Third party administrators must provide claims experience
to employers if requested.
ENTITLED, An Act to
require certain third party administrators to provide reports of claims
experience upon request.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF SOUTH DAKOTA:
be amended by adding thereto a NEW SECTION to read as
Any administrator for an employer self-funded health benefit plan shall provide, at the written
request of the employer, annual reports of the claims experience of that employer for the
immediate past policy period and for any time frame that is not more than three years prior to the
policy period in which the request was made. No administrator is required to provide any claims
information that pertains to a prior administrator's experience with that employer. The claims
report shall be of sufficient detail so as to provide the employer with the data necessary to assess
the employer's future health benefit coverage needs and shall be provided to the employer within
thirty days of receipt of the written request of the employer.
Signed February 22, 2006