# S.D. Codified Laws § 58-17H-2: Health benefit plan defined > South Dakota · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-2 ## Section - **Citation:** S.D. Codified Laws § 58-17H-2 - **Heading:** Health benefit plan defined - **Jurisdiction:** South Dakota - **Kind:** Statutes - **Status:** In force - **Text as of:** August 14, 2026 - **Source:** Compiled text - **Location:** SD Code / Title 58 / Chapter 17H / Section 58-17H-2 ## Text For the purposes of this chapter, the term, health benefit plan, means a policy, contract, certificate, or agreement entered into, offered, or issued by a health carrier to provide, deliver, arrange for, pay for, or reimburse any of the costs of health care services. The term includes short-term and catastrophic health insurance policies, and a policy that pays on a cost-incurred basis, except as otherwise specifically exempted in this definition. The term does not include coverage only for accident, or disability income insurance, or any combination thereof; coverage issued as a supplement to liability insurance; liability insurance, including general liability insurance and automobile liability insurance; workers' compensation or similar insurance; automobile medical payment insurance; credit-only insurance; coverage for on-site medical clinics; and other similar insurance coverage, specified in federal regulations issued pursuant to Public Law No. 104-191, as amended to January 1, 2011, under which benefits for medical care are secondary or incidental to other insurance benefits. The term does not include the following benefits if they are provided under a separate policy, certificate, or contract of insurance or are otherwise not an integral part of the plan: limited scope dental or vision benefits; benefits for long-term care, nursing home care, home health care, community-based care, or any combination thereof; or other similar, limited benefits specified in federal regulations issued pursuant to Public Law No. 104-191, as amended to January 1, 2011. The term does not include the following benefits if the benefits are provided under a separate policy, certificate, or contract of insurance, there is no coordination between the provision of the benefits and any exclusion of benefits under any group health plan maintained by the same plan sponsor, and the benefits are paid with respect to an event without regard to whether benefits are provided with respect to such an event under any group health plan maintained by the same plan sponsor: coverage only for a specified disease or illness; or hospital indemnity or other fixed indemnity insurance. The term does not include the following if offered as a separate policy, certificate, or contract of insurance: medicare supplemental health insurance as defined under Section 1882(g)(1) of the Social Security Act, as amended to January 1, 2011; coverage supplemental to the coverage provided under Chapter 55 of Title 10, United States Code (Civilian Health and Medical Program of the Uniformed Services (CHAMPUS)), as amended to January 1, 2011; or similar supplemental coverage provided to coverage under a group health plan. Commission Note: SL 2012, ch 239, § 1 provides: "The provisions of chapter 219 of the 2011 Session Laws shall be deemed repealed if the Patient Protection and Affordable Care Act, Pub. L. No. 111-148, 124 Stat. 119 (2010), as amended by the Health Care and Education Reconciliation Act of 2010, Pub. L. No. 111-152, 124 Stat. 1029 (2010) is found to be unconstitutional in its entirety by a final decision of a federal court of competent jurisdiction and all appeals exhausted or time for appeals elapsed." Source: SL 2011, ch 219, § 91; SL 2021, ch 210, § 14. ## Nearby sections - [S.D. Codified Laws § 58-17H-1 Definitions](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-1.md) - [S.D. Codified Laws § 58-17H-2 Health benefit plan defined](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-2.md) - [S.D. Codified Laws § 58-17H-3 Urgent care request defined](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-3.md) - [S.D. Codified Laws § 58-17H-4 Applicability of chapter](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-4.md) - [S.D. Codified Laws § 58-17H-5 Health carrier to provide emergency services coverage without requiring prior authorization--Standards for coverage of emergency services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-5.md) - [S.D. Codified Laws § 58-17H-6 In-network emergency services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-6.md) - [S.D. Codified Laws § 58-17H-7 Cost-sharing requirements for out-of-network emergency services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-7.md) - [S.D. Codified Laws § 58-17H-8 Cost-sharing requirements for covered persons--Payments to out-of-network providers](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-8.md) - [S.D. Codified Laws § 58-17H-9 Exceptions for payments by capitated and other plans without negotiated fees](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-9.md) - [S.D. Codified Laws § 58-17H-10 Negotiated amounts for in-network providers for a particular emergency service](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-10.md) - [S.D. Codified Laws § 58-17H-11 General cost-sharing requirements allowed](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-11.md) - [S.D. Codified Laws § 58-17H-12 Access to representative for post-evaluation or post-stabilization services](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-12.md) - [S.D. Codified Laws § 58-17H-13 Health carrier may be deemed to meet emergency medical coverage requirements if met by private accrediting body](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-13.md) - [S.D. Codified Laws § 58-17H-14 Health carrier responsibility for utilization review activities](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-14.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17H_S58-17H-2. Check the current official text before relying on it. Not legal advice.