South Dakota insurance law and regulation
News that affects your health insurance and planning
June 2, 2019 – Status of alternative non-ACA health plans: South Dakota does not require individuals to maintain adequate health coverage. The state provides no premium or cost-sharing subsidies for individual market coverage, permits insurers to sell non-compliant transitional policies in the individual market. South Dakota limits the sale of short-term coverage more strictly than the federal government. A maximum policy of 6 months is allowed.
March 29, 2019 – Small business health plans – Yesterday a federal court in the District of Columbia ruled in favor of states in striking down U.S. Treasury regulations that permitted the expansion of small business association health plans. Even before the court ruling, association health plans were not showing promise as cost-saving measures as was hoped. What this means to small businesses is that if they want a lower cost health plan then they must design it themselves independently from an insurance company. The problem is that most firms providing benefits services are primarily in the business of selling insurance rather than lowering costs. Freedom Benefits offers an affordable consultation to help small business owners design and document an alternate small business health plan without necessarily requiring the purchase of insurance.
The history of health care planning in South Dakota (Information is outdated and links may be expired)
12/19/2014 – OnlineNavigator reminds South Dakota residents that it is just as important to plan for expenses not covered by health insurance. The U.S. Consumer Finance Protection Bureau recently announced that 42 million American have unpaid medical debt damaging their credit scores. Most medically-triggered personal bankruptcies are people who had health insurance. Freedom Benefits lists supplemental insurance and non-insurance strategies to keep you and your family financially secure under Obamacare.
2/11/2014 Professional support for any health care reform issue is available free of charge through an arrangement with OnlineNavigator. All online inquiries are handled personally by Tony Novak, CPA. Online support is available through a number of popular social media channels including Facebook and Google+ as well as e-mail. Telephone support for insurance enrollment is available through Members Insurance Exchange at (800) 609-0683.
9/15/2013 The state of South Dakota extends rights of individuals under the age of 19 to apply for health insurance coverage during an annual open enrollment period. In accordance with the new provision, major medical insurance companies must offer children under the age of 19 coverage without regard to health status during the open enrollment period of July 1 through August 15. If you have an eligible child that meets the criteria above and would like to apply for a child-only plan, please get a quote online an apply in the usual manner but also tell your enrollment agent that you are applying under the state open enrollment period.
7/26/2013 Affordable Smart Term Life Insurance is now available to most South Dakota residents from age 20 through 60 directly online with no physical exam, agent appointment or telephone verification. Most policies are issued on the same day with coverage amounts of $25,000 up to $350,000. The level premium life insurance is available for terms of 10, 15, 20 and 30 years. Sample rates for $150,000 coverage for a preferred risk male age 30, non-tobacco $30.85 per month; tobacco user $49.55 per month. A preferred risk female age 30 non-tobacco user would be $26.49 per month and a tobacco user would be $40.96 per month. Rates are higher for older applicants and lower health risks as described online. Pricing is based on input you provide about your medical history but, unlike most other life insurers, does not consider family medical history. Coverage is issued by innovative National Life Group, rated “A” by A.M. Best Company for 2013.
3/11/2013 This page was updated to include a link to the insurance plan that will be used to determine specific “essential health benefits” for insurance that qualified for 2014 federal tax purposes. Also, a link to additional covered benefits required by state law. Non-qualified insurance is likely to continue to be available at a lower cost that does not include these benefits nor qualify for federal tax purposes.
2/1/2012 The Center for Consumer Information and Insurance Oversight, a division of the Center for Medicare and Medicaid Services (CMS)reported that as of June 30, 2011 Wellmark of South Dakota and Dakotacare are the state’s largest health insurance providers and as such, earn the right to set the benchmark for the development of the state’s essential benefit plans to debut in 2014 under health reform law.
7/27/2011 Parents are reminded that the children’s’ health insurance open enrollment period ends on Monday August 15 so applications should be submitted online before that date. See www.celticenrollment.com for information on Celtic Insurance individual health insurance plans.
