§ 58-29C-46B(1). This chapter shall provide coverage to the persons specified in subpart A for the policies or contracts of direct, nongroup life insurance, health insurance, or annuities, and for certificates under direct group policies and contracts, and for supplemental contracts to any of these, in each case except as limited by this chapter. Annuity contracts and certificates under group annuity contracts include allocated funding agreements, structured settlement annuities, and any immediate or deferred annuity contracts.(Amended effective 7/1/13) [Please note that during its 2005 session the South Dakota legislature enacted statutes which authorize the creation of a self-funded multiple employer trust to provide health benefits (see SDCL 58-18-88 through 94). The new statutes concerning MEWAs provide that a proposed MEWA must first obtain authorization from the director of the South Dakota Division of Insurance before it may provide health benefits. The statutes provide that any MEWA authorized by the director shall be a member of the South Dakota Life and Health Insurance Guaranty Association. Presumably, these statutes concerning MEWAs by implication amend the section of South Dakota's guaranty association law that provides that MEWAs are not covered].
§ 58-29C-46B(2) (a) A portion of a policy or contract not guaranteed by the member insurer, or under which the risk is borne by the policy or contract owner; (b) A policy or contract of reinsurance, unless assumption certificates have been issued pursuant to the reinsurance policy or contract; (c) A portion of a policy or contract to the extent that the rate of interest on which it is based, or the interest rate, crediting rate, or similar factor determined by use of an index or other external reference stated in the policy or contract employed in calculating returns or changes in value: (i) Averaged over the period of four years prior to the date on which the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier, exceeds the rate of interest determined by subtracting two percentage points from Moody's Corporate Bond Yield Average averaged for that same four-year period or for such lesser period if the policy or contract was issued less than four years before the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier; and (ii) On and after the date on which the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier, exceeds the rate of interest determined by subtracting three percentage points from Moody's Corporate Bond Yield Average as most recently available; (d) A portion of a policy or contract issued to a plan or program of an employer, association, or other person to provide life, health, or annuity benefits to its employees, members, or others, to the extent that the plan or program is self-funded or uninsured, including benefits payable by an employer, association, or other person under: (i) A multiple employer welfare arrangement as defined in section 3(40) of the Employee Retirement Income Security Act of 1974 (29 U.S.C. § 1002(40)); (ii) A minimum premium group insurance plan; (iii) A stop-loss group insurance plan; or (iv) An administrative services only contract; (e) A portion of a policy or contract to the extent that it provides for: (i) Dividends or experience rating credits; (ii) Voting rights; or (iii) Payment of any fees or allowances to any person, including the policy or contract owner, in connection with the service to or administration of the policy or contract; (f) A policy or contract issued in this state by a member insurer at a time when it was not licensed or did not have a certificate of authority to issue the policy or contract in this state; (g) A portion of a policy or contract to the extent that the assessments required by 58-29C-52 with respect to the policy or contract are preempted by federal or state law; (h) An obligation that does not arise under the express written terms of the policy or contract issued by the member insurer to the certificate holder, contract owner or policy owner, including without limitation: (i) Claims based on marketing materials; (ii) Claims based on side letters, riders, or other documents that were issued by the member insurer without meeting applicable policy or contract form filing or approval requirements; (iii) Misrepresentations of or regarding policy or contract benefits; (iv) Extra-contractual claims; or (v) A claim for penalties or consequential or incidental damages; (i) A contractual agreement that establishes the member insurer's obligations to provide a book value accounting guaranty for defined contribution benefit plan participants by reference to a portfolio of assets that is owned by the benefit plan or its trustee, which in each case is not an affiliate of the member insurer; (j) An unallocated annuity contract; (k) A portion of a policy or contract to the extent it provides for interest or other changes in value to be determined by the use of an index or other external reference stated in the policy or contract, but which have not been credited to the policy or contract, or as to which the policy or contract owner's rights are subject to forfeiture, as of the date the member insurer becomes an impaired or insolvent insurer under this chapter, whichever is earlier. If a policy's or contract's interest or changes in value are credited less frequently than annually, for purposes of determining the values that have been credited and are not subject to forfeiture under this subsection, the interest or change in value determined by using the procedures defined in the policy or contract shall be credited as if the contractual date of crediting interest or changing values was the date of impairment or insolvency, whichever is earlier, and will not be subject to forfeiture; and (l) A policy or contract providing any hospital, medical, prescription drug, or other health care benefits pursuant to Part C or Part D of Subchapter XVIII Chapter 7 of Title 42 of the United States Code (commonly known as Medicare Part C & D), or Subchapter XIX, Chapter 7 Title 42 of the United States Code (commonly known as Medicaid), or any regulations issued pursuant thereto. (3) The exclusion from coverage under subsection (2)(c) of this subdivision does not apply to any portion of a policy or contract, including a rider, that provides long-term care or any other health insurance benefits.
§ 58-29C-46A(2)(b). Yes. Covers nonresidents, but only under all of the following conditions: (i) The member insurer that issued the policies or contracts is domiciled in South Dakota; (ii) The states in which the persons reside have associations similar to the association created by this chapter; and (iii) The persons are not eligible for coverage by an association in any other state due to the fact that the insurer was not licensed in the state at the time specified in the state's guaranty association law;
§58-29C-51A. When a member insurer is an impaired insurer. Effective July 1, 2003 (prior statute repealed).
§58-29C-51B. When a member insurer is insolvent. Effective July 1, 2003 (prior statute repealed).
No separate provision.
§58-29C-48(10). A member insurer which, after July 1, 2003, is not an insolvent insurer, and is placed under an order of rehabilitation or conservation by a court of competent jurisdiction. Effective July 1, 2003 (prior statute repealed).
§58-29C-48(11). A member insurer which after July 1, 2003, is placed under an order of liquidation by a court of competent jurisdiction with a finding of insolvency. Effective July 1, 2003 (prior statute repealed).
§58-29C-48(12) “Member insurer,” an insurer licensed or that holds a certificate of authority to transact in this state any kind of insurance for which coverage is provided under § 58–29C–46, and includes an insurer whose license or certificate of authority in this state may have been suspended, revoked, not renewed, or voluntarily withdrawn, but does not include: (a) A hospital or medical service organization, whether for profit or nonprofit; (b) A health maintenance organization; (c) A fraternal benefit society; (d) A mandatory state pooling plan; (e) A mutual assessment company or other person that operates on an assessment basis; (f) An insurance exchange; (g) An organization engaged in the issuance of charitable gift annuities, which is described in § 58–1–16; or (h) An entity similar to any of the above; (Amended effective 7/1/13)
§58-29C-52E(1)(a). Two percent (2%) of the average premiums in state for policies covered by the account during the three calendar years preceding the impairment or insolvency. Effective July 1, 2003 (prior statute repealed).
§58-29C-52B. Two classes of assessments: Class A assessments for the purpose of meeting administrative and legal costs and other expenses; and Class B assessments to carry out the powers and duties of the association under § 58-29C-51 with regard to an impaired or an insolvent insurer. Effective July 1, 2003 (prior statute repealed).