this chapter mean:(1)"Comprehensive health maintenance services," a set of comprehensive health services which the enrollees might reasonably require to be maintained in good health, including as a minimum, but not limited to, emergency care, inpatient hospital and physician care, outpatient medical services, and preventive medical services;(2)"Director," the director of the Division of Insurance or his designee;(3)"Enrollee," any person who has entered into, or is covered by a health maintenance contract;(4)"Evidence of coverage," any certificate, agreement, or contract issued to an enrollee which sets out the coverage to which he is entitled under the health maintenance contract which covers him;(5)"Health maintenance contract," any contract whereby a health maintenance organization agrees to provide comprehensive health maintenance services to enrollees, provided that the contract may contain reasonable enrollee copayment provisions. Any contract may provide for health care services in addition to those set forth in subdivision (1);(6)"Limited health service," dental care services, vision care services, mental health services, substance abuse services, pharmaceutical services, podiatric care services, and such other services as may be determined by the director to be limited health services. Limited health service does not include hospital, medical, surgical, or emergency services except as these services are provided incident to the limited health services;(7)"Provider," any person who furnishes health services and is licensed or otherwise authorized to render such services in the state;(8)"Risk bearing entity," an intermediary organization that is a financial risk for services provided through contractual assumption of the obligation for the delivery of specified health care services to covered persons of the health maintenance organization. Source: SL 1974, ch 321, §2; SL 2013, ch 256, §1.
SD Codified L § 58-41-2 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-2 - Organizations subject to chapter.

58-41-2. Organizations subject to chapter.As used in this chapter a health maintenance organization is a corporation organized under Title 47, controlled and operated as provided in this chapter, which provides, either directly or through arrangements with providers or other persons, comprehensive health maintenance services, or arranges for the provision of such services, to enrollees on the basis of a fixed prepaid sum without regard to the frequency or extent of services furnished to any particular enrollee. A health maintenance organization may be organized pursuant to this chapter on a limited health service basis. Nothing in this chapter prohibits a health maintenance organization holding a certificate of authority in this state from issuing contracts to enrollees on a preferred provider, exclusive provider, or closed panel basis. Nothing in this chapter requires a licensed pharmacy benefit manager to obtain a certificate of authority as a health maintenance organization provided that the pharmacy benefit manager does not assume insurance risk directly from an insured. Source: SL 1974, ch 321, §2 (3); SL 1985, ch 393, §1; SL 2013, ch 256, §2.
SD Codified L § 58-41-3 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-3 - Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor.

58-41-3. Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor.No person shall establish or operate a health maintenance organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with a health maintenance organization or health maintenance contract unless such organization has a certificate of authority under this chapter. Violation of this section is a Class 2 misdemeanor. Source: SL 1974, ch 321, §§3, 50; SDCL Supp, §58-41-77; SL 1978, ch 359, §2.
SD Codified L § 58-41-4 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 41 - Health Maintenance Organizations|Section 58-41-4 - Application for certificate of authority required.

58-41-4. Application for certificate of authority required.Notwithstanding any law of this state to the contrary, any corporation organized to do so shall apply to the director of the Division of Insurance for a certificate of authority to establish and operate a health maintenance organization in compliance with the provisions of this chapter. Source: SL 1974, ch 321, §3; SL 1985, ch 393, §2.