Rule 20:06:39:34 Disclosure requirements.
requirements. Any policy or certificate of specified disease, short term
hospital-surgical care of six months or less duration but not including short
term major medical, hospital confinement indemnity, limited benefit health insurance,
or other policy or certificate that provides less benefits than as provided
under SDCL 58-17-69(2) must clearly and prominently disclose that the policy is a limited benefit health insurance plan. The following is an example of a disclosure for limited benefit coverages that is in compliance provided it is prominent and otherwise meets the requirements of this section:
This limited health benefits plan does not
provide comprehensive medical coverage. It is a basic or limited benefits
policy and is not intended to cover all medical expenses. This plan is not
designed to cover the costs of serious or chronic illness.
For short-term major medical policies
clear and prominent disclosure of the preexisting condition limitation and the
short term duration of the product must be made. The following notice is an
example of a short term major medical disclosure that is in compliance provided
it is prominent and otherwise meets the requirements of this section:
This policy is a short term medical
insurance [policy/certificate] which provides coverage for six months or less
duration and excludes coverage for preexisting conditions.
The disclosures required by this
section must be contained on the first page of the policy. The requirements of
this section also apply to outlines of coverage. Nothing in this section
applies to Medicare supplement, long-term care, disability or credit health
34 SDR 200, effective January 28, 2008; 37 SDR 215, effective May 31, 2011.
Authority: SDCL 58-17-87(6), 58-33A-7(13).
Implemented: SDCL 58-17-70, 58-33A-2(1), (3), (4), (6), and (10)
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