{"data":{"id":"us-sd/sdcl-58-12-26","jurisdiction":"us-sd","citation":"SDCL § 58-12-26","heading":"Insurer defined.","body":"For the purposes of §§ 58-12-22 to 58-12-28, inclusive, the term, insurer, means:\n(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;\n(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;\n(3) Any other entity offering health benefits for which a medicaid recipient may be eligible in addition to public medical assistance;\n(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\n(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.","path":["TITLE 58. INSURANCE","CHAPTER 58-12. INSURANCE CLAIMS AND BENEFITS"],"source_url":"https://sdlegislature.gov/Statutes/58-12-26","current_through":"2026-08-31","vintage":"","retrieved_at":"2026-09-03T15:18:57Z","sha256":"972cfd6938f8eaf9010deff6c0497ad48b2bdd65b9d54dc58ddc928323cb50ff","source_id":"us-sd","stale":true,"prev":"us-sd/sdcl-58-12-25","next":"us-sd/sdcl-58-12-27"},"notice":"GroundRules: Original legal text. Not legal advice."}