reglab/housing_qa huggingface dataset:
SC Code § 38-69-310 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 69 - Individual Annuities|Section 38-69-310. Contracts providing annuity and insurance benefits.

 For any contract which provides, within the same contract by rider or supplemental contract provision, both annuity benefits and life insurance benefits that are in excess of the greater of cash surrender benefits or a return of the gross considerations with interest, the minimum nonforfeiture benefits must be equal to the sum of the minimum nonforfeiture benefits for the annuity portion and the minimum nonforfeiture benefits, if any, for the life insurance portion computed as if each portion were a separate contract. Notwithstanding the provisions of Sections 38-69-250, 38-69-260, 38-69-270, 38-69-280, and 38-69-300, additional benefits payable (a) in the event of total and permanent disability, (b) as reversionary annuity or deferred reversionary annuity benefits, or (c) as other policy benefits additional to life insurance, endowment and annuity benefits, and considerations for all such additional benefits, must be disregarded in ascertaining the minimum nonforfeiture amounts and paid-up annuity, cash surrender, and death benefits that may be required by this section. The inclusion of such additional benefits is not required in any paid-up benefits, unless such additional benefits separately would require minimum nonforfeiture amounts and paid-up annuity, cash surrender, and death benefits.  HISTORY: Former 1976 Code Section 38-8-110 [1978 Act No. 517 Section 11] recodified as Section 38-69-310 by 1987 Act No. 155, Section 1.
SC Code § 38-69-320 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 69 - Individual Annuities|Section 38-69-320. Effective date of article as to insurer.

 After May 31, 1978, an insurer may file with the department a written notice of its election to comply with the provisions of this article after a specified date before May 31, 1980. After the filing of the notice, upon the specified date, which is the operative date of this article for the insurer, this article becomes operative with respect to annuity contracts thereafter issued by the insurer. If an insurer makes no election, the operative date of this article for the insurer is May 31, 1980.  HISTORY: Former 1976 Code Section 38-8-120 [1978 Act No. 517 Section 12] recodified as Section 38-69-320 by 1987 Act No. 155, Section 1; 1993 Act No. 181, Section 743.
SC Code § 38-69-330 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 69 - Individual Annuities|Section 38-69-330. Promulgation of regulations.

 The Director of the Department of Insurance or his designee shall promulgate regulations to implement the provisions of this chapter.  HISTORY: 2000 Act No. 312, Section 15.
SC Code § 38-70-10 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 70 - Utilization Reviews And Private Review Agents|Section 38-70-10. Definitions.

 As used in this chapter:  (1) "Utilization review" means a system for reviewing the necessary, appropriate, and efficient allocation of health care resources and services given or proposed to be given to a patient or group of patients.  (2) "Private review agent" means a person performing utilization reviews who is either under contract with or acting on behalf of, but not employed by:  (a) a South Carolina business entity;  (b) the State of South Carolina; or  (c) a hospital.  (3) "Utilization review program" means an overview of the activities performed by the private review agent.  (4) "Director or his designee" means the director or his designee of the South Carolina Department of Insurance. The director may appoint a designee or deputy director to assist in the management and operation of the department. If the director does not appoint a designee or deputy director, the term "director or his designee" shall be construed to refer to the director of the department.  (5) "Certificate" means a renewable certificate of registration granted by the director or his designee to a private review agent, authorizing the agent to perform utilization review activities in this State for two years. This certificate is not transferable.  HISTORY: 1990 Act No. 311, Section 2; 1993 Act No. 181, Sections 744, 745; 1994 Act No. 339, Section 18.
SC Code § 38-70-15 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 70 - Utilization Reviews And Private Review Agents|Section 38-70-15. Applicability of chapter.

 This chapter applies to insurance companies, administrators of insurance benefit plans, and health maintenance organizations licensed and regulated by the South Carolina Department of Insurance. Insurance companies, administrators of insurance benefit plans, and health maintenance organizations so regulated are exempt from the provisions of Sections 38-70-20(A) and (B), 38-70-30, and 38-70-50.  HISTORY: 1990 Act No. 311, Section 2; 1994 Act No. 339, Section 19.
SC Code § 38-70-20 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 70 - Utilization Reviews And Private Review Agents|Section 38-70-20. Certificate to perform activities; applications; fees; minimum standards; confidentiality of records.

