reglab/statecodes huggingface dataset:
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-112 - Minimum inpatient care coverage following delivery.

58-41-112. Minimum inpatient care coverage following delivery.
If a health maintenance contract issued or renewed on or after July 1, 1996, by a health maintenance organization 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 §58-41-113. 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, §16; SL 1998, ch 290, §6.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-113 - Shorter hospital stay permitted--Follow-up visit within forty-eight hours required.

58-41-113. 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 health maintenance contract may provide coverage for a shorter length of hospital inpatient stay for services related to maternity and newborn care than is required in §58-41-112 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, §17.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-114 - Notice to enrollees--Disclosures.

58-41-114. Notice to enrollees--Disclosures.
The health maintenance organization shall provide notice to enrollees regarding the coverage required by §58-41-112 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 enrollees in the next mailing to enrollees, in the yearly informational packet sent to enrollees, or by January 1, 1997, whichever is earliest.
Source:
SL 1996, ch 292, §18.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-115 - Health insurance policies to provide coverage for biologically-based mental illnesses.

58-41-115. Health insurance policies to provide coverage for biologically-based mental illnesses.
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 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, §6; SL 1999, ch 251, §6.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-116 - Application--Exemptions.

58-41-116. Application--Exemptions.
The provisions of §58-41-115 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.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-117 - Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations.

58-41-117. Policies to provide coverage for diabetes supplies, equipment, and education--Exceptions--Conditions and limitations.
Every health maintenance contract 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, §11.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-118 - Diabetes coverage not required of certain plans and policies.

58-41-118. Diabetes coverage not required of certain plans and policies.
The provisions of §58-41-117 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, §12.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-119 - Contracts to provide coverage for prostate cancer screening.

58-41-119. Contracts to provide coverage for prostate cancer screening.
Every health maintenance contract 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, §6.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-120 - Annual report on risk bearing entities.

58-41-120. Annual report on risk bearing entities.
A health maintenance organization shall file annually, as part of its access plan, a list of all risk bearing entities with which it has an agreement or contract and the number of covered persons assigned or selected by each risk bearing entity.
Source:
SL 2013, ch 256, §35.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-121 - Documents provided to risk bearing entity by health maintenance organization.

58-41-121. Documents provided to risk bearing entity by health maintenance organization.
In entering into, amending, or renewing a contract with a risk bearing entity, a health maintenance organization shall, unless already specified in the contract, provide the following, upon request, to a risk bearing entity:
(1)At the time the contract is entered into, a written statement describing the amount or method of remuneration to be paid to the risk bearing entity. If any part of the remuneration is a calculated amount based on variable factors, the payment methodology upon which the calculated amount will be determined. The statement shall specify the services and expenses for which the risk bearing entity is financially liable in whole or part;
(2)At the time payment is made, the basis of the calculation of that payment;
(3)For health benefit plans in which the covered persons are assigned to the risk bearing entity under a capitated payment arrangement, a list of enrollees and payments due to the risk bearing entity, to be provided monthly if not already available to the risk bearing entity;
(4)At the time the contract is entered into, a copy of the health maintenance organization's most recent annual statement filed with the NAIC; and
(5)Once the contract is in effect, the quarterly or annual statement.
Source:
SL 2013, ch 256, §36.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-122 - Documents provided to health maintenance organization by risk bearing entity.

58-41-122.Documents provided to health maintenance organization by risk bearing entity.
A health maintenance organization shall include in any contract with a risk bearing entity a requirement that the risk bearing entity provide to the health maintenance organization at the time a contract is entered into and annually thereafter the following:
(1)Annual audited GAAP report in accordance with generally accepted accounting principles in the United States (U.S. GAAP);
(2)Documentation that satisfies the health maintenance organization that the risk bearing entity has sufficient ability to accept risk; and
(3)Documentation that satisfies the health maintenance organization that the risk bearing entity has appropriate management expertise and infrastructure.
The contract shall also require that the risk bearing entity on a quarterly basis provide status reports that include the following:
(1)Financial statements prepared in accordance with U. S. GAAP;
(2)An aging report of the percentage of claims that have been paid, pended, or denied, across all contracts with risk bearing entities; and
(3)On a monthly basis, a report of the estimated reported claims and incurred but not reported claims liability of the risk bearing entity.
Source:
SL 2013, ch 256, §37.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-123 - Notice by risk bearing entity of change in conditions--Assignment of contract.

