Title 58 — INSURANCE
79 chapters · 3,532 sections in this title.
SDCL § 58-29C-45 Purpose of chapter--Creation of association
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A. The purpose of this chapter is to protect, subject to certain limitations, the persons specified in subpart A of § 58-29C-46 against failure in the performance of contractual obligations, under life, health, and annuity policies, plans, or contracts specified in subpart B of §…
SDCL § 58-29C-46 Persons provided with coverage--Policies and portions of policies not covered
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A. This chapter shall provide coverage for the policies and contracts specified in subpart B: (1) To persons who, regardless of where they reside (except for nonresident certificate holders under group policies or contracts), are the beneficiaries, assignees, or payees of the per…
SDCL § 58-29C-47 Construction of chapter
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This chapter shall be construed to effect the purpose under §
SDCL § 58-29C-48 Definitions
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Terms used in this chapter mean: (1) "Account," either of the two accounts created under § 58-29C-49 ; (2) "Association," the South Dakota Life and Health Insurance Guaranty Association described in § 58-29C-49 ; (3) "Authorized assessment" or the term "authorized" when used in t…
SDCL § 58-29C-49 Continuation of association--Membership--Function and organization--Accounts--Supervision--Meetings
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A. There is hereby continued the nonprofit legal entity known as the South Dakota Life and Health Insurance Guaranty Association as created by former §
SDCL § 58-29C-50 Board of directors--Appointment and term--Vacancies--Compensation
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A. The board of directors of the association shall consist of not less than seven nor more than eleven member insurers serving terms as established in the plan of operation. The insurer members of the board shall be elected by member insurers subject to the approval of the direct…
SDCL § 58-29C-51 Impaired or insolvent member--Actions authorized
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A. If a member insurer is an impaired insurer, the association may, in its discretion, and subject to any conditions imposed by the association that do not impair the contractual obligations of the impaired insurer and that are approved by the director: (1) Guarantee, assume, rei…
SDCL § 58-29C-52 Funding provided by assessment of members--Classification of assessments--Amounts of assessments--Abatements--Refunds
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A. For the purpose of providing the funds necessary to carry out the powers and duties of the association, the board of directors shall assess the member insurers, separately for each account, at the time and for the amounts as the board finds necessary. Assessments are due not l…
SDCL § 58-29C-53 Plan of operation--Effective date--Requirements--Delegation of powers
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A. (1) The association shall submit to the director a plan of operation and any amendments thereto necessary or suitable to assure the fair, reasonable, and equitable administration of the association. The plan of operation and any amendments thereto shall become effective upon t…
SDCL § 58-29C-54 Duties and powers of director
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In addition to the duties and powers enumerated elsewhere in this chapter, A. The director shall: (1) Upon request of the board of directors, provide the association with a statement of the premiums in this and any other appropriate states for each member insurer; (2) When an imp…
SDCL § 58-29C-55 Detection and prevention of insurer insolvencies or impairments--Reports by board
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To aid in the detection and prevention of member insurer insolvencies or impairments, A. It is the duty of the director: (1) To notify the directors of all the other states, territories of the United States and the District of Columbia within thirty days following the action take…
SDCL § 58-29C-56 Member assessment as offset against premium tax liability
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A. A member insurer may offset against its premium tax liability to this state an assessment described in subpart 58-29C-52H to the extent of twenty percent of the amount of the assessment for each of the five calendar years following the year in which the assessment was paid. If…
SDCL § 58-29C-57 Liability for unpaid assessment--Records of meetings--Association as creditor of impaired or insolvent insurer--Liquidation, rehabilitation, or conservation proceedings
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A. This chapter may not be construed to reduce the liability for unpaid assessments of the insureds of an impaired or insolvent insurer operating under a plan with assessment liability. B. Records shall be kept of all meetings of the board of directors to discuss the activities o…
SDCL § 58-29C-58 C
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For the purpose of carrying out the association's obligations under this chapter, the association is a creditor of the impaired or insolvent insurer to the extent of assets attributable to covered policies reduced by any amounts to which the association is entitled as subrogee pu…
SDCL § 58-29C-59 Association's tax exemption status
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The association shall be exempt from payment of all fees and all taxes levied by this state or any of its subdivisions, except taxes levied on real property. Source: SL 2003, ch 252 , § 16.
