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  • Topic: Health Insurance Nondiscrimination
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State Citation/Title Ascending Order
(link to state's page)
Topic(s) Summary
Alabama State Statute
opens new window Alabama: Code of Ala. 27-5-13
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
Health and disability insurers may not deny applicants insurance coverage because of a diagnosis of sickle cell anemia.
Alabama State Statute
opens new window Alabama: Code of Ala. 27-53-1 et seq.
Health Insurance Nondiscrimination Health benefit plans, including the Alabama Medicaid Agency, may not require a genetic test to determine if a person has a predisposition to cancer as a condition of insurability or use the results of such a test to determine insurability or discriminate with respect to rates or benefits. The statutes set forth penalties for insurance companies or health maintenance organizations that violate the law.
Alaska State Statute
opens new window Alaska: AS 21.36.480
Health Insurance Nondiscrimination Health care insurers offering individual or group plans must comply with the genetic information nondiscrimination requirements established under 42 USC 300gg-53, or 42 U.S.C. 300gg-1(b)(3), 42 U.S.C. 300gg-1(c) - (f), and 42 U.S.C. 300gg-91, respectively.
Alaska State Statute
opens new window Alaska: AS 21.54.100 et seq.
Health Insurance Nondiscrimination Health care insurers in the group market may not establish rules for eligibility or continued eligibility based on genetic information or impose preexisting condition exclusions based on genetic information in the absence of a diagnosis.
Arizona State Statute
opens new window Arizona: ARS 20-1379
Health Insurance Nondiscrimination Genetic information is a health status-related factor that may not be used as the basis for denial of coverage or as the basis for a pre-existing condition exclusion in the absence of a diagnosis in the individual health insurance market.
Arizona State Statute
opens new window Arizona: ARS 20-2301 et seq.
Health Insurance Nondiscrimination Accountable health plans may not (1) deny, limit or condition coverage or benefits based on health status-related factors, including genetic information or (2) impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis.
Arizona State Statute
opens new window Arizona: ARS 20-448
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
Life and disability insurers (disability insurance is defined in the statutes to include health insurers) may not refuse to consider an application on the basis of a genetic condition. Information about a genetic condition may not be used for underwriting or ratemaking of life and disability insurance policies unless supported by the applicants medical condition, medical history and either claims experience or actuarial projections. In the case of disability insurance the use of information about a genetic condition for underwriting or ratemaking purposes constitutes unfair discrimination in the absence of a diagnosis.
Arizona State Statute
opens new window Arizona: ARS 36-2912
Health Insurance Nondiscrimination Health benefit plans offered by the administration for the healthcare group program may not (1) deny, limit or condition coverage or benefits based on health status-related factors, including genetic information or (2) impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis.
Arkansas State Statute
opens new window Arkansas: Ark. Code 23-66-320
Health Insurance Nondiscrimination Insurers except those offering life, disability income and long-term care plans may not request or require an individual or family member to obtain a genetic test for the purpose of determining eligibility, establishing premiums, limiting, renewing or terminating coverage, or another other underwriting activity or condition a policy on an individual taking a genetic test.
Arkansas State Statute
opens new window Arkansas: Ark. Code 23-86-304 et seq.
Health Insurance Nondiscrimination Preexisting condition exclusions may not be based on genetic information in the absence of a diagnosis. Insurers issuing group health plans may not establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information.
California State Statute
opens new window California: Cal. Civil Code 56.17
Health Insurance Nondiscrimination,
Privacy
A person who negligently or willfully discloses genetic test results in an individuals medical records who is applying for or enrolled in a health care service plan, except with written authorization in the format specified, is subject to fines as set forth in the statutes.
California State Statute
opens new window California: Cal. Health and Safety Code 1358.24
and Insurance Code 10192.24
Health Insurance Nondiscrimination An issuer of a Medicare supplement contract must adhere to the requirements imposed by the federal Genetic Information Nondiscrimination Act of 2008 (Public Law 110-233).
California State Statute
opens new window California: Cal. Health and Safety Code 1374.7
Insurance Code 10123.3 et seq.
and 742.405 et seq.
