58-18-79 Promulgation of rules to minimally meet federal standards--Additional rules--Scope.
Promulgation of rules to minimally meet federal standards--Additional rules--Scope.
If any federal standards are in place which require additional steps to meet those standards
beyond what is required by this chapter, the director may promulgate rules, pursuant to chapter 1-26,
to require the offering of health insurance plans, the underwriting criteria that may be utilized for
such health insurance plans, the type and scope of preexisting waiting periods and creditable
coverage, the standards for nonrenewability of coverage, and other requirements related to the
availability of health insurance to employers and their employees and dependents in this state in
order to minimally meet the federal standards.
The director may also promulgate rules, pursuant to chapter 1-26, pertaining to employer health
benefit plans in the areas of:
Definition of terms;
The issuance of certificates of coverage upon loss of health insurance coverage;
Determinations relative to the application of waiting periods;
Special enrollment periods;
Treatment of late enrollees;
Preexisting condition and other waiting periods;
Breaks in coverage;
Dates of enrollment;
Creditable coverages including methods of crediting coverage;
Risk spreading mechanisms;
Requirements pertaining to mental health benefit levels in employer group plans other
than small employer group plans;
Continuation and conversion requirements; and
Claims, provided the rules are consistent with applicable federal requirements for claims
procedures, administration, and enforcement, including 29 CFR Part 2560.
SL 1997, ch 289, § 25; SL 1998, ch 289, § 22; SL 2001, ch 280, § 16; SL 2002, ch 236, § 1.