6/6/2011 Open enrollment for children under age 19 with pre-existing medical conditions run from July 1 to August 14, 2011 for all health insurance plans operating in the state. Rates may be based on medical condition. Details are posted athttp://dlr.sd.gov/reg/insurance/open_enrollment_kids.html .
Open enrollment Program information for Celtic Insurance Company information is available on the South Dakota insurance page atCelticenrollment.com.
2/12/2011 With dozens of health plans choices available online offering a wide range of pricing and benefits, how do you find the best combination of price and benefits? Celtic Insurance realizes that the choices can be overwhelming; the company offers more than 40 possible health plan designs in many parts of the United States. A new feature called “Help Me Choose” lets users easily and quickly select the benefits they value most and narrows the list down to a few of the best choices. No personal information is required other than zip code and date of birth.
1/26/2011 The Minimum Loss Ratio for individual and small group insurance, other than exempted plans, is 80 percent for 2011 through 2014. This state requirement is more stringent than federal law. Read more on the effect of the Minimum Loss Ratio regulation.
1/19/2011 Child-only health insurance for children with significant medical problems will be available through an open enrollment period mandated by federal state law under new rules developed by the state. All children, regardless of medical condition, continue to be eligible for insurance when applying as a dependent on a parent’s policy and healthy children are eligible for child-only insurance at any time. When applying for child-only insurance for more than one child, make a separate application for each child.
12/16/2010 State officials met representatives of 44 other states and numerous employees of the federal Health and Human Services Department in Washington DC this week for a two-day working meeting to discuss the next steps in establish a government-run health insurance exchange under the American Health Benefit Exchange Model Act. Their attendance at this meeting was paid for by a $1 million federal grant awarded by HHS in September to the state for research how to set up an insurance exchange. Two states (Alaska and Minnesota) declined to participate, saying that it was a waste of taxpayer money. Four other states (not identified in press reports) that received federal grants did not send representatives to the meeting. Attendees included representatives of 16 states that are suing the federal government in an attempt to overturn the federal health reform law; specifically the requirement that forces individuals to buy health insurance on the insurance exchange or pay a hefty tax fine.
In its initial federal grant request for the insurance exchange project, South Dakota said that it would: 1) Determine if the State will choose a State-based Exchange or elect a federally administered Exchange, 2) Catalog and review existing data sources to glean pertinent information regarding the uninsured, the insurance market, and small businesses, 3) Update a State-specific survey to include: a) The demographics of insured and uninsured populations, b) Eligibility of uninsured for employer based converge or Medicaid and reasons for not enrolling in creditable coverage, c) Eligibility of uninsured for subsidies through the Exchange, and d) The marketing methods needed to encourage individuals to purchase insurance through the Exchange.
The meeting reportedly did not address the role of the commercial health insurance exchanges on the implementation of new competing government systems. The model act does not address inter-state insurance exchange proposals nor insurance sales across state lines. Federal officials admitted that they may not be able to provide further guidance until 2012. Meanwhile, most states are motivated to continue to meet requirements to obtain additional funding promised by the federal government for the establishment of insurance exchange by 2014. Freedom Benefits has previously voiced the opinion that the huge amount of money being spent to set up alternate insurance sales system technologies could be better used providing health benefits to the public. We proposed on the Universal Health Insurance blog that adequate commercial insurance sales systems are already in place that could be modified in a public/private partnership to make health insurance more affordable.
5/14/2010 Diabetes Coverage: A new resource to help find health insurance for diabetics in South Carolina is now available at Freedom Benefits.
3/23/2010 South Dakota and ten other states including Alabama, Florida, Michigan, Nebraska, North Dakota, Pennsylvania, South Carolina, Texas, Utah and Washington will make a joint legal challenge to the federal health reform bill on the basis that it improperly usurps state sovereignty over health insurance and that requiring health insurance is an illegal and improper government action.
3/1/2010 State Bill 137 has been proposed to nullify federal health care reform laws within the state.