20:06:58:40.  Participants and beneficiaries -- Content of notice. The notice to participants and beneficiaries required pursuant to § 20:06:58:39 must include the following information:

          (1)  A statement that the plan or issuer is exempt from the requirements of this section and a description of the basis for the exemption;

          (2)  The name and telephone number of the individual to contact for further information;

          (3)  The plan or issuer name and plan number (PN);

          (4)  The plan administrator's name, address, and telephone number;

          (5)  For single-employer plans, the plan sponsor's name, address, and telephone number, if different from subdivision 3 of this section, and the plan sponsor's employer identification number (EIN);

          (6)  The effective date of such exemption;

          (7)  A statement regarding the ability of participants and beneficiaries to contact the plan administrator or health insurance issuer to see how benefits may be affected as a result of the plan's or issuer's election of the exemption; and

          (8)  A statement regarding the availability, upon request and free of charge, of a summary of the information on which the exemption is based, as required under § 20:06:58:43.

          Source: 41 SDR 93, effective December 3, 2014.

          General Authority: SDCL 58-17-87, 58-18-79, 58-18-79(15).

          Law Implemented: SDCL 58-17-87, 58-18-79, 58-18-80.