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

Universal Citation: SD Admin Rules 20:06:39:64

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) Have not attained the age of 30 prior to the first day of the plan year;

(b) Have received a certificate of exemption for the reasons identified in section 1302(e)(2)(B)(i) or (ii) of PPACA as defined in § 20:06:55:32.

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.

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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