STATE OF SOUTH DAKOTA
OFFICE OF
THE ATTORNEY GENERAL

August 21, 1975

Mr. Al A. Asher, Administrator
South Dakota Public Employees
Insurance System
222 East Capitol
Pierre, South Dakota 57501

OFFICIAL OPINION NO. 75-146

Mandatory participation of political subdivision employees in group insurance plan authorized by SDCL 3-12A

Dear Mr. Asher:

You have requested an opinion on the following question:

When a political subdivision participates in the group health insurance plan authorized by SDCL 3-12A, must all eligible employees be enrolled in the plan and thereafter, continue to participate until their employment is terminated or they otherwise become ineligible as provided by SDCL 3-12A-12.

You state that when more than one group health plan is involved in a claim, carriers will coordinate payments in an amount not to exceed one hundred percent. Thus, in some instances double coverage exists and would seem to result in a waste of tax dollars.

SDCL 3-12A-11 states as follows:

Political subdivision employees included in plan.-Upon the admission of a political subdivision to participate in the insurance plan, all employees eligible for membership in the insurance plan upon its admission date shall be enrolled in the plan.

However SDCL 3-12A-12 exclude employees in the following classes:

(1) Those political subdivision employees who are not employed on a permanent full-time basis as determined by the board; or

(2) Those political subdivision employees who are covered by the plan under the option to have dependents covered.

Subdivision 1 excludes part-time employees from the plan. Subdivision 2 excludes those employees who are within the definition of dependents under SDCL 3-l2A-1(6) and are covered under the state plan pursuant to SDCL 3-l2A-14. The law does not provide an exclusion for employees who may qualify as "dependents" under a group health plan other than the state plan.

Therefore, it is my opinion that the Legislature has specifically set forth in SDCL 3-12A-12 those political subdivision employees who are excluded from member participation in the plan. All other eligible employees are required to participate.

Respectfully submitted,

William Janklow
Attorney General

WJJ:LLV:jak