South Dakota Administrative Rules
Title 20 - PUBLIC SAFETY
Article 20:06 - INSURANCE
Chapter 20:06:21 - Long-term care insurance
- Section 20:06:21:01 - Definitions
- Section 20:06:21:01.01 - Nature of care - How defined
- Section 20:06:21:01.02 - Service providers - How defined
- Section 20:06:21:01.03 - Long-term care insurance
- Section 20:06:21:01.04 - Similar policy forms
- Section 20:06:21:01.05 - Treatment of accelerated benefits in life insurance
- Section 20:06:21:01.06 - Claim and clean claim - Defined
- Section 20:06:21:02 - Minimum standards for long-term care insurance policies
- Section 20:06:21:02.01 - Annuity policies with long-term care benefits subject to waiting period
- Section 20:06:21:03 - Renewability of group policies - Required disclosures
- Section 20:06:21:04 - Permissible exclusions from coverage
- Section 20:06:21:05 - Loss ratios
- Section 20:06:21:05.01 - Relation of benefits to premium for accelerated death benefit on life insurance
- Section 20:06:21:06 - Cost-of-living adjustments - Basis
- Section 20:06:21:06.01 - Cost-of-living adjustments - Minimum standards
- Section 20:06:21:06.02 - Group cost-of-living adjustments - Exceptions
- Section 20:06:21:06.03 - Cost-of-living adjustments - Continuation of benefit increases
- Section 20:06:21:06.04 - Cost-of-living adjustments - Automatic increases - Conspicuous offer of constant premium
- Section 20:06:21:06.05 - Cost-of-living adjustments - Rejection by policyholder
- Section 20:06:21:07 - Applicability of rules to long-term care insurance riders
- Section 20:06:21:08 - "Medically necessary" defined
- Section 20:06:21:09 - Basis for conversion of coverage from group defined
- Section 20:06:21:10 - Converted policy from group defined
- Section 20:06:21:11 - Converted policy from group - Time allowed for written application
- Section 20:06:21:12 - Converted policy from group - Calculation of policy premium
- Section 20:06:21:13 - Continuation or conversion is mandatory - Exceptions
- Section 20:06:21:14 - Converted policy from group to individual - Reduction of benefits - Exception
- Section 20:06:21:15 - Converted policy from group - Benefits payable
- Section 20:06:21:16 - Converted policy from group - Eligibility for coverage of relatives
- Section 20:06:21:17 - Converted policy from group - Managed care plan defined
- Section 20:06:21:18 - Discontinuance and replacement of a group policy
- Section 20:06:21:19 - Premium increase prohibitions
- Section 20:06:21:20 - Lapse or termination notice required
- Section 20:06:21:21 - Lapse or termination for payment through payroll or pension deduction plan
- Section 20:06:21:22 - Lapse or termination for nonpayment of premium
- Section 20:06:21:23 - Disclosure of renewability
- Section 20:06:21:24 - Disclosure of payment of benefits based on certain standards
- Section 20:06:21:25 - Disclosure of limitations on preexisting conditions
- Section 20:06:21:26 - Disclosure of other limitations or conditions on eligibility for benefits
- Section 20:06:21:26.01 - Notice to claimants - Temporary leave
- Section 20:06:21:27 - Outline of coverage
- Section 20:06:21:28 - Outline of coverage - Standard format
- Section 20:06:21:28.01 - Applications - Questions about replacement
- Section 20:06:21:29 - Replacement notices
- Section 20:06:21:30 - Filing requirements for advertising - Exemption
- Section 20:06:21:31 - Standards for marketing - Requirements
- Section 20:06:21:32 - Standards for marketing - Prohibited practices
- Section 20:06:21:33 - Standards for marketing - Associations
- Section 20:06:21:34 - Extension of benefits
- Section 20:06:21:35 - Basis for continuation or conversion from group coverage required
- Section 20:06:21:36 - Basis for continuation of coverage from group defined
- Section 20:06:21:37 - Reinstatement
- Section 20:06:21:38 - Disclosure of riders and endorsements
- Section 20:06:21:39 - Disclosure of tax consequences
- Section 20:06:21:40 - Applications - Health and medication questions
- Section 20:06:21:41 - Applications - Notice about incorrect answers
- Section 20:06:21:42 - Policies - Notice about incorrect answers on applications
- Section 20:06:21:43 - Elderly applicants - Required information
- Section 20:06:21:44 - Applications - Delivery
- Section 20:06:21:44.01 - Applications - Delivery upon approval.Repealed
- Section 20:06:21:45 - Records of rescissions - Maintaining and filing records
- Section 20:06:21:46 - Minimum standards for home health and community care benefits
- Section 20:06:21:47 - Policy summary for individual life insurance policy containing long-term care benefits
- Section 20:06:21:48 - Monthly report to policyholder
- Section 20:06:21:49 - Incontestability period
- Section 20:06:21:50 - Assisted living center or facility defined
- Section 20:06:21:51 - Assisted living centers - Minimum benefit standards
- Section 20:06:21:52 - Reporting requirements for insurers
