reglab/housing_qa huggingface dataset:
SD Codified L § 58-18B-12 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-12 - Ceding arrangements resulting in less than fifty percent of obligation or risk retained by carrier prohibited.

58-18B-12. Ceding arrangements resulting in less than fifty percent of obligation or risk retained by carrier prohibited.Unless otherwise authorized by the director, no small employer carrier may enter into one or more ceding arrangements with respect to health benefit plans delivered or issued for delivery to small employers in the state if the arrangements would result in less than fifty percent of the insurance obligation or risk for such health benefit plans being retained by the ceding carrier. Source: SL 1995, ch 281, §5.
SD Codified L § 58-18B-13 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-13 - Transition period when acquiring additional class of business.

58-18B-13. Transition period when acquiring additional class of business.The director may promulgate rules pursuant to chapter 1-26 to provide for a period of transition in order for a small employer carrier to come into compliance with subdivision 58-18B-1(5) when the carrier acquires an additional class of business from another small employer carrier. Source: SL 1995, ch 281, §6.
SD Codified L § 58-18B-14 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-14 - Rate changes only for small employer business.

58-18B-14. Rate changes only for small employer business.Unless otherwise specified, nothing in this chapter requires a carrier to change any of its rates or rating methodologies for any business other than the small employer business subject to the provisions of this chapter. Source: SL 1995, ch 281, §7.
SD Codified L § 58-18B-15 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-15 - Provisions for premium rates.

58-18B-15. Provisions for premium rates.Premium rates for health benefit plans subject to this chapter are subject to the following provisions:(1)Adjustments in rates for claim experience, health status, and duration of coverage may not be charged to individual employees or dependents. Any such adjustments shall be applied uniformly to the rates charged for all employees and dependents of the small employer;(2)A small employer carrier may utilize industry as a case characteristic in establishing premium rates, if the highest rate factor associated with any industry classification does not exceed the lowest rate factor associated with any industry classification by more than fifteen percent;(3)Small employer carriers shall apply rating factors, including case characteristics, consistently with respect to all small employers in a class of business;(4)For the purposes of this section, a health benefit plan that utilizes a restricted provider network is not considered similar coverage to a health benefit plan that does not utilize such a network, if utilization of the restricted provider network results in substantial differences in claims costs; and(5)No small employer carrier may use case characteristics, other than age, gender, industry, family composition, and group size without prior approval of the director. Source: SL 1995, ch 281, §8.
SD Codified L § 58-18B-17 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-17 - Limit on premium rates.

58-18B-17. Limit on premium rates.The premium rates for an individual covered in a small employer plan may not exceed the premium rate for any other individual covered under the same small employer carrier because of age alone by a factor of 3:1. A small employer carrier may not require any individual to pay any premium or contribution that is greater than that for a similarly situated individual enrolled in the plan. Nothing in this section prohibits a group health plan, and a health insurance issuer offering group health insurance coverage, from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion or disease prevention. Source: SL 1995, ch 281, §10; SL 1997, ch 289, §15; SL 2001, ch 279, §2.
SD Codified L § 58-18B-18 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-18 - Promulgation of rules for rating practices.

58-18B-18. Promulgation of rules for rating practices.The director may promulgate rules pursuant to chapter 1-26 to implement the provisions of §§58-18B-1 to 58-18B-3, inclusive, §58-18B-7, §§58-18B-15 to 58-18B-18, inclusive, and to assure that rating practices used by small employer carriers are consistent with the purposes of this chapter, including rules that:(1)Assure that differences in rates charged for health benefit plans by small employer carriers are reasonable and reflect objective differences in plan design not including differences due to the nature of the groups assumed to select particular health benefit plans; and(2)Prescribe the manner in which case characteristics may be used by small employer carriers. Source: SL 1995, ch 281, §11.
SD Codified L § 58-18B-20 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-20 - Small employer carrier to issue plan to any small employer--Criteria--Exceptions--Two percent earned premium threshold.

