S.D. Admin. R. 20:06:40:76

Current through Register Vol. 50, page 151, June 10, 2024
Section 20:06:40:76 - Guaranteed issue

A small employer health insurance issuer must offer each of its small employer plans to any eligible small employer on a guaranteed issue basis without medical underwriting. A small employer health insurance issuer may use reasonable contribution and participation requirements that are consistent between small employers and which do not relate to the health status or health history of the employees or dependents of a small employer or the risk characteristics of the small employer as a whole. A health insurance issuer may limit the availability of health insurance coverage offered in the small group market to an annual enrollment period that begins November 15 and extends through December 15 of each year if a plan sponsor is unable to comply with a material plan provision relating to employer contribution or group participation rules as required by SDCL 58-18B-24 to 58-18B-26, inclusive. With respect to coverage in the small group market, and in the large group market if such coverage is offered in a Small Business Health Options Program (SHOP) as defined in § 20:06:55:32 in this state, coverage must become effective consistent with the dates described in 45 CFR § 155.725(h).

S.D. Admin. R. 20:06:40:76

39 SDR 203, effective 6/10/2013.

General Authority: SDCL 58-18B-36(7)(8)(11), 58-18B-46.

Law Implemented: SDCL 58-18B-36, 58-18B-37, 58-18B-46.