58-41-123. Notice by risk bearing entity of change in conditions--Assignment of contract.
A health maintenance organization shall require in any contract with a risk bearing entity that the risk bearing entity provide notice to the health maintenance organization within thirty days of:
(1)Any changes involving the ownership structure of the risk bearing entity; or
(2)Financial or operational concerns regarding the financial viability of the risk bearing entity.
A health maintenance organization shall also require in any contract with a risk bearing entity a provision that allows the director, in the event that a risk bearing entity fails to comply with any provision of §§58-41-120 to 58-41-126, inclusive, to assign for six months, the risk bearing entity's contract with providers to furnish covered services.
Source:
SL 2013, ch 256, §38.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-124 - Notice to director that risk bearing entity has materially failed to perform contract.

58-41-124. Notice to director that risk bearing entity has materially failed to perform contract.
A health maintenance organization shall have procedures in place to notify the director within a reasonable time that a risk bearing entity has materially failed to perform under its contract with the health maintenance organization. A health maintenance organization is not in violation of this section if it acts in good faith in its attempt to comply with this section. A health maintenance organization shall maintain systems and controls for reviewing the information provided to the health maintenance organization by the risk bearing entity pursuant to §§58-41-120 to 58-41-126, inclusive.
Source:
SL 2013, ch 256, §39.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-125 - Confidentiality of information.

58-41-125. Confidentiality of information.
Any information provided to the director by a health maintenance organization relative to risk bearing entities with which it is contracted is confidential and may not be disclosed to any person except to the extent that it is necessary to carry out the purposes of §§58-41-120 to 58-41-126, inclusive, and as allowed by state law, regardless of whether the information is in the form of paper, is preserved on microfilm, or is stored in computer readable form. If the information is disclosed pursuant to this section, the health maintenance organization providing the notice is not liable for the disclosure or any subsequent use or misuse of the information. The health maintenance organization is entitled to claim any statutory privileges against disclosure that the entity that provided the information to the health maintenance organization is entitled to claim. This section is not intended to create a private right of action.
Source:
SL 2013, ch 256, §40.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-126 - Nontransferable responsibilities of health maintenance organization.

58-41-126. Nontransferable responsibilities of health maintenance organization.
Notwithstanding any agreement to the contrary, the health maintenance organization shall:
(1)Retain full responsibility on a prospective basis for the provision of health care services pursuant to any applicable health benefit plan; and
(2)At all times, be able to demonstrate to the satisfaction of the director that the health maintenance organization can fulfill its nontransferable obligation to provide health care services to covered persons in any event, including the failure, for any reason, of a risk bearing entity.
Source:
SL 2013, ch 256, §41.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 41 - Health Maintenance Organizations › Section 58-41-127 - Coverage for treatment of hearing impairment for persons under age nineteen.

58-41-127. Coverage for treatment of hearing impairment for persons under age nineteen.
Any qualified health plan issued on or after January 1, 2015, that offers coverage for professional audiology services shall include coverage for medically necessary physician services appropriate for the treatment of hearing impairment to a person under the age of nineteen. This shall include professional services rendered by an audiologist licensed pursuant to chapter 36-24.
The benefits provided shall be subject to the same dollar limits, deductibles, coinsurance and other limitations provided for other covered benefits in the policy.
Nothing in this section requires the payment by the health plan of hearing aids, devices, or equipment to correct hearing impairment or loss.
Source:
SL 2014, ch 237, §4.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-2 - Annual audit required--Filing audited financial report--Extension of filing date--Audit committee.