58-18B-20. Small employer carrier to issue plan to any small employer--Criteria--Exceptions--Two percent earned premium threshold.A small employer carrier shall issue health benefit plans to any small employer that applies for a plan and agrees to make the required premium payments and to satisfy the other reasonable provisions of the health benefit plan not inconsistent with this chapter. If, on the first day of the plan year, a small employer plan has fewer than two participants who are current employees, the carrier is not required to issue a policy to the small employer. A small employer carrier may apply reasonable criteria in determining whether to accept a small employer into a particular class of business if:(1)The criteria are not related to the health status or claim experience of the small employer;(2)The criteria are applied consistently to all small employers applying for coverage in the class of business; and(3)The small employer carrier provides for the acceptance of all eligible small employers into one or more classes of business.The provisions of this section do not apply to a class of business into which the small employer carrier is no longer enrolling new small businesses. If the director determines that all carriers in the small employer market have met the two percent threshold, the threshold shall, upon order of the director, be expanded an additional two percent. The threshold shall be expanded in additional two percent increments if all small employer carriers meet the previous threshold. No small employer carrier is required to issue coverage to any small employer if the small employers who are at high-risk constitute two percent of that carrier's earned premium on an annual basis from small employer health benefit plans. The director may promulgate rules pursuant to chapter 1-26 to determine which policies may be used to determine the two percent threshold, the procedures involved, and the applicable time frames. In making that determination, the director shall develop a method designed to limit the number of high risk groups to which any one carrier may be required to issue coverage. Source: SL 1995, ch 281, §14; SL 1997, ch 289, §16; SL 1998, ch 289, §14; SL 2001, ch 279, §3.
SD Codified L § 58-18B-23 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-23 - Uniform application of requirements used to determine eligibility of employers.

58-18B-23. Uniform application of requirements used to determine eligibility of employers.Except as provided in §58-18B-26, requirements used by a small employer carrier in determining whether to provide coverage to a small employer, including requirements for minimum participation of eligible employees and minimum employer contributions, shall be applied uniformly among all small employers with the same number of eligible employees applying for coverage or receiving coverage from the small employer carrier. An association of small employer plans may require, as a condition of obtaining or continuing coverage, membership in the association. Source: SL 1995, ch 281, §17.
SD Codified L § 58-18B-24 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-24 - Application of minimum participation and minimum employer contribution requirements.

58-18B-24. Application of minimum participation and minimum employer contribution requirements.A small employer carrier may vary application of minimum participation requirements and minimum employer contribution requirements only by the size of the small employer group or by the class of business. Source: SL 1995, ch 281, §18.
SD Codified L § 58-18B-25 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-25 - Considerations in applying minimum participation requirements--Premium discounts.

58-18B-25. Considerations in applying minimum participation requirements--Premium discounts.In applying minimum participation requirements with respect to a small employer, a small employer carrier may consider employees or dependents who have creditable coverage in determining whether the applicable percentage of participation is met. If any employee or dependent with other creditable coverage is to be considered towards calculating the applicable percentage of participation, the employee or dependent shall be counted as participating in the plan.A carrier may provide up to a twenty percent discount for any small employer who achieves a one hundred percent participation rate in the prior year. The discount may be less than the base rate by a factor up to twenty percent. However, no discount below the base rate may be used in determining the index rate for that class of business. Source: SL 1995, ch 281, §19; SL 1997, ch 289, §17; SL 2001, ch 279, §4; SL 2005, ch 271, §1.
SD Codified L § 58-18B-26 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-26 - Increase in minimum requirements for employee participation or employer contribution prohibited after acceptance for coverage.

58-18B-26. Increase in minimum requirements for employee participation or employer contribution prohibited after acceptance for coverage.No small employer carrier may increase any requirement for minimum employee participation or any requirement for minimum employer contribution applicable to a small employer at any time after the small employer has been accepted for coverage. Source: SL 1995, ch 281, §20.
SD Codified L § 58-18B-27 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-27 - Modification to exclude certain diseases prohibited.

