The requirements of §§ 20:06:21:87 to 20:06:21:103, inclusive, apply to a benefit trigger request made after December 31, 2010, under a long-term care insurance policy.

As used for purposes of independent review, a benefit trigger is a contractual provision in the insured's long-term care insurance conditioning the payment of benefits on a determination of the insured's ability to perform activities of daily living and on cognitive impairment. For purposes of a tax-qualified long term care insurance contract as defined in Section 7702B of the Internal Revenue Code of 1986, as amended, a benefit trigger shall include a determination by a licensed health care practitioner that an insured is a chronically ill individual.

Source: 36 SDR 209, effective July 1, 2010; 44 SDR 184, effective June 25, 2018.

General Authority: SDCL 58-17B-4 .

Law Implemented: SDCL 58-17B-4 .

Prior versions effective: 2010-07-01.