After December 31, 2013, a health insurance issuer must provide special enrollment periods consistent with this section outside the Exchange, during which qualified individuals and enrollees may enroll in nongrandfathered health plans or change enrollment from one plan to another. Once a qualified individual is determined eligible for a special enrollment period, the health insurance issuer must ensure that the qualified individual's effective date of coverage is:

1. (1) Between the first and the fifteenth day of any month, the plan must ensure a coverage effective date of the first day of the following month;
2. (2) Between the sixteenth and the last day of any month, the plan must ensure a coverage effective date of the first day of the second following month;
3. (3) In the case of birth, adoption or placement for adoption, the plan must ensure that coverage is effective on the date of birth, adoption, or placement for adoption; and

4. (4) In the case of marriage, or in the case where a qualified individual loses minimum essential coverage, the plan must ensure coverage is effective on the first day of the following month.

   Unless specifically stated otherwise herein, a qualified individual or enrollee has 60 days from the date of a triggering event to select a nongrandfathered health plan.

Source: 39 SDR 203, effective June 10, 2013.

General Authority: SDCL 58-17-87.

Law Implemented: SDCL 58-17-87.