SDCL § 58-29C-60 No liability for performance of powers and duties of association or its members
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There is no liability on the part of and no cause of action of any nature may arise against any member insurer or its agents or employees, the association or its agents or employees, members of the board of directors, or the director or the director's representatives, for any act…
SDCL § 58-29C-61 Stay of proceedings against insolvent insurer--Default judgment set aside
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All proceedings in which the insolvent insurer is a party in any court in this state shall be stayed one hundred eighty days from the date an order of liquidation, rehabilitation, or conservation is final to permit proper legal action by the association on any matters germane to …
SDCL § 58-29C-62 Use of existence of association for sales, solicitation, or inducement to purchase insurance prohibited--Summary document of purposes and limitations of chapter--Disclaimer
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A. No person, including a member insurer, agent, or affiliate of a member insurer may make, publish, disseminate, circulate, or place before the public, or cause directly or indirectly, to be made, published, disseminated, circulated, or placed before the public, in any newspaper…
SDCL § 58-29D-1 Definition of terms
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Terms used in this chapter mean: (1) "Affiliate" or "affiliated," any entity or person who directly or indirectly through one or more intermediaries, controls or is controlled by, or is under common control with, a specified entity or person; (2) "Underwrites" or "underwriting," …
SDCL § 58-29D-10 Insurer's ownership of administrator's records
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The insurer shall own the records generated by the administrator pertaining to the insurer. However, the administrator shall retain the right to continuing access to books and records to permit the administrator to fulfill all of its contractual obligations to insured parties, cl…
SDCL § 58-29D-11 Transfer of records to new administrator
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In the event the insurer and the administrator cancel their agreement, notwithstanding the provisions of § 58-29D-8 , the administrator may, by written agreement with the insurer, transfer all records to a new administrator rather than retain them for five years. In such cases, t…
SDCL § 58-29D-12 Advertising--Approval of insurer
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An administrator may use only such advertising pertaining to the business underwritten by an insurer as has been approved in writing by the insurer in advance of its use. Source: SL 1992, ch 352 , § 12.
SDCL § 58-29D-13 Insurer responsibility for procedures and administration of its programs--Review and audit of administrator
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If an insurer utilizes the services of an administrator, the insurer is responsible for determining the benefits, premium rates, underwriting criteria and claims payment procedures applicable to such coverage and for securing reinsurance, if any. The rules pertaining to these mat…
SDCL § 58-29D-14 Fiduciary capacity of administrator--Accounting of underwriting transactions
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All insurance charges or premiums collected by an administrator on behalf of or for an insurer or insurers, and the return of premiums received from that insurer or insurers, shall be held by the administrator in a fiduciary capacity. Such funds shall be immediately remitted to t…
SDCL § 58-29D-15 Records of deposits and withdrawals from fiduciary account
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If charges or premiums deposited in a fiduciary account have been collected on behalf of or for one or more insurers, the administrator shall keep records clearly recording the deposits in and withdrawals from the account on behalf of each insurer. The administrator shall keep co…
SDCL § 58-29D-16 Provisions in written agreement as to withdrawals from fiduciary account
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The administrator may not pay any claim by withdrawals from a fiduciary account in which premiums or charges are deposited. Withdrawals from such account shall be made as provided in the written agreement between the administrator and the insurer. The written agreement shall addr…
SDCL § 58-29D-17 SDCL 58-29D-17
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Repealed by SL 2012, ch 252 , § 37.
SDCL § 58-29D-18 Compensation of administrator
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An administrator may not enter into any agreement or understanding with an insurer in which the effect is to make the amount of the administrator's commissions, fees, or charges contingent upon savings effected in the adjustment, settlement, and payment of losses covered by the i…
SDCL § 58-29D-19 Notice of use of administrator to policyholder--Itemized charges--Disclosure of fees or commissions
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When the services of an administrator are utilized, the administrator shall provide a written notice approved by the insurer to covered individuals advising them of the identity of, and relationship among, the administrator, the policyholder, and the insurer. When an administrato…
SDCL § 58-29D-2 Administrator defined--Exceptions
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For the purposes of this chapter, an administrator or third - party administrator or TPA is a person who directly or indirectly solicits or effects coverage of, underwrites, collects charges or premiums from, or adjusts or settles claims on residents of this state, or residents o…
SDCL § 58-29D-20 Delivery of written communications from insurer
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Any policies, certificates, booklets, termination notices, or other written communications delivered by the insurer to the administrator for delivery to insured parties or covered individuals shall be delivered by the administrator promptly after receipt of instructions from the …
SDCL § 58-29D-20.1 Annual report to employer of self-funded health benefit plan claims experience
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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…
SDCL § 58-29D-21 Administrator's license or registration required
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No person may act as, or offer to act as, or hold himself out to be an administrator in this state without a valid license or registration as an administrator issued by the director. Source: SL 1992, ch 352 , § 21; SL 2001, ch 285 , § 3.
