# S.D. Codified Laws § 58-17I-2: Health benefit plan defined > South Dakota · Statutes · In force URL: https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-2 ## Section - **Citation:** S.D. Codified Laws § 58-17I-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 17I / Section 58-17I-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, § 93; SL 2021, ch 210, § 15. ## Nearby sections - [S.D. Codified Laws § 58-17I-1 Definitions](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-1.md) - [S.D. Codified Laws § 58-17I-2 Health benefit plan defined](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-2.md) - [S.D. Codified Laws § 58-17I-3 Urgent care request defined](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-3.md) - [S.D. Codified Laws § 58-17I-4 Register of grievances required--Information to be compiled--Maintenance](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-4.md) - [S.D. Codified Laws § 58-17I-6 Grievance procedures--Filing--Certificate of compliance--Contact information](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-6.md) - [S.D. Codified Laws § 58-17I-7 Review of adverse determination--Time for filing--Designation and notice of reviewers--Scope of review](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-7.md) - [S.D. Codified Laws § 58-17I-8 Rights of covered person or authorized representative on review--Access to documentation](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-8.md) - [S.D. Codified Laws § 58-17I-9 Time for decision and notice--Calculation of time periods](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-9.md) - [S.D. Codified Laws § 58-17I-10 Procedures for providing new or additional evidence](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-10.md) - [S.D. Codified Laws § 58-17I-11 Issuance of decision--Required contents](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-11.md) - [S.D. Codified Laws § 58-17I-12 Expedited review for adverse determinations involving urgent care requests--Appointment of peers for review](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-12.md) - [S.D. Codified Laws § 58-17I-13 Transmission of necessary information for certain expedited reviews](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-13.md) - [S.D. Codified Laws § 58-17I-14 Expedited review decision not initial determination for benefits--Notification--Time periods--Continuation of service involving concurrent review urgent care requests](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-14.md) - [S.D. Codified Laws § 58-17I-15 Expedited review decision--Notification--Required contents](https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-15.md) --- Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_SD_T58_C17I_S58-17I-2. Check the current official text before relying on it. Not legal advice.