 (A) No private review agent may conduct utilization reviews in this State unless the director or his designee has granted the private review agent a certificate to perform these activities. The director or his designee, in his discretion, may approve or deny certificate applications.  (B) An applicant for a certificate shall pay the director or his designee the application fee as provided in Section 38-70-50 and shall submit an application to the director or his designee on forms and with any supporting documentation that the director or his designee requires. The application must contain information regarding the utilization review programs to be conducted by the applicant which must meet the requirements contained in subsection (C).  (C) A utilization review program of the applicant must meet the following minimum standards:  (1) notification of an adverse decision by the utilization review agent must be provided to the insured or other party designated by the insured within five business days;  (2) all utilization review agents shall maintain a procedure by which insured or providers may seek reconsideration of appeal of determinations of the utilization review agent;  (3) a representative of the utilization review agent must be accessible by telephone to insureds or providers in South Carolina, at least forty hours each week during normal business hours;  (4) the type and qualification of the personnel either employed or under contract to perform the utilization reviews must be included in the utilization review program information submitted to the director or his designee;  (5) a copy of the materials designed to inform applicable patients of the requirements of the utilization plan and the responsibilities and rights of patients under the plan must be provided interested parties upon request; and  (6) an acknowledgment that all applicable state and federal laws to protect the confidentiality of individual medical records are followed.  HISTORY: 1990 Act No. 311, Section 2; 1993 Act No. 181, Section 746.
SC Code § 38-70-30 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 70 - Utilization Reviews And Private Review Agents|Section 38-70-30. Renewal of certificate.

 A certificate must be renewed on the second anniversary of its effective date and is considered to be approved upon payment of the fee unless the director or his designee takes action to withdraw or cancel the certificate.  HISTORY: 1990 Act No. 311, Section 2; 1993 Act No. 181, Section 747.
SC Code § 38-70-50 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 70 - Utilization Reviews And Private Review Agents|Section 38-70-50. Application and registration fees.

 (A) Every private review agent, before transacting business in this State, shall pay an application fee of not more than four hundred dollars and a registration fee of not more than eight hundred dollars to the department by July first each even-numbered year. The certificate year runs July first to the following June thirtieth.  (B) The department shall promulgate regulations necessary to establish these registration and application fees.  HISTORY: 1990 Act No. 311, Section 2; 1992 Act No. 501, Part II Section 11Q; 1993 Act No. 181, Section 749.
SC Code § 38-70-60 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 70 - Utilization Reviews And Private Review Agents|Section 38-70-60. Promulgation of regulations to enforce chapter.

 The department, after consultation with payers, providers, utilization review agents, the Department of Health and Environmental Control and other interested parties, shall promulgate regulations to implement and enforce the requirements of this chapter in accordance with the State Administrative Procedures Act.  HISTORY: 1990 Act No. 311, Section 2; 1993 Act No. 181, Section 750.
SC Code § 38-71-10 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-10. Coverages which may be written by licensed accident and health insurers.

 All licensed accident and health insurers are entitled to:  (a) issue and deliver service benefit contracts to provide for prepayment of any health care service and to make payment directly to the provider of the services, in whole or in part, including, but not limited to, professional services, any institutional care, personal services, and supplies;  (b) issue and deliver contracts of indemnity or contracts providing for payment of money directly to the insureds or for them for health care services.  HISTORY: Former 1976 Code Section 38-35-20 [1962 Code Section 37-442; 1968 (55) 2584] recodified as Section 38-71-10 by 1987 Act No. 155, Section 1.
SC Code § 38-71-20 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-20. Insurers may act as administering agency for government-sponsored health, hospital, and medical service programs.

 Insurers licensed to do business in this State have the corporate power to contract to act as agent in the administration of programs of health, hospital, and medical insurance sponsored or financed by an agency of the United States Government or any political subdivision.  HISTORY: Former 1976 Code Section 38-35-50 [1962 Code Section 37-444; 1968 (55) 2569] recodified as Section 38-71-20 by 1987 Act No. 155, Section 1.
SC Code § 38-71-30 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-30. Whole contract, including application, must appear in policy; oral applications.

 Every insurer doing accident or health insurance business in the State shall deliver with each policy of insurance issued by it a copy of the application made by the insured so that the whole contract appears in the application and policy of insurance. If the insurer violates this requirement, no defense is allowed to the policy on account of anything contained in or omitted from the application. If the insurance policy is issued upon an oral application, no defense is allowed to the policy on account of anything contained in or omitted from the oral application.  HISTORY: Former 1976 Code Section 38-9-70 [1947 (45) 322; 1949 (46) 600; 1952 Code Section 37-146; 1962 Code Section 37-146; 1980 Act No. 305, Section 1] recodified as Section 38-71-30 by 1987 Act No. 155, Section 1.
SC Code § 38-71-40 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-40. Effect of false statement in application.

