2020 South Dakota Codified Laws
Title 58 - Insurance
Chapter 12 - Insurance Claims And Benefits
Section 58-12-26 - Insurer defined.
58-12-26. Insurer defined.
For the purposes of §§58-12-22 to 58-12-28, inclusive, the term, insurer, means:
(1)Any commercial insurance company, employer-employee benefit plan, health maintenance organization, professional association, service benefit plan, public self-funded employer or pool, union, or fraternal group selling or otherwise offering individual or group health insurance coverage including self-insured and self-funded plans;
(2)Any profit or nonprofit prepaid plan offering either medical services of full or partial payment for services included in the department's medicaid plan;
(3)Any other entity offering health benefits for which a medicaid recipient may be eligible in addition to public medical assistance;
(4)Any managed care organization, third-party administrator, pharmacy benefits manager, or other entity which processes claims, administers services, or otherwise manages health benefits on behalf of any of the aforementioned insurers; or
(5)Any other party that is by statute, contract, or agreement, legally responsible for payment of a claim for a health care item or service including workers' compensation, automobile insurance, and liability insurance plans.
Source: SL 2005, ch 263, §5; SL 2007, ch 286, §3; SL 2021, ch 210, § 6.