58-43-2. Annual audit required--Filing audited financial report--Extension of filing date--Audit committee.
Each insurer having direct premiums written in this state of more than one million dollars in any calendar year and more than one thousand policyholders or certificate holders of directly written policies nationwide at the end of a calendar year is required to have an annual audit by an accountant of the financial statements reporting the financial position and the results of operations. This chapter also applies to insurers having assumed premiums pursuant to contracts or treaties of reinsurance of one million dollars or more. The director may require insurers with less than one million dollars in direct premiums and less than one thousand policyholders or certificate holders to have independent audits to determine the financial status of the insurer.
The insurer shall file an audited financial report with the director on or before June first for the immediately preceding year. The director may require an insurer to file an audited financial report earlier than June first with ninety days advance notice to the insurer.
Extensions of the June first filing date may be granted by the director for thirty-day periods upon showing by the insurer and its accountant to the director that there is good cause for an extension. The request for extension shall be submitted in writing to the director not less than ten days prior to the due date in sufficient detail to permit the director to make an informed decision.
If an extension is granted, a similar extension of thirty days is granted for the filing of the Management's Report of Internal Control over Financial Reporting.
Each insurer required to file an annual audited financial report pursuant to this chapter shall designate a group of individuals as constituting the insurer's audit committee. The audit committee of an entity that controls an insurer may be deemed to be the insurer's audit committee for purposes of this chapter at the election of the controlling person.
Source:
SL 1992, ch 357, §2; SL 2009, ch 271, §3.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-3 - Foreign or alien insurers--Exemption.

58-43-3. Foreign or alien insurers--Exemption.
Foreign or alien insurers, filing audited financial reports in another state which report has been found by the director to be substantially similar to the requirements of §58-43-4, are exempt if:
(1)A copy of the audited financial report, communication of internal control related matters noted in an audit, and the accountant's letter of qualifications which are filed with the other state are filed with the director in accordance with the filing dates specified in §§58-43-2, 58-43-14, and 58-43-15. Canadian insurers may submit accountants' reports as filed with the Office of the Superintendent of Financial Institutions, Canada;
(2)A copy of any notification of adverse financial condition report filed with that other state is filed with the director within the time specified in §58-43-14.
This section does not prohibit, preclude or in any way limit the director of insurance from ordering or conducting or performing examinations of insurers under this title.
Source:
SL 1992, ch 357, §3; SL 2009, ch 271, §4.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-4 - Annual audited financial report--Contents.

58-43-4. Annual audited financial report--Contents.
The annual audited financial report shall report the financial position of the insurer as of the end of the most recent calendar year and the results of its operations, cash flows, and changes in capital and surplus for the year then ended. The audit shall reflect the statutory accounting practices prescribed, or otherwise permitted, by the division. The report shall include the following:
(1)Report of the accountant;
(2)Balance sheet reporting admitted assets, liabilities, capital, and surplus;
(3)Statement of operations;
(4)Statement of cash flows;
(5)Statement of changes in capital and surplus; and
(6)Notes to financial statements.
Any notes to financial statements shall be prepared in accordance with the Annual Statement Instructions Manual and the Accounting Practices and Procedures Manual prescribed by the National Association of Insurance Commissioners as promulgated by rules by the director pursuant to chapter 1-26 and shall also include a reconciliation of differences, if any, between the audited statutory financial statements and the annual statement filed pursuant to §58-6-75 with a written description of the nature of these differences.
Source:
SL 1992, ch 357, §4; SL 2003, ch 257, §1; SL 2009, ch 271, §5.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-5 - Financial statements.

58-43-5. Financial statements.
The financial statements included in the audited financial report shall be prepared in a form and using language and groupings substantially the same as the relevant sections of the annual statement filed pursuant to §58-6-75 and the financial statement shall be comparative, presenting the amounts as of December thirty-first of the current year and the amounts as of the immediately preceding December thirty-first. In the first year in which an insurer is required to file an audited financial report, the comparative data may be omitted.
Source:
SL 1992, ch 357, §5.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-5.1 - Examination of financial statements by accountant.

58-43-5.1. Examination of financial statements by accountant.
Financial statements furnished pursuant to §58-43-4 shall be examined by the independent certified public accountant. The audit of the insurer's financial statements shall be conducted in accordance with generally accepted auditing standards. In accordance with AU Section 319 of the Professional Standards of the AICPA, Consideration of Internal Control in a Financial Statement Audit as of January 1, 2009, the independent certified public accountant should obtain an understanding of internal control sufficient to plan the audit. To the extent required by AU Section 319, for those insurers required to file a Management's Report of Internal Control over Financial Reporting pursuant to §58-43-16.13, the independent certified public accountant should consider, as that term is defined in Statement on Auditing Standards (SAS) No. 102, Defining Professional Requirements in Statements on Auditing Standards as of January 1, 2009, the most recently available report in planning and performing the audit of the statutory financial statements. Consideration shall be given to the procedures illustrated in the Financial Condition Examiners Handbook promulgated by the National Association of Insurance Commissioners as adopted by the director by rules promulgated pursuant to chapter 1-26, as the independent certified public accountant deems necessary.
Source:
SL 2009, ch 271, §14.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-6 - Registration of retained accountant--Letter of acknowledgment from accountant.

