20:06:53:75.  One level of internal appeals. A health insurance issuer offering individual health insurance coverage may only have one level of internal appeals. A claimant may seek either external review or judicial review immediately after an adverse benefit determination is upheld in the first level of the internal appeals process.

          Source: 37 SDR 63, effective September 23, 2010; 37 SDR 111, effective December 7, 2010.

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

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