South Dakota Risk Pool, certain provider contracts permitted.
be amended by adding thereto a NEW SECTION to read as
be amended to read as follows:
The risk pool shall offer three plan designs that provide comprehensive coverage
benefits consistent with major medical coverage currently being offered in the individual health
insurance market and that include a disease management program. The coverage and benefits for
plans provided pursuant to §§ 58-17-68, 58-17-70, 58-17-85, and 58-17-113 to 58-17-142,
inclusive, may be established by the board, consistent with the requirements of §§ 58-17-68, 58-
17-70, 58-17-85, and 58-17-113 to 58-17-142, inclusive, and may not be altered by any other state
law without specific reference to
58-17-68, 58-17-70, 58-17-85, and 58-17-113 to 58-17-142,
inclusive, indicating a legislative intent to add or delete from the coverage provided pursuant to
§§ 58-17-68, 58-17-70, 58-17-85, and 58-17-113 to 58-17-142, inclusive. The three plan designs,
henceforth known as Plan A, Plan B, and Plan C, shall have annual deductibles of one thousand
dollars, three thousand dollars, and ten thousand dollars, respectively. After the deductible has
been met, the plan shall pay seventy-five percent of the eligible expenses and the enrollee is
responsible for the balance of the coinsurance amount. The enrollee is responsible for a maximum
out-of-pocket coinsurance amount of two thousand two hundred fifty dollars in addition to the
deductible amount. All three plans shall cover biologically-based mental illnesses on the same
basis as other covered illnesses.
The board may create additional plan designs to meet federal
requirements for qualifying high deductible health plans for health savings accounts.
Whereas, this Act is necessary for the immediate preservation of the public peace,
health, or safety, an emergency is hereby declared to exist, and this Act shall be in full force and
effect from and after its passage and approval.