58-43-6. Registration of retained accountant--Letter of acknowledgment from accountant.
Each insurer required to file an annual audited financial report shall, within sixty days after becoming subject to the requirement, register with the director in writing the name and address of the independent certified public accountant or accounting firm retained to conduct the annual audit set forth in this chapter. Any insurer not retaining an independent certified public accountant on July 1, 2009, shall register the name and address of the insurer's retained independent certified public accountant not less than six months before the date when the first audited financial report is to be filed.
The insurer shall obtain a letter from the accountant, and file a copy with the director, stating that the accountant is aware of the laws of the state of domicile that relate to accounting and financial matters and affirming that the accountant will express his or her opinion on the financial statements in terms of their conformity to the statutory accounting practices prescribed or permitted and specify any exceptions.
Source:
SL 1992, ch 357, §6; SL 2009, ch 271, §6.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-7 - Notification of dismissal or resignation of insurer's accountant--Reporting disagreements.

58-43-7. Notification of dismissal or resignation of insurer's accountant--Reporting disagreements.
If an accountant who was the accountant for the immediately preceding filed audited financial report is dismissed or resigns, the insurer shall mail notification to the director within five business days of the dismissal or resignation. The insurer shall mail the director a separate letter within ten business days of the above notification stating whether in the twenty-four months preceding this dismissal or resignation there were any disagreements with the former accountant on any matter of accounting principles or practices, financial statement disclosure, or auditing scope or procedure, which disagreements, if not resolved to the satisfaction of the former accountant, would have caused him to make reference to the subject matter of the disagreement in connection with his opinion.
Source:
SL 1992, ch 357, §7.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-8 - Explanation of disagreements between insurer and accountant--Letters from both insurer and accountant to director.

58-43-8. Explanation of disagreements between insurer and accountant--Letters from both insurer and accountant to director.
The disagreements required in §58-43-7 to be reported include both those resolved to the former accountant's satisfaction and those not resolved to the former accountant's satisfaction. Disagreements contemplated by this section are those that occur at the decision-making level, such as, between personnel of the insurer responsible for presentation of its financial statements and personnel of the accounting firm responsible for rendering its report. The insurer shall request in writing the former accountant to furnish a letter addressed to the insurer stating whether the accountant agrees with the statements contained in the insurer's letter and, if not, stating the reasons for which he does not agree. The insurer shall furnish the responsive letter from the former accountant to the director together with its own. The accountant shall also furnish a copy of the responsive letter to the director.
Source:
SL 1992, ch 357, §8.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9 - Qualifications of accountant.

58-43-9. Qualifications of accountant.
An accountant shall be recognized as qualified as long as the accountant conforms to the standards of the profession, as contained in the Code of Professional Ethics of the American Institute of Certified Public Accountants and the requirements of chapter 36-20B and rules promulgated pursuant to that chapter.
Source:
SL 1992, ch 357, §9; SL 2007, ch 294, §2.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9.1 - Disqualification of accountant.

58-43-9.1. Disqualification of accountant.
No person or firm may be recognized as a qualified independent certified public accountant if the person or firm:
(1)Is not in conformity with the Code of Professional Ethics of the American Institute of CPA's and in all states in which the accountant is licensed to practice, or, for a Canadian or British company, that is not a chartered accountant; or
(2)Has either directly or indirectly entered into an agreement of indemnity or release from liability with respect to the audit of the insurer.
Source:
SL 2007, ch 294, §3.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9.2 - Disqualification of accountant for services provided contemporaneously with audit.

