S.D. Admin. R. 20:06:58:34

Current through Register Vol. 51, page 57, November 12, 2024
Section 20:06:58:34 - Increased cost exemption

If the application of §§ 20:06:58:01 to 20:06:58:45, inclusive, to a group health plan, or health insurance coverage offered in connection with such plans, results in an increase for the plan year involved of the actual total cost of coverage with respect to medical or surgical benefits and mental health and substance use disorder benefits as determined and certified under § 20:06:58:36 by an amount that exceeds the applicable percentage described in § 20:06:58:36 of the actual total plan costs, the provisions of this section shall not apply to such plan, or coverage, during the following plan year, and such exemption shall apply to the plan, or coverage, for one plan year. An employer or issuer may elect to continue to provide mental health and substance use disorder benefits in compliance with this section with respect to the plan or coverage involved regardless of any increase in total costs.

S.D. Admin. R. 20:06:58:34

41 SDR 93, effective 12/3/2014.

General Authority: SDCL 58-17-87, 58-18-79, 58-18-79(15).

Law Implemented: SDCL 58-17-87, 58-18-79, 58-18-80.