Health Insurance Nondiscrimination Health care service plans, self-insured employee welfare benefit plans, and multiple employer welfare arrangements may not refuse to enroll any person, refuse to accept or renew a subscriber, charge a higher rate, or offer different terms, conditions or benefits on the basis of genetic characteristics that may be associated with disability in that person or that persons offspring. A plan may not seek information about genetic characteristics for non-therapeutic purposes. Specific penalties are set forth for violations by self-insured employee welfare benefit plans and multiple employer welfare arrangements.
California State Statute
opens new window California: Cal. Health and Safety Code 1399.804
and Insurance Code 10902.1
Health Insurance Nondiscrimination Health care service plans and carriers, agents or brokers offering health benefit plans to individuals or solicitors may not encourage or direct federally eligible defined individuals to refrain from an application for coverage because of genetic information. Plans, agents or brokers may not enter into any contract, agreement or arrangement with a solicitor that provides for or results in the compensation paid to a solicitor for the sale of a health care service plan contract or health benefit plan design to be varied because of genetic information.
California State Statute
opens new window California: Cal. Health and Safety Code 1357.03 and 1357.52
Insurance Code 10198.9 and 10705
Health Insurance Nondiscrimination Small group health policies or contracts may not establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information. Except in the case of a late enrollee or for satisfaction of a preexisting condition clause these plans as well as disability insurers providing coverage for health care services may not exclude any eligible employee or dependent based on genetic information.
California State Statute
opens new window California: Cal. Ins. Code 10950 et seq. and Health and Safety Code 1399.825 et seq.
Health Insurance Nondiscrimination The statutes require carriers and health care service plans offering plan contracts in the individual market, other than individual grandfathered plan coverage, to offer to the responsible party for a child coverage for the child that does not exclude or limit coverage due to any preexisting condition of the child. A health care service plan may not condition the issuance or offering of individual coverage on certain factors, including genetic information.
California State Statute
opens new window California: Cal. Insurance Code 10140 et seq.
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
Disability insurers covering hospital, medical and surgical expenses may not fail or refuse to accept an application, fail or refuse to issue insurance, cancel or refuse to renew insurance, charge a higher rate or premium, offer or provide different terms, conditions or benefits, or place a limitation on coverage based on genetic characteristics that may be associated with disability in a person of that persons offspring. These insurers also may not seek information about a persons genetic characteristics for non-therapeutic purposes. Specific penalties are set forth for violations. Life and disability insurers may not discriminate based solely on the fact that the person to be insured carries a gene that may be associated with disability in that person or the persons offspring, but which causes no adverse effects in the carrier, including but not limited to Tay-Sachs trait, sickle cell trait, thalassemia trait, and X-linked hemophilia trait.
Colorado State Statute
opens new window Colorado: CRS 10-16-02
Health Insurance Nondiscrimination Health-status related factor is defined to include genetic information in Title 10 Article 16, which pertains to health care coverage.
Colorado State Statute
opens new window Colorado: CRS 10-3-1104.6
Health Insurance Nondiscrimination,
Privacy,
Research
Genetic information the property of the individual, and written consent is required for its disclosure other than for diagnosis, treatment or therapy. Health care entities may not retain or use genetic information for non-therapeutic purposes or request or require a genetic test; however, test results may be used on a limited basis to make payment decisions. Exceptions under the law include the use of genetic information for scientific research if the identity of the individual to whom the genetic information pertains is not disclosed to a third party other than the individuals physician with written consent. The law provides remedies for individuals whose rights are violated.
Connecticut State Statute
opens new window Connecticut: GSC 38a 476
Health Insurance Nondiscrimination Any hospital and medical expense incurred policy, hospital or medical service plan contract and health care center subscriber contract providing individual or group health insurance coverage may not refuse to insure, continue to insure, limit coverage, or charge an individual a different rate because of genetic information. In this type of coverage and all health insurance plans pre-existing condition exclusions may not be based on genetic information in the absence of a diagnosis.