58-43-9.2. Disqualification of accountant for services provided contemporaneously with audit.
The director may not recognize as a qualified independent certified public accountant, nor accept an annual audited financial report, prepared in whole or in part by an accountant who provides to an insurer, contemporaneously with the audit, the following nonaudit services:
(1)Bookkeeping or other services related to the accounting records or financial statements of the insurer;
(2)Financial information systems design and implementation;
(3)Appraisal or valuation services, fairness opinions, or contribution-in-kind reports;
(4)Actuarially-oriented advisory services involving the determination of amounts recorded in the financial statements. The accountant may assist an insurer in understanding the methods, assumptions, and inputs used in the determination of amounts recorded in the financial statement only if it is reasonable to conclude that the services provided will not be subject to audit procedures during an audit of the insurer's financial statements. An accountant's actuary may also issue an actuarial opinion or certification on an insurer's reserves if the following conditions have been met:
(a)Neither the accountant nor the accountant's actuary has performed any management functions or made any management decisions;
(b)The insurer has competent personnel or engages a third party actuary to estimate the reserves for which management takes responsibility; and
(c)The accountant's actuary tests the reasonableness of the reserves after the insurer's management has determined the amount of the reserves;
(5)Internal audit outsourcing services;
(6)Management functions or human resources;
(7)Broker or dealer, investment adviser, or investment banking services;
(8)Legal services or expert services unrelated to the audit; or
(9)Any other services that the director determines, by rules promulgated pursuant to chapter 1-26, are impermissible.
Source:
SL 2009, ch 271, §8.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9.3 - Exemption from disqualification provisions of § 58-43-9.2.

58-43-9.3. Exemption from disqualification provisions of §58-43-9.2.
Any insurer having direct written and assumed premiums of less than one hundred million dollars in any calendar year may request an exemption from the provisions of §58-43-9.2. The insurer shall file with the director a written statement discussing the reasons why the insurer should be exempt from these provisions. If the director finds, upon review of this statement, that compliance with these provisions would constitute a financial or organizational hardship upon the insurer, an exemption may be granted.
Source:
SL 2009, ch 271, §9.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9.4 - Services which do not disqualify accountant--Audit committee preapproval.

58-43-9.4. Services which do not disqualify accountant--Audit committee preapproval.
A qualified independent certified public accountant who performs the audit may engage in other nonaudit services, including tax services, that are not described in or that do not conflict with the provisions of §58-43-9.2, only if the activity is approved in advance by the audit committee, in accordance with the provisions of §58-43-9.5.
Source:
SL 2009, ch 271, §10.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9.5 - Preapproval of auditing and nonaudit services by audit committee--SOX compliant entities.

58-43-9.5. Preapproval of auditing and nonaudit services by audit committee--SOX compliant entities.
Any auditing services or nonaudit services provided to an insurer by the qualified independent certified public accountant of the insurer shall be preapproved by the audit committee. This preapproval requirement is waived with respect to nonaudit services if the insurer is a SOX compliant entity or a direct or indirect wholly-owned subsidiary of a SOX compliant entity or:
(1)The aggregate amount of all such nonaudit services provided to the insurer constitutes not more than five percent of the total amount of fees paid by the insurer to its qualified independent certified public accountant during the fiscal year in which the nonaudit services are provided;
(2)The services were not recognized by the insurer at the time of the engagement to be nonaudit services; and
(3)The services are promptly brought to the attention of the audit committee and approved prior to the completion of the audit by the audit committee or by one or more members of the audit committee who are the members of the board of directors to whom authority to grant such approvals has been delegated by the audit committee.
Source:
SL 2009, ch 271, §11.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9.6 - Delegation of preapproval duties.

58-43-9.6. Delegation of preapproval duties.
The audit committee may delegate to one or more designated members of the audit committee the authority to grant the preapprovals required by the provisions of §58-43-9.5. The decisions of any member to whom this authority is delegated shall be presented to the full audit committee at each of its scheduled meetings.
Source:
SL 2009, ch 271, §12.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-9.7 - Disqualification of accountant due to previous employment of partner or senior manager of insurer--Relief from requirement.

58-43-9.7. Disqualification of accountant due to previous employment of partner or senior manager of insurer--Relief from requirement.
The director may not recognize an independent certified public accountant as qualified for a particular insurer if a member of the board, president, chief executive officer, controller, chief financial officer, chief accounting officer, or any person serving in an equivalent position for that insurer, was employed by the independent certified public accountant and participated in the audit of that insurer during the one-year period preceding the date that the most current statutory opinion is due. This section shall only apply to partners and senior managers involved in the audit.
An insurer may make application to the director for relief from this requirement on the basis of unusual circumstances. The insurer shall file, with the insurer's annual statement filing, the approval for relief with the states that it is licensed in, with the states that it is doing business in, and with the National Association of Insurance Commissioners. If the nondomestic state accepts electronic filing with the National Association of Insurance Commissioners, the insurer shall file the approval in an electronic format acceptable to the National Association of Insurance Commissioners.
Source:
SL 2009, ch 271, §13.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-10 - Rotation of accountant--Application for relief from rotation requirement.

