If you buy health insurance on the individual market, without help from an employer, you may want to know what South Dakota is doing to protect you from unfair and unnecessary premium rate increases. Here’s a summary of the South Dakota laws that govern rate increases.
- South Dakota has authority to pre-approve rate increases before they go into effect for HMOs and insurers. S.D. Codified Laws § 58-41-46 (HMOs); S.D. Codified Laws § 58-17-4.1 (accident and health insurance).
- HMO rates may not be “excessive, inadequate, or unfairly discriminatory. S.D. Codified Laws § 58-41-44.
- Rates for insurers must be “reasonable in relation to the benefits available.” S.D. Codified Laws § 58-17-4.2.
- Rates are deemed approved if they are not disapproved 30 days after filing. S.D. Codified Laws § 58-41-26; S.D. Codified Laws § 58-17-4.1.
- Nonprofit insurers and HMOs must provide their members with at least 45 days’ notice of any change in benefits or premiums. S.D. Codified Laws § 58-38-28; S.D. Codified Laws § 58-40-25; S.D. Codified Laws § 58-41-102.
- By regulation, all individual policies must have a minimum loss ratio of 80%. ARSD 20:06:22:02.