Connecticut State Statute
opens new window Connecticut: GSC 38a 816
Health Insurance Nondiscrimination An insurance company, hospital service corporation, health care center or fraternal benefit society providing individual or group health insurance coverage may not refuse to insure, continue to insure, limit coverage, or charge an individual a different rate because of genetic information. In this type of coverage and all health insurance plans pre-existing condition exclusions may not be based on genetic information in the absence of a diagnosis.
District of Columbia State Statute
opens new window DC Official Code 2-1401.01 et seq.
Employment Nondiscrimination,
Health Insurance Nondiscrimination
Employers, employment agencies and labor organizations may not discriminate based on genetic information with some exceptions such as to investigate a workers' compensation claim. A health benefit plan or health insurer may not establish rules for the eligibility or adjust premium or contribution amounts for an individual on the basis of genetic information concerning the individual or his/her family member, including information about a request for or receipt of genetic services by an individual or the individual's family member. Health insurers also may not require or request a genetic test.
Delaware State Statute
opens new window Delaware: Del. Code 18 2317
Health Insurance Nondiscrimination Discrimination is prohibited in the issuance, denial or renewal of or in the fixing of the rates, terms or conditions for health insurance, excluding disability or long-term care insurance. The law provides for a cause of action in the nature of defamation, invasion of privacy or negligence with some exceptions.
Delaware State Statute
opens new window Delaware: Del. Code 18 3571M
3572
3602
3611
and 7202
Health Insurance Nondiscrimination A health status-related factor is defined to include genetic information with respect to large group health plans, individual health plans and small employer health insurance. Group health insurers may not establish rules for eligibility of an individual to enroll based on a health status related factor. Individual health insurers may not establish rules for eligibility of an individual to enroll under the terms of the coverage based on a health status-related factor.
Florida State Statute
opens new window Florida: FS 627.6561 et seq.
Health Insurance Nondiscrimination An insurer that offers a group health insurance policy may not establish rules for eligibility or continued eligibility based on certain health status-related factors, including genetic information or use genetic information in the absence of a diagnosis as the basis for a pre-existing condition exclusion.
Florida State Statute
opens new window Florida: FS 641.31071 et seq.
Health Insurance Nondiscrimination Health care service programs may not treat genetic information as a preexisting condition in the absence of a diagnosis. A health maintenance organization that offers group health insurance coverage may not establish rules for eligibility or continued eligibility of an individual to enroll under the terms of the contract based on certain health status-related factors, including genetic information.
Florida State Statute
opens new window Florida: FS 627.4301
636.0201
and 641.438
Health Insurance Nondiscrimination Insurers offering health insurance, a self-insured plan, a multiple employer welfare arrangement, a prepaid limited health service organization, a health maintenance organization, a prepaid health clinic, a fraternal benefit society or any health care arrangement where risk is assumed may not cancel, limit, or deny coverage or establish differentials in premium rates based on genetic information in the absence of a diagnosis. Health insurers may not require or solicit genetic information, use genetic test results, or consider a person's decisions or actions relating to genetic testing for any insurance purpose. The law does not apply to a life insurance policy, disability income policy, long-term care policy, accident-only policy, hospital indemnity or fixed indemnity policy, dental policy, or vision policy.
Georgia State Statute
opens new window Georgia: OCGA 33-54-1 et seq.
Health Insurance Nondiscrimination,
Privacy,
Research
Genetic information is the property of the individual tested. Prior written authorization is required for genetic testing and release of results to anyone other than the person tested. A fraternal benefit society, a nonprofit medical service corporation, a health care corporation, a health maintenance corporation, or a self-insured health plan not subject to the exclusive jurisdiction of ERISA may not seek information derived from genetic testing, and if it is received, the information may not be used for any nontherapeutic purpose or be released without explicit written consent. Exceptions include scientific research facilities, which may conduct genetic testing and use information derived from testing for scientific research if the identity of any individual tested is not disclosed to any third party, except to an individual's physician with consent.
Hawaii State Statute
opens new window Hawaii: HRS 431:10A-118
431:10A-404.5
432:1-607
432:2-404.5
and 432D-26
Health Insurance Nondiscrimination,
Privacy
No insurer providing accident and health or sickness insurance coverage or extended health insurance coverage, mutual benefit society, fraternal benefit society, or health maintenance organization may use an individual's or a family member's genetic information or a request for genetic services to (1) deny or limit any coverage or (2) establish eligibility, continuation, enrollment, or premium payment. These entities may not request or require collection or disclosure of genetic information of an individual or family member or disclose genetic information without written consent.
