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ARSD 20:06:39 – Individual Plans | Midpage
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Administrative Rules of South Dakota
Title 20
20:06
Chapter 20:06:39
ARSD 20:06:39
Individual Plans
20:06:39:01
Dual eligibility.
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Creditable coverage and preexisting waiting periods for newborn and adopted children.
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Permissible rating factors.
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Certificates required upon loss of coverage.
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Standards for determinations on length of preexisting waiting periods.
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Student health plans -- Bona fide association plans.
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Requirements for breaks in coverage when applying for a new policy.
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Active marketing required.
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Prohibited practices.
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Prohibited compensation arrangements.
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Guaranteed issue -- Effective date of coverage.
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Guaranteed issue -- Tolling of 63-day time frame.
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Required timeframe in which to submit subsequent applications for guaranteed issue plans if rejection was received after February 24, 2002.
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Required timeframe in which to submit subsequent applications for guaranteed issue plans if rejection was received prior to February 25, 2002.
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Subsequent rejections and timeframes.
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Exceptions for those applying during 63-day timeframe following loss of creditable coverage.
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Effective date of guaranteed issue plan.
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Definition of ordinarily prudent person in preexisting condition clauses.
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Fair market standards for carriers.
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Group applicability to individual market.
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Usual, customary, and reasonable charges for standard and basic plans.
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Contract of more than six months -- Defined.
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Disclosure requirements.
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Renewability of short term major medical plans.
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Policy not subject to group requirements.
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Medically necessary leave of absence defined.
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Dependent coverage.
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Notification.
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Continued application in case of changed coverage.
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Effective date.
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Creditable coverage -- Children's Health Insurance Program.
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Association health insurance plans subject to individual market rating requirements.
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Definitions.
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Prohibition on genetic information in setting premium rates.
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Limitation on requesting or requiring genetic testing.
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Exceptions to requiring genetic testing.
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Research exception.
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Prohibitions on collection of genetic information for underwriting purposes.
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Medical appropriateness.
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Collection of genetic information prior to or in connection with enrollment.
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Incidental collection exception.
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Prohibition on genetic information as a condition of eligibility.
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Prohibition on genetic information as preexisting condition.
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Medicare supplemental health insurance.
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Applicability to excepted benefits.
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Effective date.
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Guaranteed availability of coverage in the individual market.
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Denial of coverage.
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Open enrollment.
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Initial open enrollment period.
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Annual open enrollment period.
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Special enrollment period effective dates.
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Coverage issued outside open enrollment.
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Enrollment in catastrophic plans.
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Student health insurance coverage.
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Clinical trial.
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Nonrenewal of coverage.
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Discontinuing a particular product.
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Discontinuing all coverage.
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Special enrollment periods for marriage, birth, and adoption.
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Special enrollment triggers.
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Preexisting condition exclusion and waiting period prohibited.
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Health insurance issuer defined.
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Applicability.