S.D. Admin. R. 20:06:39:35
If a carrier upon application for an individual health benefit plan takes reasonable steps to ensure that premiums are not paid by an employer, then a carrier, upon becoming aware of a premium payment by an employer for an individual health benefit plan, must request substitute payment from the individual insured which is not paid by an employer
A carrier which fails to either take reasonable steps to ensure premiums are not paid by an employer during the application process or fails to request substitute payment from the individual insured which is not paid by an employer must treat the policy or policies as group contracts if a payment is received from an employer unless the employer has only one employee.
S.D. Admin. R. 20:06:39:35
General Authority: SDCL 58-17-70, 58-18B-2.
Law Implemented: SDCL 58-17-87.