South Dakota Code § 58-41-3

Certificate of authority required for health maintenance organization or contracts--Violation as misdemeanor
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No person shall establish or operate a health maintenance organization in this state, nor sell or offer to sell, or solicit offers to purchase or receive advance or periodic consideration in conjunction with a health maintenance organization or health maintenance contract unless such organization has a certificate of authority under this chapter. Violation of this section is a Class 2 misdemeanor.

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