ARSD 20:06:56:09. Prohibited discriminatory benefit design

A health insurance issuer does not provide essential health benefits if its benefit design, or the implementation of its benefit design, discriminates based on an individual's age, expected length of life, present or predicted disability, degree of medical dependency, quality of life, or other health conditions. An issuer must not employ discriminatory marketing practices or benefit designs that will have the effect of discouraging the enrollment of individuals with significant health needs in nongrandfathered health plans. Issuers may continue to use reasonable medical management techniques that are evidence based.