South Dakota Administrative Rules
Title 20 - PUBLIC SAFETY
Article 20:06 - INSURANCE
Chapter 20:06:39 - Individual plans
Section 20:06:39:64 - Enrollment in catastrophic plans
Current through Register Vol. 50, page 114, March 25, 2024
A health plan is a catastrophic plan if it meets the following conditions:
(1) Meets all applicable requirements for health insurance coverage in the individual market and is offered only in the individual market;
(2) Does not provide a bronze, silver, gold, or platinum level of coverage described in § 20:06:56:11;
(3) Provides coverage of the essential health benefits under § 20:06:56:03 once the annual limitation on cost sharing is reached;
(4) Provides coverage for at least three primary care visits per year before reaching the deductible; and
(5) Covers only individuals who meet either of the following conditions:
A catastrophic plan may not impose any cost-sharing requirements, such as a copayment, coinsurance, or deductible, for preventive services, in accordance with § 20:06:56:03. For other than self-only coverage, each individual enrolled must meet the requirements.
General Authority: SDCL 58-17-87.
Law Implemented: SDCL 58-17-87.