58-18B-27. Modification to exclude certain diseases prohibited.No small employer carrier may modify a health benefit plan with respect to a small employer or any eligible employee or dependent through riders, endorsements, or otherwise, to restrict or exclude coverage for certain diseases or medical conditions otherwise covered by the health benefit plan. A small employer carrier may not establish rules for eligibility for any individual to enroll under a plan, including continued eligibility, based on health status-related factors which include health status, medical condition, claims experience, receipt of health care, medical history, genetic information, evidence of insurability, including conditions arising out of acts of domestic violence, and disability. Source: SL 1995, ch 281, §22; SL 1997, ch 289, §18; SL 1998, ch 289, §17.
SD Codified L § 58-18B-27.1 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-27.1 - Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited--Exception for sickness or injury caused in commission of felony.

58-18B-27.1. 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 health benefit plan of a small employer carrier 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, §§3, 7.
SD Codified L § 58-18B-28 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-28 - Requirements lifted from small employer carrier in financially impaired condition.

58-18B-28. Requirements lifted from small employer carrier in financially impaired condition.No small employer carrier may be required to provide coverage to small employers pursuant to §58-18B-20, for any period of time for which the director determines that requiring the acceptance of small employers in accordance with the provisions of §58-18B-20, would place the small employer carrier in a financially impaired condition. Source: SL 1995, ch 281, §23.
SD Codified L § 58-18B-35 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-35 - Director to promulgate rules regulating sale of multiple employer trusts and welfare arrangements--Scope of rules.

58-18B-35. Director to promulgate rules regulating sale of multiple employer trusts and welfare arrangements--Scope of rules.The director shall promulgate rules pursuant to chapter 1-26 regulating the solicitation and sale of multiple employer trusts and multiple employer welfare arrangements. In considering the promulgation of rules pursuant to this section, the director shall take into consideration, the status of the small employer market, the impact such rules would have on the availability of health insurance and the impact such rules may have on the fair marketing of health insurance in this state. Rules promulgated pursuant to this section may not directly or indirectly affect stop loss or excess insurance covering health claims of employees arising from self-funded employee health programs. The rules may cover:(1)Suitability and eligibility of insureds for coverage;(2)Method of premium payments;(3)Contractual obligations and policy provisions of carriers;(4)Form filing requirements, including those for approval and disapproval;(5)Reporting and recordkeeping requirements;(6)Definition of terms; and(7)Eligibility of insurers. Source: SL 1995, ch 281, §30; SL 1997, ch 289, §20; SL 1998, ch 293, §1.
SD Codified L § 58-18B-36 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-36 - Rules governing implementation and administration of this chapter.

58-18B-36. Rules governing implementation and administration of this chapter.The director shall promulgate rules pursuant to chapter 1-26 to provide for the implementation and administration of this chapter. The rules shall cover:(1)Terms of renewability;(2)Initial and subsequent conditions of eligibility;(3)Probationary periods;(4)Benefit limitations, exceptions and reductions;(5)Requirements for replacement;(6)Participation and contribution requirements;(7)Definition of terms;(8)Marketing practices;(9)Reporting and disclosure practices or requirements;(10)Compensation arrangements between insurers or other entities and their agents, representatives, or producers;(11)Guaranteed acceptance of small groups by small group carriers;(12)Continuation and conversion rights; and(13)Group discontinuance and replacement.The director may promulgate rules pursuant to chapter 1-26 that specify prohibited policy or certificate provisions not otherwise specifically authorized by statute which, in the opinion of the director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a policy or certificate. If any federal standards are in place which would require additional steps to meet those standards beyond what is required by this chapter, the director may promulgate rules to require the offering of health insurance plans, in addition to those specifically required by §58-18B-20, the underwriting criteria that may be utilized for such health insurance plans, and other requirements related to the availability of health insurance to individuals in this state in order to minimally meet the federal standards. Source: SL 1995, ch 281, §31; SL 1997, ch 289, §21; SL 1998, ch 289, §19.
SD Codified L § 58-18B-37 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-37 - Marketing health benefit plans--Denial of coverage to employer.

