Rule 20:06:40:12 Health benefit arrangement defined.
20:06:40:12. Health benefit arrangement defined.
For purposes of SDCL 58-18-44, a health benefit arrangement includes an arrangement by a state, the membership composition of which is specified by the state, which is established and maintained primarily to provide health insurance coverage for individuals who are residents of the state and who, because of the existence or history of a medical condition, are unable to acquire medical care coverage for a condition through insurance or from an HMO or are able to acquire coverage only at a rate which is substantially in excess of the rate for such coverage through the membership organization.
24 SDR 35, effective September 29, 1997.
Authority: SDCL 58-18-79.
Implemented: SDCL 58-18-44.
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