 The falsity of any statement in the application for any policy covered by this chapter does not bar the right to recovery thereunder unless the false statement was made with actual intent to deceive or unless it materially affected either the acceptance of the risk or the hazard assumed by the insurer.  HISTORY: Former 1976 Code Section 38-35-180 [1947 (45) 322; 1952 Code Section 37-451; 1962 Code Section 37-451] recodified as Section 38-71-40 by 1987 Act No. 155, Section 1.
SC Code § 38-71-46 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-46. Diabetes Mellitus coverage in health insurance policies; diabetes education.

 (A) On or after January 1, 2000, every health maintenance organization, individual and group health insurance policy, or contract issued or renewed in this State must provide coverage for the equipment, supplies, Food and Drug Administration-approved medication indicated for the treatment of diabetes, and outpatient self-management training and education for the treatment of people with diabetes mellitus, if medically necessary, and prescribed by a health care professional who is legally authorized to prescribe such items and who demonstrates adherence to minimum standards of care for diabetes mellitus as adopted and published by the Diabetes Initiative of South Carolina. This subsection does not prohibit a health maintenance organization or an individual or a group health insurance policy from providing coverage for medication according to formulary or using network providers. Coverage must not be denied unless the health care professional demonstrates a persistent pattern of failure to adhere to the minimal standards of care and unless the health maintenance organization or insurer has first provided written notice to the health care professional that coverage will be denied if the health care professional fails to adhere to the minimal standards of care.  (B) Services and payment for diabetes education programs shall conform to regulations of the Health Care Financing Administration, US Department of Health and Human Services, pursuant to Section 4105 of the Balanced Budget Act of 1997. Diabetes outpatient self-management training and education shall be provided by a registered or licensed health care professional with certification in diabetes by the National Certification Board of Diabetes Educators, or other accredited program approved by the Diabetes Initiative of South Carolina, or by the Diabetes Control Program of the SC Department of Health and Environmental Control in order to meet the needs of rural communities wherein certified health care professionals providing this service are not available.  (C) Nothing contained in this section may be construed to affect in any way the ability of a managed care plan to credential or recredential a provider.  (D) For purposes of this section: "health insurance policy" means a health benefit plan, contract, or evidence of coverage providing health insurance coverage as defined in Section 38-71-670(6) and Section 38-71-840(14).  HISTORY: 1999 Act No. 98, Section 5; 2000 Act No. 348, Section 1.
SC Code § 38-71-50 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-50. Alteration of application.

 No alteration of any written application for insurance by erasure, insertion, or otherwise may be made by any person other than the applicant without his written consent, and the making of any such alteration without the consent of the applicant is a misdemeanor. However, insertions may be made by the insurer, for administrative purposes only, in a manner that clearly indicates that the insertions are not to be ascribed to the applicant.  HISTORY: Former 1976 Code Section 38-35-190 [1947 (45) 322; 1952 Code Section 37-452; 1962 Code Section 37-452] recodified as Section 38-71-50 by 1987 Act No. 155, Section 1.
SC Code § 38-71-60 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-60. Certain acts do not constitute a waiver by insurer.

 The acknowledgment of any insurer of the receipt of notice given under any policy covered by this chapter, the furnishing of forms for filing proofs of loss, the acceptance of proofs of loss, or the investigation of any claim thereunder does not operate as a waiver of any of the rights of the insurer in defense of any claim arising under the policy.  HISTORY: Former 1976 Code Section 38-35-200 [1947 (45) 322; 1952 Code Section 37-458; 1962 Code Section 37-458] recodified as Section 38-71-60 by 1987 Act No. 155, Section 1.
SC Code § 38-71-70 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-70. Certain policies may conform to laws of other states.

 Any foreign insurer authorized to do business in this State may, with the approval of the director or his designee, insert in any policy covered by this chapter so issued or delivered any provision required by the laws of any state or country in which the insurer is licensed, if the provision is not substantially in conflict with any law of this State. A domestic insurer may insert in any policy covered by this chapter issued for delivery in another state or foreign country and governed by the laws thereof any provision required by the laws of the other state or country applicable to the policy.  HISTORY: Former 1976 Code Section 38-35-40 [1947 (45) 322; 1952 Code Section 37-453; 1962 Code Section 37-453] recodified as Section 38-71-70 by 1987 Act No. 155, Section 1; 1993 Act No. 181, Section 751.
SC Code § 38-71-80 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-80. Construction of policy issued in violation of chapter.