58-18B-37. Marketing health benefit plans--Denial of coverage to employer.Each small employer carrier shall actively market health benefit plan coverage, to eligible small employers in the state. A small employer carrier may not deny coverage to a small employer on the basis of the health status or claims experience of the small employer or its employees or dependents. A network plan is not required to offer coverage to an employer whose employees do no work or reside within the carrier's established geographic service. A network plan may deny coverage to employers if it demonstrates it does not have the capacity to deliver services adequately to enrollees of any additional groups because of its obligations to existing group contract holders and enrollees, and if it is applying this denial of coverage uniformly to all employers without regard to the claims experience of those employers, and their employees and their dependents, or any health status-related factor relating to the employees and dependents. Source: SL 1995, ch 281, §32; SL 1997, ch 289, §22; SL 1998, ch 289, §20.
SD Codified L § 58-18B-38 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-38 - Prohibited activities of small employer carriers or insurance producers.

58-18B-38. Prohibited activities of small employer carriers or insurance producers.No small employer carrier or insurance producer may, directly or indirectly, engage in the following activities:(1)Encouraging or directing small employers to refrain from filing an application for coverage with the small employer carrier because of the health status, claims experience, industry, occupation, or geographic location of the small employer; or(2)Encouraging or directing small employers to seek coverage from another carrier because of the health status, claims experience, industry, occupation, or geographic location of the small employer. Source: SL 1995, ch 281, §33; SL 2001, ch 286, §123.
SD Codified L § 58-18B-39 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-39 - Information regarding restricted network provision of carrier.

58-18B-39. Information regarding restricted network provision of carrier.The provisions of §58-18B-38 do not apply with respect to information provided by a small employer carrier or insurance producer to a small employer regarding a restricted network provision of a small employer carrier. Source: SL 1995, ch 281, §34; SL 2001, ch 286, §124.
SD Codified L § 58-18B-40 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-40 - Agent compensation based on characteristics of small employer prohibited--Commission on sale of health insurance plan through exchange.

58-18B-40. Agent compensation based on characteristics of small employer prohibited--Commission on sale of health insurance plan through exchange.No small employer carrier may, directly or indirectly, enter into any contract, agreement, or arrangement with an insurance producer that provides for or results in the compensation paid to an agent for the sale of a health benefit plan to be varied because of the health status, claims experience, industry, occupation, or geographic location of the small employer.Any qualified health plan sold in South Dakota through a health care exchange, as mandated by the Patient Protection and Affordable Care Act of 2010, shall provide for placement through a licensed insurance producer upon enrollment. Any commission paid by a health insurance carrier for the sale of a health insurance plan through a health exchange shall be the same as commission paid by the same health insurance carrier outside the exchange for a similar plan. Source: SL 1995, ch 281, §35; SL 2001, ch 286, §125; SL 2013, ch 249, §2.
SD Codified L § 58-18B-41 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-41 - Compensation of insurance producer based on percentage of premium.

58-18B-41. Compensation of insurance producer based on percentage of premium.The provisions of §58-18B-40 do not apply with respect to a compensation arrangement that provides compensation to an insurance producer on the basis of percentage of premium, if the percentage does not vary because of the health status, claims experience, industry, occupation, or geographic area of the small employer. Source: SL 1995, ch 281, §36; SL 2001, ch 286, §126.
SD Codified L § 58-18B-43 (2021)
2021 South Dakota Codified Laws|Title 58 - Insurance|Chapter 18B - Regulation Of Small Businesses' Group And Blanket Health Insurance|Section 58-18B-43 - Status of insurance producer's employment may not be affected by health status, claims experience, occupation, or location of small employer placed with carrier.

58-18B-43. Status of insurance producer's employment may not be affected by health status, claims experience, occupation, or location of small employer placed with carrier.No small employer carrier may terminate, fail to renew, or limit its contract or agreement of representation with an insurance producer for any reason related to the health status, claims experience, occupation, or geographic location of the small employers placed by the agent with the small employer carrier. Source: SL 1995, ch 281, §38; SL 2001, ch 286, §128.