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.
S.D. Admin. R. 20:06:53:75
General Authority: SDCL 58-17-87, 58-18-79.
Law Implemented: SDCL 58-17-87, 58-18-79.