ARSD 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.