SDCL § 58-29D-22 Application by administrator--Contents--Fee
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An administrator shall apply to the director upon a form to be furnished by the director. The application shall include or be accompanied by the following information and documents: (1) All basic organizational documents of the administrator, including any articles of incorporati…
SDCL § 58-29D-22.1 Annual financial statement--Contents of application--Required audit
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Any annual financial statement or report required under § 58-29D-22 must be audited. The applicant is presumed to be solvent if the applicant has a positive net worth. If the applicant has been in existence for less than two fiscal years, the applicant shall include in the applic…
SDCL § 58-29D-23 Inspection of applicant's contracts
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The applicant shall make available for inspection by the director copies of all contracts with insurers or other persons utilizing the services of the administrator. Source: SL 1992, ch 352 , § 23.
SDCL § 58-29D-24 Denial of license
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The director may not issue a license if the director determines that the administrator, or any individual responsible for the conduct of affairs of the administrator as defined in subdivision 58-29D-22(3), is not qualified for licensure by reason of §
SDCL § 58-29D-25 Validity of license
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A license issued under this chapter shall remain valid, unless surrendered, suspended, or revoked by the director, for so long as the administrator continues in business in this state and remains in compliance with this chapter. Source: SL 1992, ch 352 , § 25.
SDCL § 58-29D-26 Conditions not requiring license
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An administrator is not required to hold a license as an administrator in this state if all of the following conditions are met: (1) The administrator has its principal place of business in another state; (2) The administrator is not soliciting business as an administrator in thi…
SDCL § 58-29D-27 Servicer of certain employee benefit plans--Exempt from licensure--Requirements
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A person is not required to hold a license as an administrator in this state if the person exclusively provides services to one or more bona fide employee benefit plans, each of which is established by an employer or an employee organization, or both, and for which the insurance …
SDCL § 58-29D-28 Notice of administrator's change in circumstance
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An administrator shall immediately notify the director of any material change in its ownership, control, or other fact or circumstance affecting its qualification for a license in this state. Source: SL 1992, ch 352 , § 28.
SDCL § 58-29D-29 Waiver of application requirements
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Upon request from an administrator, the director may waive the application requirements of § 58-29D-22 if the administrator has a valid license as an administrator issued in a state which has standards for administrators that are at least as stringent as those contained in this c…
SDCL § 58-29D-3 Insurer defined
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For the purposes of this chapter, an insurer is any person undertaking to provide workers' compensation, life or health insurance coverage in this state. An insurer includes a licensed insurance company, a prepaid hospital or medical care plan, a health maintenance organization, …
SDCL § 58-29D-30 Annual renewal of administrator--Fee--Lapse of license or registration
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Each administrator licensed or registered shall file an annual renewal for the preceding calendar year with the director on or before July first of each year, or within such extension of time as the director for good cause may grant. The renewal shall be in the form and contain s…
SDCL § 58-29D-31 Grounds for denial, suspension, or revocation of license or registration
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The application or annual renewal must be denied and the license or registration of an administrator must be suspended or revoked if the director finds that the administrator or applicant: (1) Is in an unsound financial condition; (2) Is using methods or practices in the conduct …
SDCL § 58-29D-32 Immediate suspension of license--No notice required
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The director may, in his discretion and without advance notice of hearing thereon, immediately suspend the certificate of any administrator if the director finds that one or more of the following circumstances exist: (1) The administrator is insolvent or impaired; (2) A proceedin…
SDCL § 58-29D-32.1 Notice of denial of application or renewal--Request for hearing--Hearing on suspension or revocation--Notice
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If the director denies an application or annual renewal for a license or registration, the director shall notify the applicant or licensee and advise, in writing, the applicant or licensee of the reason for the denial. The applicant or licensee may make a written request to the d…
SDCL § 58-29D-33 Money penalty in lieu of suspension or revocation
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If the director finds that one or more grounds exist for the denial of an application, suspension, or revocation of a license issued under this chapter, the director may, in lieu of denial, suspension, or revocation, impose a money penalty pursuant to §
SDCL § 58-29D-34 Promulgation of rules
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The director may promulgate rules pursuant to chapter 1-26 to provide for the enforcement and administration necessary to administer this chapter. Source: SL 1992, ch 352 , § 34.
SDCL § 58-29D-4 Written agreement between administrator and insurer
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No administrator may act as such without a written agreement between the administrator and the insurer, and such written agreement shall be retained as part of the official records of both the insurer and the administrator for the duration of the agreement and for five years ther…