58-43-10. Rotation of accountant--Application for relief from rotation requirement.
The lead or coordinating audit partner, having primary responsibility for the audit pursuant to this chapter, may not act in that capacity for more than five consecutive years. The person shall be disqualified from acting in that or a similar capacity for the same company or its insurance subsidiaries or affiliates for a period of five consecutive years. An insurer may make application to the director for relief from the above rotation requirements for good cause. This application shall be made at least thirty days before the end of the calendar year. The director may consider the following factors in determining if the relief should be granted:
(1)Number of partners, expertise of the partners or the number of insurance clients in the currently registered firm;
(2)Premium volume of the insurer; or
(3)Number of jurisdictions in which the insurer transacts business.
The insurer shall file, with the insurer's annual statement filing, the approval for relief with the states that the insurer is licensed in, with the states that the insurer is doing business in, and with the National Association of Insurance Commissioners. If the nondomestic state accepts electronic filing with the National Association of Insurance Commissioners, the insurer shall file the approval in an electronic format acceptable to the National Association of Insurance Commissioners.
Source:
SL 1992, ch 357, §10; SL 2009, ch 271, §7.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-11 - Rejection of accountant or audited financial report--Grounds.

58-43-11. Rejection of accountant or audited financial report--Grounds.
The director may not recognize as an accountant, nor accept any annual audited financial report, prepared in whole or in part by, any natural person who:
(1)Has been convicted of fraud, bribery, a violation of the Racketeer Influenced and Corrupt Organizations Act, 18 U.S.C. §§1961-1968, or any dishonest conduct or practices under federal or state law;
(2)Has been found to have violated the insurance laws of this state with respect to any previous reports submitted under this chapter; or
(3)Has demonstrated a pattern or practice of failing to detect or disclose material information in previous reports filed under the provisions of this chapter.
Source:
SL 1992, ch 357, §11.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-12 - Disqualification hearing.

58-43-12. Disqualification hearing.
An accountant which has been disqualified or any firm which has had an accountant disqualified by the director may request a hearing on the disqualification. The director may, as a result of the hearing, require the insurer to replace the accountant with another qualified accountant.
Source:
SL 1992, ch 357, §12.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-13 - Application to file consolidated or combined financial statements--Worksheet--Contents.

58-43-13. Application to file consolidated or combined financial statements--Worksheet--Contents.
An insurer may make written application to the director for approval to file audited consolidated or combined financial statements in lieu of separate annual audited financial statements if the insurer is part of a group of insurance companies which utilizes a pooling or one hundred percent reinsurance agreement that affects the solvency and integrity of the insurer's reserves and the insurer cedes all of its direct and assumed business to the pool. In such cases, a columnar consolidating or combining worksheet shall be filed with the report as follows:
(1)Amounts shown on the consolidated or combined audited financial report shall be shown on the worksheet;
(2)Amounts for each insurer subject to this section shall be stated separately;
(3)Noninsurance operations may be shown on the worksheet on a combined or individual basis;
(4)Explanations of consolidating and eliminating entries shall be included; and
(5)A reconciliation shall be included of any differences between the amounts shown in the individual insurer columns of the worksheet and comparable amounts shown on the annual statements of the insurers.
Source:
SL 1992, ch 357, §13.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-14 - Report of material misstatement of financial condition or that capital and surplus requirements not met--Time limit--Liability of accountant.

