58-17-85 Eligibility requirements for state risk pool--Residency requirement--Application deadline....
Eligibility requirements for state risk pool--Residency requirement--Application
If a person has an aggregate of at least twelve months of creditable coverage, is a resident
of this state, and applies within sixty-three days of the date of losing prior creditable coverage, the
person is eligible for coverage as provided for in §§ 58-17-68, 58-17-70, 58-17-85, and 58-17-113
to 58-17-142, inclusive, if none of the following apply:
The applicant is eligible for continuation of coverage under an employer plan;
The person is eligible for an employer group plan, Part A or Part B of medicare, or
The person has other health insurance coverage;
The person's most recent coverage was terminated because of the person's nonpayment
of premium or fraud;
The person loses coverage under a short term or limited duration plan; or
The person's last coverage was creditable coverage as defined in subdivision 58-17-69(13)
or a federal preexisting condition insurance plan.
Any person who has exhausted continuation rights and who is eligible for conversion or other
individual or association coverage has the option of obtaining coverage pursuant to this section or
the conversion plan or other coverage. If a person chooses conversion coverage, other than pursuant
to § 58-17-74, in lieu of coverage pursuant to this section and the person later exhausts the lifetime
maximum of the conversion coverage, the person may obtain coverage pursuant to this section as
long as the person continues to satisfy the criteria of this section. A person who is otherwise eligible
for the issuance of coverage pursuant to this section may not be required to show proof that coverage
was denied by another carrier.
For purposes of this section, reasonable evidence that the prospective enrollee is a resident of this
state shall be required. Factors that may be considered include a driver's license, voter registration,
and where the prospective enrollee resides.
Any person who was eligible for the risk pool and opted for coverage pursuant to § 58-17-74
may, at any time while covered under that policy or within sixty-three days of terminating that
coverage, elect to enroll in the risk pool.
Source: SL 1996, ch 286, § 20; SL 1997, ch 289, § 5; SL 1998, ch 289, § 3; SL 1999, ch 250, § 2;
SL 2001, ch 275, § 3; SL 2002, ch 235, § 1; SL 2003 (SS), ch 1, § 30; SL 2004, ch 301, § 2; SL
2005, ch 264, § 1; SL 2008, ch 263, § 2; SL 2011, ch 218, § 1.