For the individual market, a health insurance issuer shall consider the claims experience of all individual health plans, other than those enrolled in grandfathered health plans and group plans subject to SDCL 58-17-70, and excepted benefits offered by the issuer in the individual market in a state, including those enrollees who do not enroll in such plans through an Exchange, to be members of a single risk pool.

For the small group market, a health insurance issuer shall consider the claims experience of all enrollees in all health plans, other than grandfathered health plans, subject to SDCL chapter 58-18B and offered by the issuer in the small group market in a state, including those enrollees who do not enroll in such plans through an Exchange, to be members of a single risk pool.

Source: 39 SDR 203, effective June 10, 2013; 46 SDR 26, effective September 4, 2019.

General Authority: SDCL 58-17-4.2 , 58-17-87 , 58-18B-18 , 58-18B-36.

Law Implemented: SDCL 58-17-74.1 , 58-17-87 , 58-18B-18 , 58-18B-36.

Prior versions effective: 2013-06-10.