§ 58-17A-1 — Definition of terms.

South Dakota § 58-17A-1

• Jurisdiction: South Dakota
• Title 58: INSURANCE
• Ch. 58-17A: MEDICARE SUPPLEMENT POLICIES

Text

Terms used in this chapter mean: (1) "Applicant," in the case of an individual medicare supplement policy or subscriber contract, the person who seeks to contract for insurance benefits; and in the case of a group medicare supplement policy or subscriber contract, the proposed certificate holder; (2) "Certificate," any certificate issued under a group medicare supplement policy, which policy has been delivered or issued for delivery in this state; (3) "Certificate form," the form on which the certificate is delivered or issued for delivery by the issuer; (4) "Issuer," includes insurance companies, fraternal benefit societies, health care service plans, health maintenance organizations, and any other entity delivering or issuing for delivery in this state medicare supplement policies or certificates; (5) "Medicare," the Health Insurance for the Aged Act, Title XVIII of the Social Security Amendments of 1965 and as amended through December 31, 1991; (6) "Medicare supplement policy," a group or individual policy of health insurance or a subscriber contract of nonprofit hospital, medical and surgical service plans, or health maintenance organizations, which is advertised, marketed, or designed primarily as a supplement to reimbursements under medicare for the hospital, medical or surgical expenses of persons eligible for medicare. The term does not include insurance policies or health care benefit plans, including group conversion policies, provided to medicare eligible persons which policies are not marketed or held to be medicare supplement policies or benefit plans, nor does it apply to a policy or contract of one or more employers or labor organizations, or of the trustees of a fund established by one or more employers or labor organizations, or combination thereof, for employees or former employees or a combination thereof, or for members or former members, or a combination thereof, of the labor organizations. The term does not include a policy issued pursuant to a contract under Section 1876 of the federal Social Security Act, 42 U.S.C. § 1395 et seq., or a policy issued under a demonstration project specified in 42 U.S.C. § 1395ss(g)(i). The term does not include any medicare advantage plan established under Medicare Part C, any outpatient prescription drug plan established under Medicare Part D, or any health care prepayment plan that provides benefits pursuant to an agreement under § 1833(a)(1)(A) of the Social Security Act; (7) "Policy form," the form on which the policy is delivered or issued for delivery by the issuer.

Legislative History

SL 1982, ch 360, § 1; SL 1989, ch 431, § 1; SL 1990, ch 396, § 1; SL 1992, ch 347, § 1; SL 1996, ch 293, § 1; SL 2005, ch 267, § 1.