Rule 20:06:48:15 Cooperation required. CHAPTER 20:06:21

          20:06:48:15.  Cooperation required. An enrollee must cooperate with the risk pool board by providing information, upon request, that shows continued eligibility for the risk pool and by submitting applications for health insurance and other applicable programs. Cooperation, in the form of payment of copayments, coinsurance and deductible amounts to a provider for services covered by the risk pool, is required for continued eligibility for the risk pool. The failure of an enrollee, upon notice by the plan, to remit to a provider copayments, coinsurance, and deductibles for services covered by the risk pool in a manner satisfactory to the risk pool administrator is sufficient grounds for the termination of coverage in the risk pool for that enrollee.

 

          Source: 30 SDR 51, effective October 28, 2003; 32 SDR 203, effective June 5, 2006.

          General Authority: SDCL 58-17-124(5)(7).

          Law Implemented: SDCL 58-17-124(5)(7), 58-17-136.