Idaho State Statute
opens new window Idaho: IC 41-1313
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
With respect to disability insurance or any health benefit plan, no person may discriminate on the basis of a genetic test or private genetic information in the issuance of coverage or the fixing of rates, terms or conditions.
Idaho State Statute
opens new window Idaho: IC 41-2221
41-3940
and 41-4708
Health Insurance Nondiscrimination General managed care plans and health benefit plans covering large and small employers may not treat genetic information in the absence of a diagnosis as a pre-existing condition.
Illinois State Statute
opens new window Illinois: 215 ILCS 5/356v
Health Insurance Nondiscrimination An insurer must comply with the provisions of the Genetic Information Privacy Act in connection with the amendment, delivery, issuance, or renewal of, or claims for or denial of coverage under, an individual or group policy of accident and health insurance. Genetic information may not be treated as a pre-existing condition in the absence of a diagnosis of the condition under the Illinois Health Insurance Portability and Accountability Act.
Illinois State Statute
opens new window Illinois: 215 ILCS 97/20 and 97/25
Health Insurance Nondiscrimination A group health plan and a health insurance issuer offering group health insurance coverage may not impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis or establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information.
Illinois State Statute
opens new window Illinois: 410 ILCS 513/1 et seq.
Employment Nondiscrimination,
Health Insurance Nondiscrimination,
Privacy
Genetic information may only be released to the individual tested and to other authorized persons with a few exceptions. An insurer may not seek information derived from genetic testing for use in connection with a policy of accident and health insurance, and an insurer that receives this information may not use it for non-therapeutic purposes unless the favorable results of a genetic test are voluntarily submitted. An employer, employment agency, labor organization, and licensing agency must treat genetic testing and genetic information in a manner that is consistent with federal law, including but not limited to the Genetic Information Nondiscrimination Act of 2008. Prohibited actions by employers, employment agencies and labor organizations are specified. No person may disclose the identity of any person upon whom a genetic test is performed or the results of a genetic test in a manner that permits identification of the subject of the test with some exceptions.
Indiana State Statute
opens new window Indiana: IC 16-39-5-2
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
An insurer (except a life insurance company) may not obtain genetic screening or testing results without a separate written consent from an individual, but these entities are not liable for inadvertent receipt of results without consent.
Indiana State Statute
opens new window Indiana: IC 27-4-1-4 and 27-8-26-1 et seq.
Health Insurance Nondiscrimination Every accident and sickness policy, contract through which an HMO furnishes health care, government self-insured health care plan, and employee welfare benefit plan may not (1) require a genetic screening or testing; (2) consider screening or testing information in a manner adverse to member, applicant or their family members; (3) inquire about genetic screening or test results, use or base a decision on such information to cancel, refuse to issue, renew or enter into a contract, limit benefits, or charge higher premiums under health care services coverage; or (4) make an adverse decision about applicants or their family based genetic testing or screening results in medical records or other reports. An insurer may consider voluntarily submitted genetic test results if they are favorable. A violation of the law is an unfair method of competition deceptive act and practice in the business of insurance.
Iowa State Statute
opens new window Iowa: IC 514J.101 et seq.
Health Insurance Nondiscrimination A health carrier to notify a covered person of the right to request an external review and include appropriate statements and information in the written notice of a final adverse decision. Health carriers also must include with the notice an authorization form or other document developed by the state that complies with the federal Genetic Information Nondiscrimination Act.
Iowa State Statute
opens new window Iowa: IC 507B.4
513B.9A and 513B.10
Health Insurance Nondiscrimination,
Privacy,
Research
Health insurers may not discriminate based on genetic information or tests. Authorization is required to obtain genetic information or samples. Consent requirements are established to collect, retain, transmit or use genetic information. Exceptions under consent requirements include medical or scientific research and eduction and for use in medical repositories and registries if it does not contain personally identifiable information. Health insurers may not release genetic information without prior written authorization. Exceptions for release requirements include (1) if an individual is participating in research settings, including those governed by the federal policy for the protection of human subjects, and (2) tests conducted purely for research. A carrier or organized delivery system offering group health insurance coverage may not establish rules for eligibility or continued eligibility based on a health status-related factors, including genetic information, or impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis.
