ARSD 20:06:55:34. Issuer standards and certification criteria

In order to participate in an Exchange, a health insurance issuer must have in effect a certification issued or recognized by the director to demonstrate that each health plan it offers in an Exchange is a qualified health plan. The director may certify a health plan as a qualified health plan if the requirements of § 20:06:55:35 are met or the director determines that making the health plan available is in the interest of the qualified individuals and qualified employers. The director may not exclude a health plan on the following basis: (1) Such plan is a fee-for-service plan; (2) Through the imposition of premium price controls; or (3) That the health plan provides treatments necessary to prevent patients' deaths in circumstances determined to be inappropriate or too costly.