20:06:40:01.  Waiting periods, affiliation periods, and applications relating to breaks in coverage. Waiting periods and delays in the provision of coverage by the employer do not count toward the maximum break in coverage of 63 days. An affiliation period may not be used in counting toward the maximum break in coverage. Any waiting period for a new employee to be eligible to enroll in the employer’s health benefit plan counts toward the satisfaction of any waiting period for preexisting conditions contained in that health benefit plan. For employees who have a waiting period after employment to qualify for coverage under the employer’s health benefit plan, the enrollment date is the date of employment. For late enrollees, the enrollment date is the date coverage begins. The time period after substantial completion of an application for coverage does not count toward the maximum 63-day break in coverage whether or not coverage is ultimately obtained. If an individual withdraws a pending application or fails to fully complete a pending application after a reasonable period of time, the carrier may count the period of time since substantial completion of the application toward the maximum break in coverage of 63 days.

          Source: 24 SDR 35, effective September 19, 1997.

          General Authority: SDCL 58-18-79.

          Law Implemented: SDCL 58-18-43, 58-18-44, 58-18-45, 58-18-48, 58-18-79.