Kansas State Statute
opens new window Kansas: KS 40-2209
40-2209p
40-2257
and 40-2259
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
The statutes restrict the use of genetic tests, information about whether an individual or family member has obtained a genetic test, and test results by a health insurance company, health maintenance organization, nonprofit medical and hospital, dental, optometric or pharmacy corporation, or a group subject to K.S.A. 12-2616 et seq. offering group policies and certificates of coverage or individual policies providing hospital, medical or surgical expense benefits. These entities may not require any individual, as a condition of enrollment or continued enrollment, higher premiums or contributions or than a similarly situated individual based on a genetic test or adjust premium or contribution amounts based on a genetic test. An accident or sickness insurer may not deny coverage based on a health status-related factors, including genetic information, and group policies providing hospital, medical or surgical expense benefits may not impose pre-existing condition exclusions based on genetic information in the absence of a diagnosis. The use of such information by an insurer writing life insurance, disability income insurance or long-term care insurance coverage also is restricted unless it is for the purpose of writing life insurance coverage. Life, disability income or long-term care insurers also may not provide for rates or any other aspect of coverage that is not reasonably related to the risk involved.
Kentucky State Statute
opens new window Kentucky: KRS 304.12-085
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination,
Privacy
Individual or group health benefit plan or insurers may not (1) deny, cancel, or refuse to renew the benefits or coverage, or vary the premiums, terms, or conditions for the benefits or coverage, for any participant or beneficiary based on a genetic test for which symptoms have not manifested or a request or receipt of genetic services or (2) disclose any genetic test without prior authorization for each disclosure. A group or individual health benefit plan or insurer or a disability income insurer may not request or require the disclosure of any genetic test about a participant or beneficiary without prior written authorization for each disclosure.
Kentucky State Statute
opens new window Kentucky: KRS 304.17A-200 et seq.
Health Insurance Nondiscrimination An insurer that offers health benefit plan coverage in the small group, large group, or association market may not establish rules for eligibility based on health status-related factors, including genetic information. Health insurers offering individual health benefit plan coverage may not impose a pre-existing conditions exclusion based on genetic information in the absence of a diagnosis.
Louisiana State Statute
opens new window Louisiana: LRS 22:1023
40:2210
and 22: 1097
Health Insurance Nondiscrimination,
Privacy,
Research
The statutes prohibit discrimination based on genetic information of an individual or family member or the request or receipt of genetic services by a hospital, health, or medical expense insurance policy, hospital or medical service contract, employee welfare benefit plan, health and accident insurance policy, preferred provide organization or any other insurance contract of this type. Other restrictions also are placed on these entities with respect to genetic information and testing. An insurer offering individual or group health insurance coverage may request a genetic test if the request is made in compliance with the Common Rule and other specified criteria are met. Exceptions under the law include anonymous research where the identity of the subjects will not be released. An insured or enrollees genetic information is the property of the individual to whom it pertains and may not be retained without authorization with some exceptions. Civil penalties for violations are set forth.
Louisiana State Statute
opens new window Louisiana: LRS 22:1061 and1063
Health Insurance Nondiscrimination A group health plan, and a health insurance issuer offering group health insurance coverage may not use genetic information in the absence of a diagnosis as the basis for a pre-existing condition exclusion or establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information.
Louisiana State Statute
opens new window Louisiana: LRS 22:1964
Health Insurance Nondiscrimination It is an unfair method of competition and deceptive act and practice in the business of insurance to discriminate against an insured, enrollee, or beneficiary in the issuance, payment of benefits, withholding of coverage, cancellation or nonrenewal of a policy, contract, plan, or program based upon the results of a genetic test or receipt of genetic information. Actions of an insurer or third parties dealing with an insurer taken in the ordinary course of business in connection with the sale, issuance or administration of a life, disability income, or long-term care insurance policy are exempt from the law.