58-43-14. Report of material misstatement of financial condition or that capital and surplus requirements not met--Time limit--Liability of accountant.
An insurer shall require the accountant to report, in writing, within five business days to the board of directors or its audit committee any determination by the accountant that the insurer has materially misstated its financial condition as reported to the director as of the balance sheet date currently under examination or that the insurer does not meet the minimum capital and surplus requirement of §§58-5-21 and 58-6-23 as of that date. An insurer who has received a report pursuant to this section shall forward a copy of the report to the director within five business days of receipt of the report and shall provide the accountant making the report with evidence of the report being furnished to the director. If the accountant fails to receive the evidence within the required five business-day period, the accountant shall send or deliver to the director a copy of its report within the next five business days.
No accountant is liable in any manner to any person for any statement made in connection with this section if the statement is made in good faith.
Source:
SL 1992, ch 357, §14.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-15 - Accountant's action upon awareness of new facts subsequent to filing audited report.

58-43-15. Accountant's action upon awareness of new facts subsequent to filing audited report.
If the accountant, subsequent to the date of the audited financial report filed pursuant to this chapter becomes aware of facts which might affect his report, the accountant shall take the action prescribed in volume 1, section AU 561 of the professional standards of the American Institute of Certified Public Accountants.
Source:
SL 1992, ch 357, §15.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-16 - Written communication as to unremediated material weaknesses in internal controls over financial reporting.

58-43-16. Written communication as to unremediated material weaknesses in internal controls over financial reporting.
In addition to the annual audited financial report, each insurer shall furnish the director with a written communication as to any unremediated material weaknesses in the insurer's internal controls over financial reporting noted during the audit. The communication shall be prepared by the accountant within sixty days after the filing of the annual audited financial report. The communication shall contain a description of any unremediated material weakness as of December thirty-first for the immediately preceding year in the insurer's internal control over financial reporting noted by the accountant during the course of the accountant's audit of the financial statements. If no unremediated material weaknesses were noted, the communication shall so state.
The insurer shall provide a description of remedial actions taken or proposed to correct unremediated material weaknesses, if the actions are not described in the accountant's communication.
The insurer shall maintain information about significant deficiencies communicated by the independent certified public accountant. The information shall be made available to the examiner conducting a financial condition examination for review and kept confidential pursuant to §58-3-22.
Source:
SL 1992, ch 357, §16; SL 2009, ch 271, §15.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-16.1 - Applicability of §§ 58-43-16.2 to 58-43-16.9.

58-43-16.1. Applicability of §§58-43-16.2 to 58-43-16.9.
The provisions of §§58-43-16.2 to 58-43-16.9, inclusive, do not apply to any foreign or alien insurer licensed in this state or any insurer that is a SOX compliant entity or a direct or indirect wholly-owned subsidiary of a SOX compliant entity.
Source:
SL 2009, ch 271, §16.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-16.2 - Responsibilities of audit committee.

58-43-16.2. Responsibilities of audit committee.
The audit committee shall be directly responsible for the appointment, compensation, and oversight of the work of any accountant, including resolution of disagreements between management and the accountant regarding financial reporting, for the purpose of preparing or issuing the audited financial report or related work pursuant to this chapter. Each accountant shall report directly to the audit committee.
The audit committee of an insurer or a group of insurers shall be responsible for overseeing the insurer's internal audit function and granting each person performing the function suitable authority and resources to complete the audit committee's responsibilities required by §§58-43-16.25 to 58-43-16.28, inclusive.
Source:
SL 2009, ch 271, §17, eff. Jan. 1, 2010; SL 2018, ch 283, §2.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-16.3 - Membership of audit committee.

58-43-16.3. Membership of audit committee.
Each member of the audit committee shall be a member of the board of directors of the insurer or a member of the board of directors of an entity elected pursuant to §58-43-16.6.
Source:
SL 2009, ch 271, §18, eff. Jan. 1, 2010.
2023 South Dakota Codified Laws › Title 58 - Insurance › Chapter 43 - Independent Audit Of Insurers › Section 58-43-16.4 - Independence of audit committee members.

58-43-16.4. Independence of audit committee members.
A member of the audit committee may not be considered independent, other than in the member's capacity as a member of the audit committee, the board of directors, or any other board committee, if the member accepts any consulting, advisory, or other compensatory fee from the entity or be an affiliated person of the entity or any subsidiary thereof. However, if a law requires board participation by otherwise nonindependent members, that law shall prevail, and the members may participate in the audit committee and be designated as independent for audit committee purposes unless the member is an officer or employee of the insurer or one of its affiliates.
Source:
SL 2009, ch 271, §19, eff. Jan. 1, 2010.