S.D. Admin. R. 20:06:40:80

Current through Register Vol. 51, page 57, November 12, 2024

Section 20:06:40:80 - Special enrollment period effective dates

A health insurance issuer must provide special enrollment periods consistent with this section, during which qualified individuals and enrollees may enroll in plans or change enrollment from one nongrandfathered health plan to another. Once a qualified individual is determined eligible for a special enrollment period, the health insurance issuer must ensure that the qualified individual's effective date of coverage is:

(1) Between the first and the fifteenth day of any month, the plan must ensure a coverage effective date of the first day of the following month;

(2) Between the sixteenth and the last day of any month, the plan must ensure a coverage effective date of the first day of the second following month;

(3) In the case of birth, adoption, or placement for adoption, the plan must ensure that coverage is effective on the date of birth, adoption, or placement for adoption; and

(4) In the case of marriage, or in the case where a qualified individual loses minimum essential coverage, the plan must ensure coverage is effective on the first day of the following month.

Unless specifically stated otherwise herein, a qualified individual or enrollee has 30 days from the date of a triggered event to select a plan.

S.D. Admin. R. 20:06:40:80

39 SDR 203, effective 6/10/2013.

General Authority: SDCL 58-18-79.

Law Implemented: SDCL 58-18-79, 58-18-80.