 A policy issued in violation of this chapter is held valid but must be construed as provided in this chapter, and, when any provision in the policy is in conflict with any provision of this chapter, the rights, duties, and obligations of the insurer, the policyholder, and the beneficiary are governed by the provisions of this chapter.  HISTORY: Former 1976 Code Section 38-35-210 [1947 (45) 322; 1952 Code Section 37-454; 1962 Code Section 37-454] recodified as Section 38-71-80 by 1987 Act No. 155, Section 1.
SC Code § 38-71-90 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-90. Penalty for violation of chapter.

 An insurer, health maintenance organization, or its officer or agent that issues or delivers to any person in this State any policy in wilful violation of any of the provisions of this chapter or any other applicable state or federal law governing the transaction of business of insurance the Department of Insurance is authorized to enforce is subject to the provisions of Section 38-2-10 for each offense.  HISTORY: Former 1976 Code Section 38-35-220 [1947 (45) 322; 1952 Code Section 37-459; 1962 Code Section 37-459] recodified as Section 38-71-90 by 1987 Act No. 155, Section 1; 1988 Act No. 374, Section 38; 2018 Act No. 219 (H.4657), Section 6, eff May 18, 2018.  Effect of Amendment  2018 Act No. 219, Section 6, inserted ", health maintenance organization," following "An insurer", and inserted "or any other applicable state or federal law governing the transaction of business of insurance the Department of Insurance is authorized to enforce" following "provisions of this chapter".
SC Code § 38-71-100 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-100. Policies exempt from chapter.

 Nothing in this chapter applies to or affects:  (1) any policy of workers' compensation insurance or any policy of liability insurance with or without supplementary coverage therein;  (2) any policy or contract of reinsurance;  (3) any blanket or group policy of insurance, except as specifically required in this chapter; or  (4) life insurance, endowment, or annuity contracts or contracts supplemental thereto which contain only such provisions relating to accident and health insurance as (a) provide additional benefits in case of death or dismemberment or loss of sight by accident or (b) operate to safeguard the contracts against lapse or to give a special surrender value or special benefit or an annuity in the event that the insured or annuitant becomes totally and permanently disabled, as defined by the contract or supplemental contract.  HISTORY: Former 1976 Code Section 38-35-230 [1947 (45) 322; 1952 Code Sections 37-460 and 37-461; 1956 (49) 2029; 1962 Code Section 37-460] recodified as Section 38-71-100 by 1987 Act No. 155, Section 1.
SC Code § 38-71-110 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-110. Notice of failure of employer to remit deducted premium required before forfeiture.

 No insurer doing business in this State and issuing health or accident insurance policies, other than contracts of group insurance of disability, accidental death, or disability and accidental death benefits in connection with policies of life insurance, the premium for which is to be collected in weekly, monthly, or other periodic installments by authority of a payroll deduction order executed by the insured and delivered to the insurer or the insured's employer authorizing the deduction of premium installments from the insured's salary or wages, may, during the period for which the policy is issued and while the insured remains employed by the authorized employer, declare forfeited or lapsed the policy until and unless a written or printed notice of the failure of the employer to remit the premium or installment thereof, stating the amount or portion thereof due on the policy and to whom it must be paid, has been duly addressed and mailed to the person who is insured under the policy at least fifteen days before the policy is terminated or lapsed.  HISTORY: Former 1976 Code Section 38-35-170 [1947 (45) 322; 1952 Code Section 37-457; 1962 Code Section 37-457] recodified as Section 38-71-110 by 1987 Act No. 155, Section 1.
SC Code § 38-71-125 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-125. Mastectomies; hospitalization requirements; early release provisions.

 All individual and group health insurance policies and health maintenance organizations providing coverage for the hospitalization for mastectomies must provide benefits for hospitalization for at least forty-eight hours following a mastectomy. Nothing in this section shall be construed to prohibit an attending physician from releasing the patient prior to the expiration of the time provided herein. In the case of an early release, coverage shall include at least one home care visit if ordered by the attending physician.  HISTORY: 1998 Act No. 329, Section 3.
SC Code § 38-71-130 (2021)
2021 South Carolina Code of Laws|Title 38 - Insurance|Chapter 71 - Accident And Health Insurance|Section 38-71-130. Breast reconstruction and prosthetic devices; coverage following mastectomy surgery.

 All individual and group health insurance policies and health maintenance organizations providing coverage for mastectomy surgery must provide coverage for prosthetic devices and reconstruction of the breast on which surgery for breast cancer has been performed and surgery and reconstruction of the non-diseased breast, if determined medically necessary by the patient's attending physician with the approval of the insurer or HMO. The provisions of this section shall not require supplemental health insurance policies to provide coverage for reconstruction of the nondiseased breast.  HISTORY: 1998 Act No. 329, Section 4.