Department of Labor and Regulation

Title - Division of Insurance email the Division of Insurance

Individual Disability
Health Rate & Form Filing Requirements

South Dakota Codified Laws
21-25A-3 Arbitration not permitted.
58-9-3 "Health insurance" defined.
58-11-1 "Premium" defined.
58-11-2 Contents of policy.
58-11-3 Statement of basis and rates for determination of premium included in policy.
58-11-5 Standard or uniform provisions of insurance contracts.
58-11-7 Substitute provisions required by law of domicile of foreign or alien insurer, approval by director.
58-11-8 Assessable policies.
58-11-10 Additional policy provisions.
58-11-11 Charter and bylaws, inclusion as part of contract of insurance.
58-11-12 Policy forms must be submitted for approval.
58-11-21 Discretionary clause not permitted.
58-11-22 Identification of contracts issued and forms filed with director.
58-11-23 Execution of policy by authorized representative of insurer.
58-11-26 Jointly issued policies.
58-11-27 Combination policy.
58-11-36 Assignment of policies.
58-11-39 Modification by rider, endorsement, or application made part of policy.
58-11-62 Notice of intent to cease marketing block of business.
58-11A-1 Definitions.
58-11A-2 Policies subject to chapter.
58-11A-3 Reading ease.
58-11A-4 Alternate reading ease tests.
58-11A-5 Certificate concerning reading ease.
58-11A-6 Variation of reading ease requirement.
58-11A-9 Law permitting issuance of policies after form on file for specified period.
58-17-1 Requirements for all health insurance policies delivered in state.
58-17-2 Persons covered by policy.
58-17-2.1 Health insurance on a franchise plan.
58-17-3 Time of commencement and termination to be set out in policy.
58-17-4 Consideration for policy to be stated.
58-17-4.1 Filing and prior approval of individual premium rates by director.
58-17-4.2 Premium rates required to be reasonable.
58-17-5 Identification of forms, riders and endorsements--Form number, location.
58-17-6 Style and arrangement of policy provisions--Printing, size of type.
58-17-7 Documents forming part of policy--Setting forth in full, rates and classifications excepted.
58-17-8 Exceptions and reductions of coverage to be clearly set out.
58-17-9 Renewal of policy at option of insurer--Statement in policy so informing the policyholder.
58-17-10.1 Reduction of benefits because of increase in statutory disability benefits prohibited.
58-17-11 Free look period.
58-17-12 Required provisions.
58-17-13 Omission from policy of inapplicable provision.
58-17-14 Insured signature required for contract changes.
58-17-15 Incontestability clause.
58-17-16 Incontestability clause--Optional provisions.
58-17-17 Grace period on premiums required in policy.
58-17-18 Renewal of policy.
58-17-19 Reinstatement when premium not paid within grace period.
58-17-20 Omission of provision as to application of premiums accepted in connection with reinstatement.
58-17-21 Notice of claim.
58-17-22 Notice of claim--Optional provision.
58-17-23 Claim forms--Furnishing by insurer.
58-17-24 Proofs of loss--Provision required in policy.
58-17-25 Time of payment of claims.
58-17-26 Payment of claims.
58-17-27 Payment of claims--Optional provisions.
58-17-28 Physical examination and autopsy in case of death.
58-17-29 Time limits for legal action.
58-17-30 Beneficiary.
58-17-30.8 Exclusion of benefits for injury while under the influence of alcohol or drugs prohibited.
58-17-31 Optional policy provisions.
58-17-32 Occupational change.
58-17-33 Misstatement of age.
58-17-34 Earnings of insured--Policy provision for adjustment of benefits.
58-17-35 Earnings adjustment clause to be coupled with insured's right to continue policy in force.
58-17-36 Option of insurer to define "valid loss of time coverage".
58-17-37 Unpaid premiums--Deduction from benefits.
58-17-38 Conformity with state statutes of insured.
58-17-39 Illegal occupation of insured.
58-17-40 Renewal of policy at option of insurer.
58-17-41 Order of policy provisions.
58-17-42 Age limit in policy.
58-17-44 Foreign or alien insurer--Policy provision required by home state.
58-17-45 Policy of domestic insurer delivered in other state.
58-17-46 Policy provisions not subject to chapter.
58-17-47 Nonconforming and conflicting provisions construed in conformity with statute.
58-17-97 Provisions covering preexisting conditions.
58-17-108 "Disability income insurance" defined.
58-17-109 Exclusion or reduction of benefits.
58-17-110 Commencement of loss.
58-17-111 Minimum standards.  
58-33-13 Unfair discrimination as misdemeanor.
58-33-13.1 Sex or marital status discrimination prohibited.
58-33-13.2 Definition of sex or marital status discrimination terms.
Administrative Rules of South Dakota
20:06:22:01 Types of renewal clauses.
20:06:22:02 Anticipated loss ratio requirements.
20:06:22:03 Rate filing required,
 20:06:22:04 Filings of rate revisions.
20:06:22:05 Requirements for history of experience.
20:06:28:01 Filing fees.
20:06:28:03 Filings by third parties.
20:06:28:08 Electronic filings.
20:06:39:21 Definition of ordinarily prudent person in preexisting condition clauses.
20:06:52 Discretionary Clause not permitted
Bulletins
Bulletin 07-01 SERFF required for all form and rate filings
Bulletin 08-04  
  • An application or a policy form may not include a statement that indicates that the agent cannot bind the company. An application or a policy form may contain language that indicates that agents or others have no authority to modify or waive any provisions of the policy or certificate.
  • For disability policies or certificates, the provisions of SDCL 58-17-109 allowing for reduction of benefits if the insured is receiving benefits under a governmental program or eligible to receive benefits under another insurance policy do not extend to benefits received or eligible to be received by the spouse or child of the insured.
  • No policy or certificate may contain a provision that allows for the decision of a insurer selected medical provider to be binding for purposes of determining medical appropriateness or medical necessity of any claimed benefit.
  • No health policy or certificate amendment or endorsement filing may contain blank provisions that may be completed upon issuance by the insurer.
  • No policy or certificate may exclude covered sicknesses or injuries caused by alcohol or drug use unless it is in the commission of a felony.

 

 


Division of Insurance
124 S. Euclid Ave., 2nd Floor
Pierre, SD 57501
Tel. 605.773.3563
Fax. 605.773.5369