South Dakota Administrative Rules
Title 20 - PUBLIC SAFETY
Article 20:06 - INSURANCE
Chapter 20:06:58 - Mental Health Parity
- Section 20:06:58:01 - Definitions
- Section 20:06:58:02 - Parity requirements with respect to aggregate lifetime and annual dollar limits
- Section 20:06:58:03 - Plan with no limit or limits on less than one-third of all medical or surgical benefits
- Section 20:06:58:04 - Plan with a limit on at least two-thirds of all medical or surgical benefits
- Section 20:06:58:05 - Determining one-third and two-thirds of all medical or surgical benefits
- Section 20:06:58:06 - Plan not described in sections 20:06:58:03 or 20:06:58:04 of this chapter
- Section 20:06:58:07 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of classification of benefits
- Section 20:06:58:08 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of type of financial requirement or treatment limitation
- Section 20:06:58:09 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of level of a type of financial requirement or treatment limitation
- Section 20:06:58:10 - Parity requirements with respect to financial requirements and treatment limitations - Clarification of coverage unit
- Section 20:06:58:11 - General parity requirement
- Section 20:06:58:12 - Classifications of benefits used for applying rules
- Section 20:06:58:13 - Application to out-of-network providers
- Section 20:06:58:14 - Financial requirements and quantitative treatment limitations - Determining substantially all
- Section 20:06:58:15 - Financial requirements and quantitative treatment limitations - Determining predominant
- Section 20:06:58:16 - Financial requirements and quantitative treatment limitations - Determining portion based on plan payments
- Section 20:06:58:17 - Financial requirements and quantitative treatment limitations - Determining clarifications for certain threshold requirements and dollar amount of plan payments
- Section 20:06:58:18 - Application to different coverage units
- Section 20:06:58:19 - Special rule for multi-tiered prescription drug benefits
- Section 20:06:58:20 - Special rule for multiple network tiers
- Section 20:06:58:21 - Special rule for sub-classifications permitted for office visits, separate from other outpatient services
- Section 20:06:58:22 - No separate cumulative financial requirements or cumulative quantitative treatment limitations
- Section 20:06:58:23 - Nonquantitative treatment limitations
- Section 20:06:58:24 - Illustrative list of nonquantitative treatment limitations
- Section 20:06:58:25 - Exemptions
- Section 20:06:58:26 - Availability of plan information - Criteria for medical necessity determinations
- Section 20:06:58:27 - Availability of plan information - Reasons for denial
- Section 20:06:58:28 - Applicability and effective dates - Group health plans
- Section 20:06:58:29 - Applicability and effective dates - Health insurance issuers
- Section 20:06:58:30 - Scope
- Section 20:06:58:31 - Coordination with EHB requirements
- Section 20:06:58:32 - Small employer exemption
- Section 20:06:58:33 - Determining employer size
- Section 20:06:58:34 - Increased cost exemption
- Section 20:06:58:35 - Applicable percentage
- Section 20:06:58:36 - Determinations by actuaries
- Section 20:06:58:37 - Formula
- Section 20:06:58:38 - Six month determination
- Section 20:06:58:39 - Notification
- Section 20:06:58:40 - Participants and beneficiaries - Content of notice
- Section 20:06:58:41 - Use of summary of material reductions in covered services or benefits
- Section 20:06:58:42 - Delivery
- Section 20:06:58:43 - Available documentation
- Section 20:06:58:44 - Sale of nonparity health insurance coverage
- Section 20:06:58:45 - Special effective date for certain collective-bargained plans
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