CHAPTER 258

(SB 45)

Group health plan break in coverage restriction modified.

         ENTITLED, An Act to  modify certain requirements for group health coverage for premature births, congenital defects, and birth abnormalities.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:

     Section  1.  That § 58-18-33 be amended to read as follows:

     58-18-33.   The coverage for a newly born child from the moment of birth or for a newly adopted child, from the beginning of the six-month adoption bonding period, shall consist of coverage of injury or sickness including the necessary care and treatment of premature birth and medically diagnosed congenital defects and birth abnormalities. The coverage required by this section applies to any subsequent health benefit plan that is purchased providing coverage for that newly born or newly adopted child if application for the subsequent coverage is made within sixty-three days of the termination of the prior coverage . If there is a break in coverage that exceeds sixty-three days, the health benefit plan may apply preexisting exclusion limitations as permitted by §  58-18-45. The provisions of §§ 58-18-32 to 58-18-34, inclusive, apply to any group health benefit plan issued or renewed by any health insurer, health carrier, health maintenance organization, fraternal benefit society, nonprofit medical and surgical plan, nonprofit hospital service plan, or other entity providing coverage through a health benefit plan subject to the provisions of this title.

     Signed February 21, 2006

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