South Dakota § 58-17A-2 - Regulations to establish specific standards for policy provisions.

§ 58-17A-2. Regulations to establish specific standards for policy provisions.

The director shall promulgate rules pursuant to chapter 1-26 to establish specific standards and requirements for medicare supplement policies and certificates. The standards and requirements shall be in addition to and in accordance with applicable laws of this state and may cover, but are not limited to:

(1)    Terms of renewability;

(2)    Initial and subsequent conditions of eligibility;

(3)    Nonduplication of coverage;

(4)    Probationary periods;

(5)    Benefit limitations, exceptions, and reductions;

(6)    Elimination periods;

(7)    Requirements for replacement;

(8)    Recurrent conditions;

(9)    Definitions of terms;

(10)    Filing requirements for forms and rates and rate schedules;

(11)    Marketing practices;

(12)    Reporting practices;

(13)    Compensation arrangements between insurers or other entities and their agents, representatives, or producers;

(14)    Suitability and appropriateness of policy sold;

(15)    Data on application forms;

(16)    Continuation and conversion rights;

(17)    Loss ratio requirements and refund and credit calculations;

(18)    Suspension and reinstitution of coverage; and

(19)    Refund of premium for duplication and suspension and reinstitution of coverage.

The director may promulgate rules pursuant to chapter 1-26 that specify prohibited policy or certificate provisions not otherwise specifically authorized by statute which, in the opinion of the director, are unjust, unfair, or unfairly discriminatory to any person insured or proposed for coverage under a medicare supplement policy or certificate. The director may also promulgate rules assuring public access to rate and form information, establishing procedures for rate and form approvals or disapprovals, and establishing a uniform methodology for calculating and reporting loss ratios.

The director shall promulgate rules pursuant to chapter 1-26 to establish minimum standards for benefits and claims payment under medicare supplement policies and certificates and to establish procedures for rate hearings.

Source: SL 1982, ch 360, § 2; SL 1989, ch 431, § 2; SL 1990, ch 396, § 2; SL 1992, ch 347, § 2.