S.D. Admin. R. 20:06:55:19

Current through Register Vol. 51, page 39, September 16, 2024
Section 20:06:55:19 - Group plans - Special enrollment

An individual enrolling in a group health plan pursuant to § 20:06:55:18 must be treated as if the individual were a special enrollee pursuant to §§ 20:06:40:05 and 20:06:40:05.01. The individual eligible for special enrollment must be offered all the benefit packages available to similarly situated individuals who did not lose coverage by reason of reaching a lifetime limit on the dollar value of all benefits. Any difference in benefits or cost-sharing constitutes a different benefit package. The individual may not be required to pay more for coverage than similarly situated individuals who did not lose coverage by reason of reaching a lifetime limit on the dollar value of all benefits.

S.D. Admin. R. 20:06:55:19

37 SDR 63, effective 9/23/2010; 37 SDR 111, effective 12/7/2010.

General Authority: SDCL 58-18-79.

Law Implemented: SDCL 58-18-79.