Rule 20:06:13:56 Continuation and conversion rights.
and conversion rights. Group members of a group Medicare supplement
insurance policy may continue or convert their rights under the following
(1) If a group Medicare
supplement insurance policy is terminated by the group policyholder and not
replaced as provided in subdivision (3) of this section, the issuer shall offer
certificateholders an individual Medicare supplement policy. The issuer shall
offer certificateholders at least the following choices:
(a) Continuation of
benefits contained in the group policy; or
(b) An individual
policy which provides for benefits which otherwise meets the requirements of
(2) If membership in a
group is terminated, the issuer shall:
(a) Offer the certificateholder
the conversion opportunities described in subdivision (1) of this section; or
(b) At the option of
the group policyholder, offer the certificateholder continuation of coverage
under the group policy;
(3) If a group Medicare
supplement policy is replaced by another group Medicare supplement policy
purchased by the same policyholder, the succeeding issuer shall offer coverage
to all persons covered under the old group policy on its date of termination.
Coverage under the new group policy may not result in any exclusion for
preexisting conditions that would have been covered under the group policy
This section applies to 1990
standardized Medicare supplement benefit plans as well as 2010 standardized
Medicare supplement benefit plans.
16 SDR 174, effective May 2, 1990; 18 SDR 225, effective July 17, 1992; 35 SDR
183, effective February 2, 2009; 36 SDR 209, effective July 1, 2010.
Authority: SDCL 58-4-1, 58-17A-2.
Implemented: SDCL 58-17A-2, 58-17A-3.1.
Minimum benefit standards, § 20:06:13:17.
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