ARSD 20:06:40 – Employer Plans | Midpage

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Administrative Rules of South Dakota

Chapter 20:06:40

ARSD 20:06:40

Employer Plans

20:06:40:01.01Waiting periods and affiliation periods relating to breaks in coverage.20:06:40:02Short-term, limited duration policies.20:06:40:03.01Certificates required upon losing coverage.20:06:40:04Standards for determinations on length of preexisting waiting periods.20:06:40:05Special enrollment periods for marriage, birth, and adoption.20:06:40:05.01Special enrollment periods for loss of other coverage.20:06:40:13Public health plan defined.20:06:40:16Notice describing plan’s special enrollment required.20:06:40:17Group health plans to offer breast reconstruction options after covered mastectomy.20:06:40:17.01Written notification regarding coverage of reconstructive surgery after a mastectomy required.20:06:40:17.02Prohibited practices.20:06:40:17.03Not a termination of collective bargaining agreement.20:06:40:17.04Applicability.20:06:40:18Claims experience defined.20:06:40:23Medically necessary leave of absence defined.20:06:40:24Dependent coverage.20:06:40:25Notification.20:06:40:26Continued application in case of changed coverage.20:06:40:27Effective date.20:06:40:28Creditable coverage -- Children's Health Insurance Program.20:06:40:29Definitions.20:06:40:30Group rating based on health factors.20:06:40:31No group-based discrimination based on genetic information.20:06:40:32Limitation on requesting or requiring genetic testing.20:06:40:33Exceptions to requiring genetic testing.20:06:40:34Research exception.20:06:40:35Prohibitions on collection of genetic information for underwriting purposes.20:06:40:36Medical appropriateness.20:06:40:37Collection of genetic information prior to or in connection with enrollment.20:06:40:38Incidental collection exception.20:06:40:39General exception for certain small group health plans.20:06:40:40Applicability to excepted benefits.20:06:40:41Effective date.20:06:40:75Definitions.20:06:40:76Guaranteed issue.20:06:40:77Disclosure requirements.20:06:40:78Guaranteed availability of coverage in the group market.20:06:40:79Denial of coverage.20:06:40:80Special enrollment period effective dates.20:06:40:81Special enrollment triggers.20:06:40:82Nonrenew or discontinuance of coverage.20:06:40:83Discontinuing a particular product.20:06:40:84Discontinuing all coverage.20:06:40:85Exception for uniform modification of coverage.20:06:40:86Preexisting condition exclusion and waiting period prohibited.20:06:40:87Clinical trial.20:06:40:88Full-time equivalents treated as full-time employees.20:06:40:89Applicability.20:06:40:0AExample of Certificate of Prior Group Health Plan Coverage.20:06:40:0BNotice of Research Exception.