<html> <head> <title>Rule 55:08:06:01 Notice of denial of claim.</title> <META NAME="Keywords" Content="Administrative Rules 55:08:06:01"> <META NAME="Description" Content="Administrative Rules 55:08:06:01 Notice of denial of claim."> <meta http-equiv=Content-Type content="text/html; charset=windows-1252"> <meta name=Generator content="Microsoft Word 14 (filtered)"> <style> <!-- /* Font Definitions */ @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {margin:0in; margin-bottom:.0001pt; font-size:12.0pt; font-family:"Times New Roman","serif";} .MsoChpDefault {font-size:10.0pt;} @page WordSection1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in;} div.WordSection1 {page:WordSection1;} --> </style> </head> <body lang=EN-US> <div class=WordSection1> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>55:08:06:01.&nbsp;&nbsp;Notice of denial of claim.</b> The benefits manager shall provide written notice to an eligible employee whose claim for benefits is denied. The notice shall include the specific reason for denial, including reference to the plan provision upon which denial is based, and a description of additional material or information necessary for the eligible employee to complete the employee s claim, including an explanation of the claims review procedure.</p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Source:</b> 38 SDR 213, effective July 1, 2012.</p> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>General Authority:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=3-6E-13">3-6E-13.</A></p> <p class=MsoNormal style='text-align:justify'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <b>Law Implemented:</b> SDCL <A HREF="/statutes/DisplayStatute.aspx?Type=Statute&Statute=3-6E-1">3-6E-1.</A></p> <p class=MsoNormal style='text-align:justify'>&nbsp;</p> </div> </body> </html>