ARSD 20:06:55 – Market Regulations | Midpage

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Administrative Rules of South Dakota

Chapter 20:06:55

ARSD 20:06:55

Market Regulations

20:06:55:01Eligibility of children up to age 26.20:06:55:02Restrictions on plan definition of dependent.20:06:55:03Coverage of grandchildren not required.20:06:55:04Uniformity irrespective of age.20:06:55:05Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Applicability.20:06:55:06Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Opportunity to enroll required.20:06:55:07Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Written notice.20:06:55:08Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Effective date.20:06:55:09Individuals whose coverage ended by reason of reaching a dependent eligibility threshold -- Group health plan special enrollee.20:06:55:10Special rule for grandfathered group health plans.20:06:55:11Applicability.20:06:55:12Choice of primary care providers.20:06:55:13Emergency services.20:06:55:14Rescissions.20:06:55:15Group plans -- Lifetime limits.20:06:55:16Group plans -- Annual limits.20:06:55:17Group plans -- Eligibility.20:06:55:18Group plans -- Notices and enrollment.20:06:55:19Group plans -- Special enrollment.20:06:55:20Group plans -- Applicability.20:06:55:21Individual plans -- Lifetime limits.20:06:55:22Individual plans -- Annual limits.20:06:55:23Reinstatement of coverage.20:06:55:24Individual plans -- Applicability.20:06:55:25.01Individual plans -- No preexisting condition.20:06:55:26Group plans -- No preexisting condition for a person under the age of 19.20:06:55:27Excepted benefits -- Defined.20:06:55:32Definitions.20:06:55:33Certifying qualified health plans.20:06:55:34Issuer standards and certification criteria.20:06:55:35Qualified health plan defined.20:06:55:36Exchange network adequacy standards.20:06:55:37Network adequacy standards.20:06:55:38Essential community providers defined.20:06:55:39Essential community providers.20:06:55:40Payment of federally-qualified health centers.20:06:55:41Treatment of direct primary care medical homes.20:06:55:42Recertification of qualified health plans.20:06:55:43Decertification of qualified health plan.20:06:55:44Non-renewal and decertification of qualified health plans.20:06:55:45Rates.20:06:55:46Health plan applications and notices.20:06:55:47Accreditation of qualified health plan issuers.20:06:55:49Annual open enrollment period.20:06:55:50Changing qualified health plans.20:06:55:50.01Loss of coverage.20:06:55:50.02Special enrollment period effective dates.20:06:55:51Compensation.20:06:55:52Plan offerings in the exchange.20:06:55:53Applicability and effective dates.20:06:55:0AModel Choice of Health Care Professional Notice Language.