Maine State Statute
opens new window Maine: MRS 24A 2159-C and 24A 6981
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination,
Research
A carrier that issues individual or group hospital, health or dental insurance and the Dirigo Health Self-administered Plan may not discriminate against an individual or eligible dependent on the basis of genetic information, the refusal to submit to a genetic test, refusal to make available the results of a genetic test, or based on the receipt of a genetic test or genetic counseling. A carrier may request, but not require, that an individual undergo a genetic test if the request is made pursuant to research that complies with the Common Rule and other specified criteria are met. Life, credit life, disability, long-term care, accidental injury, specified disease, hospital indemnity or credit accident insurers or an annuity may not discriminate unfairly, which includes the use of genetic test results in a manner that is not reasonably related to anticipated claims experience.
Maine State Statute
opens new window Maine: MRS 24A 2850 and 24A 2850-C
Health Insurance Nondiscrimination An individual, group and blanket medical insurance contract subject to chapters 33 and 35 of Title 24A (with some exceptions) may not impose pre-existing condition exclusions based on genetic information in the absence of a diagnosis. Group medical insurance contracts subject to chapter 35 of Title 24A (with some exceptions) may not establish rules for eligibility of an individual to enroll or require an individual to pay a premium or contribution that is greater than that for a similarly situated individual, based on genetic information.
Maryland State Statute
opens new window Maryland: Md. Insurance Code 15?509
Health Insurance Nondiscrimination Insurers, nonprofit health service plans and health maintenance organizations, may seek verification from health care providers that offer wellness programs about health factors that make it unreasonably difficult or medically inadvisable for an individual to satisfy or attempt to satisfy an otherwise applicable standard to qualify for a reward of the wellness program. Health factors are defined to include genetic information.
Maryland State Statute
opens new window Maryland: Md. Insurance Code 27-909
and Md. Health-General Code 19-706
Health Insurance Nondiscrimination,
Privacy,
Research
An insurer, nonprofit health service plan, or health maintenance organization, which does not include life insurance policies, annuity contracts, long-term care insurance policies, or disability insurance policies, may not (1) use a genetic test, the results of a genetic test, genetic information, or a request for genetic services to affect a health insurance policy or contract, (2) request or require a genetic test, the results of a genetic test, or genetic information for certain purposes, or (3) release identifiable genetic information or the results of a genetic test except for internal business and to a participating health care provider without prior written authorization. Disclosure of identifiable genetic information to an employee or authorized health care provider may only be for the purpose of providing medical care to patients or conducting research approved by an institutional review board established in accordance with federal law. The insurance commissioner has the authority to issue orders where a violation is found.
Maryland State Statute
opens new window Maryland: Md. Insurance Code 15-1201
15-1301 and 15-1401
Health Insurance Nondiscrimination Health status-related factors, including genetic information may not be used to cancel or refuse to renew a small employer group plan or individual health plans or to establish rules for eligibility or to charge higher premiums than similarly situated individuals in a group health plan.
Massachusetts State Statute
opens new window Massachusetts: MGL 175 108H
176A 3B
176B 5B
176G 24
176I 4A
Health Insurance Nondiscrimination A health maintenance organization, company, insurance broker, medical service corporation, non-profit hospital service corporation or preferred provider organization may not cancel, refuse to issue or renew, or make any distinction or discrimination in the amount of payment of premium or rates charged, in the length of coverage or in any of the terms and conditions based on genetic information. These entities may not require genetic tests or private genetic information.
Massachusetts State Statute
opens new window Massachusetts: MGL 176M 1 and 176J 1
Health Insurance Nondiscrimination Genetic information may not be treated as a pre-existing condition in the absence of a diagnosis under the definitions for chapter 176M on nongroup health plans and 176J on small group health insurance.
Michigan State Statute
opens new window Michigan: MCL 500.2212c
Health Insurance Nondiscrimination,
Privacy
The law requires a workgroup to develop a standard prior written authorization methodology for prescribers. If the workgroup develops a paper form, it must allow an insurer to request and require additional information beyond the form. Additional information may include patient clinical information regarding genetic tests.