- Section 20:06:21:53 - Appropriateness of recommended purchase or replacement
- Section 20:06:21:53.01 - Suitability standards
- Section 20:06:21:53.02 - Suitability - Long-term care insurance personal worksheet
- Section 20:06:21:53.03 - Suitability - Response letter
- Section 20:06:21:53.04 - Suitability - Policies not included
- Section 20:06:21:53.05 - Suitability - Overinsurance
- Section 20:06:21:54 - Requirement to deliver shopper's guide
- Section 20:06:21:55 - Standards for benefit triggers
- Section 20:06:21:56 - Additional standards for benefit triggers for qualified long-term care insurance contracts
- Section 20:06:21:57 - Nonforfeiture benefits
- Section 20:06:21:58 - Nonforfeiture benefit requirement
- Section 20:06:21:59 - Electronic enrollment for group policies
- Section 20:06:21:60 - Required disclosure of rating practices to consumers - Rate stabilization
- Section 20:06:21:61 - Initial filing requirements
- Section 20:06:21:62 - Reserve standards
- Section 20:06:21:63 - Premium rate schedule increases - Notice of pending increase
- Section 20:06:21:64 - Premium rate schedule increase requirements
- Section 20:06:21:65 - Premium rate schedule increases - Review by the director
- Section 20:06:21:66 - Premium rate schedule increases - Adverse lapsation
- Section 20:06:21:67 - Premium rate schedule increases - Policies to which does not apply
- Section 20:06:21:68 - Premium rate schedule increases - Group insurance policies
- Section 20:06:21:69 - Premium rate schedule increases - Adoption of rules
- Section 20:06:21:70 - Premium rate schedule increases - Exceptional increases
- Section 20:06:21:71 - Permitted compensation arrangements
- Section 20:06:21:72 - Disclosure to applicant for a claim denial
- Section 20:06:21:73 - Providers in a different state
- Section 20:06:21:74 - Agent training required to market long-term care plans
- Section 20:06:21:75 - Insurers required to verify agent training and maintain records
- Section 20:06:21:76 - Long-term care partnership policies - Inflation protection requirements
- Section 20:06:21:77 - Long-term care partnership policies - Required policy disclosures
- Section 20:06:21:78 - Long-term care partnership policies - Filing requirements
- Section 20:06:21:79 - Long-term care - Minimum benefit requirements
- Section 20:06:21:80 - Long-term care partnership policies - Policy amendments
- Section 20:06:21:81 - Long-term care policies - Policy amendments
- Section 20:06:21:82 - Availability of new services or providers
- Section 20:06:21:83 - Policies issued considered exchanges
- Section 20:06:21:84 - Policies offered through employers, labor unions, and associations
- Section 20:06:21:85 - Applicability of new provider or service requirements
- Section 20:06:21:86 - Right to reduce coverage and lower premiums
- Section 20:06:21:87 - Authorized representative
- Section 20:06:21:88 - Notice to insured
- Section 20:06:21:89 - Internal appeal
- Section 20:06:21:90 - Internal appeal notice requirements
- Section 20:06:21:91 - Independent review of benefit trigger determination
- Section 20:06:21:92 - Independent review process
- Section 20:06:21:93 - Additional appeal information
- Section 20:06:21:94 - Independent review notification
- Section 20:06:21:95 - Independent review organization selection
- Section 20:06:21:96 - Review of information
- Section 20:06:21:97 - Additional information to independent review
- Section 20:06:21:98 - Process if determination overturned
- Section 20:06:21:99 - Review decision requirements
- Section 20:06:21:100 - Acceptance of state certification
- Section 20:06:21:101 - Certification of long-term care insurance independent review organizations
- Section 20:06:21:102 - Maintenance of records and reporting obligations by independent review organizations
- Section 20:06:21:103 - Additional rights
- Section 20:06:21:104 - Applicability
- Section 20:06:21:105 - Payment of clean claim
- Section 20:06:21:106 - Claim timeframes
- Section 20:06:21:107 - Unpaid claims
- Section 20:06:21:108 - Violations
- Appendix A - Outline of Coverage
- Appendix B - Replacement of Individual Accident and Sickness or Long-Term Care Coverage
- Appendix C - Replacement of Accident and Sickness or Long-Term Care Coverage
- Appendix D - Rescission Reporting Form
- Appendix E - Personal Worksheet
- Appendix F - Disclosure Form
- Appendix G - Response Letter
- Appendix H - Sample Claims Denial Format
- Appendix I - Potential Rate Increase Disclosure Form
- Appendix J - Replacement and Lapse Reporting Form
- Appendix K - Partnership Disclosure Form
- Appendix L - Partnership Certification Form
- Appendix M - Guidelines for Long-Term Care Independent Review Entities
Disclaimer: These regulations may not be the most recent version. South Dakota may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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