South Dakota Administrative Rules
Title 20 - PUBLIC SAFETY
Article 20:06 - INSURANCE
Chapter 20:06:46 - HIPAA rules - Nondiscrimination in the group market
Section 20:06:46:02 - Criteria that cannot be used to determine benefit eligibility

A carrier may not use health status; medical condition, including both physical and mental illnesses; claims experience; receipt of health care; medical history; genetic information; evidence of insurability, including acts arising out of domestic violence or participation in activities, such as motorcycling, snowmobiling, all-terrain vehicle riding, horseback riding, skiing, and other similar activities; or disability in determining the eligibility of an individual for coverage under a plan. Nothing in this section requires a health plan to offer or provide particular benefits other than those provided under the terms of the plan or prevents a plan or issuer from establishing limitations or restrictions on the amount, level, extent, or nature of the benefits for similarly situated individuals enrolled in the plan or coverage. For purposes of this section, health factor does not include the decision whether to elect health insurance coverage, including the time chosen to enroll, such as under special enrollment or late enrollment.

General Authority: SDCL 58-18-79.

Law Implemented: SDCL 58-18-79.