South Dakota Administrative Rules
Title 67 - Department of Social Services
Article 67:46 - Eligibility for medical services
Chapter 67:46:14 - Children's health insurance (CHIP-NM)
Section 67:46:14:01 - Definitions

Universal Citation: SD Admin Rules 67:46:14:01

Current through Register Vol. 50, page 114, March 25, 2024

Terms used in this chapter mean;

(1) "Caretaker," the adult who lives with and provides care and control of a child eligible for services under this chapter. The caretaker may include the child's parent or parents;

(2) "Child," an individual who has not attained the age of 19;

(3) "CHIP-MN," the nonmedicaid children's health insurance program for children eligible under the provisions of this chapter;

(4) "Group health plan," a plan of, or contributed to by, an employer, including a self-employed person, or employee organization to provide health care, directly or otherwise, to the employees, former employees, the employer, others associated or formerly associated with the employer in a business relationship, or their families. A group health plan includes self-insured plans and plans of incorporated or unincorporated organizations that are organized and operated for educational, religious, charitable, or other purposes and that hold funds exclusively for its members and use those funds to meet the health care needs of its members;

(5) "Health insurance," benefits consisting of medical care provided directly, through insurance or reimbursement, or otherwise, under any hospital or medical service policy or certificate, hospital or medical service plan contract, or health maintenance organization contract offered by a health insurance issuer; and

(6) "Health insurance issuer," an insurance company, insurance service, or insurance organization, including a health maintenance organization, that is required to be licensed to engage in the business of insurance in South Dakota. A health insurance issuer does not include a group health plan;

(7) "Family size/Household," an individual's family size/household has the same meaning as determined under the provisions of 42 C.F.R. § 435.603.

General Authority: SDCL 28-6-1.

Law Implemented: SDCL 28-6-1.

Application of modified adjusted gross income (MAGI), 42 C.F.R. § 435.603 (July 15, 2013).

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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