S.D. Admin. R. 20:06:13:43
A health insurance policy issued to a Medicaid recipient or to a person who already possesses insurance substantially covering the same risk and paying for the same coverage is overinsurance. If the director determines after investigation that overinsurance exists and provides notice, the duplicating insurer must offer a full refund less benefits paid. Any sale of a Medicare supplement policy or certificate that will provide an individual more than one Medicare supplement policy or certificate is prohibited.
Duplication of Medicare supplement insurance, as prohibited by §58-17A-15, exists whenever an insured has more than one Medicare supplement policy or certificate in force, regardless of the number of days in which multiple policies or certificates are in force, including any duplication of coverage that is 30 days or less. Any overlap of coverage requires the replacing or subsequent issuer, upon notice from the policyholder, to adjust the dates of coverage and provide credit for premiums paid during the period of duplication. Any such refund or credit shall be reduced by the amount of any claims paid by the replacing or subsequent issuer during the period of duplication. The replacing or subsequent issuer is not in violation of this rule if the effective date of the policy or contract does not precede the paid to or expiration date of the prior policy as shown on the application, provided that upon notice to the issuer of overinsurance, refunds are made or offered pursuant to this section.
S.D. Admin. R. 20:06:13:43
General Authority: SDCL 58-4-1, 58-17A-2.
Law Implemented: SDCL 58-17A-2, 58-17A-15, 58-33-5, 58-33-6, 58-33-8.