Michigan State Statute
opens new window Michigan: MCL 500.3829a
Health Insurance Nondiscrimination,
Privacy
Insurers that provide Medicare supplement policies or certificates only may not deny or condition the issuance or effectiveness of insurance, including pre-existing condition exclusions, on the basis of genetic information. Insurers of these policies or certificates may not (1) discriminate with respect to pricing on the basis of genetic information, (2) request or require an individual or family member to undergo a genetic test (with an exception regarding requesting a test), or (3) use the manifestation of disease in an individual as genetic information about another group members and to further increase premiums for the group. Insurers may request a genetic test from an individual or family member only if the request is pursuant to research that applies to the Common Rule and other criteria are met.
Michigan State Statute
opens new window Michigan: MCL 500.3407b and 550.1401
Health Insurance Nondiscrimination An expense-incurred hospital, medical, surgical policy or certificate or health care corporation may not require an insured or his or her dependent or an asymptomatic applicant or his or her asymptomatic dependent to undergo a genetic test or disclose whether a genetic test has been conducted, the results of a genetic test or genetic information. The law allows issuers of expense-incurred hospital, medical, or surgical policies or certificates to require an applicant to answer questions about family history.
Minnesota State Statute
opens new window Minnesota: MS 13.7191 (Section 8 Subd. 6)
Health Insurance Nondiscrimination,
Privacy
The law requires the Minnesota Insurance Marketplace to provide any data subject asked to supply private data with a notice of rights related to the handling of genetic information. The Minnesota Insurance Marketplace is a state health benefit exchange as described in section 1311 of the federal Patient Protection and Affordable Care Act (Public Law 111-148), and further defined through amendments to the act and regulations issued under the act.
Minnesota State Statute
opens new window Minnesota: MS 62A.31
Health Insurance Nondiscrimination,
Research
An issuer of a Medicare supplement policies or certificates may not deny or condition the issuance or effectiveness of insurance, including pre-existing condition exclusions, on the basis of genetic information. These entities also may not discriminate with respect to pricing on the basis of genetic information; request or require an individual or family member to undergo a genetic test; or use the manifestation of disease in an individual as genetic information about another group member and to further increase premiums for the group. Insurers may request a genetic test from an individual or family member only if the request is pursuant to research that applies to the Common Rule and other criteria are met.
Minnesota State Statute
opens new window Minnesota: MS 72A.139
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
A health plan company in determining eligibility for coverage, establishing premiums, limiting coverage, renewing coverage, or any other underwriting decision may not (1) require or request an individual or his or her blood relative to take a genetic test, (2) make any inquiry about a genetic test or what the results of any such test were, or (3) take into consideration the fact that a genetic test was taken or refused or the results of such a test. A life insurance company or fraternal benefit society requiring a genetic test for the purpose of determining insurability for life insurance must obtain informed written consent. A violation is subject to the investigative and enforcement authority of the insurance commissioner.
Missouri State Statute
opens new window Missouri: MRS 375.1300 and 375.1303
Health Insurance Nondiscrimination An insurer in making any underwriting decision may not (1) require or request a person or his/her blood relative to provide genetic information or take a genetic test, (2) inquire about a genetic test or what the results of any such test were unless given approval by that person, or (3) consider without the approval of such person the fact that genetic information or a genetic test was taken or refused by a person or blood relative of the person or the results of a test. A violation is an unfair trade practice. The law does not apply to any policy, contract or certificate of life insurance, reinsurance, disability income or long-term care coverage.
Missouri State Statute
opens new window Missouri: MRS 376.450
376.451
379.930
and 379.940
Health Insurance Nondiscrimination A health insurance issuer offering group health insurance coverage may not establish rules for eligibility or continued eligibility of any individual to enroll under the terms of the group health plan based on health status-related factors, including genetic information, or impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis. A small employer carrier may apply reasonable criteria in determining whether to accept a small employer into a class of business, provided that the criteria are not based on a health status-related factor, including genetic information.
Montana State Statute
opens new window Montana: MCA 33-18-901 et seq.
Health Insurance Nondiscrimination,
Research
An insurer, health service corporation, health maintenance organization, fraternal benefit society, or other issuer of an individual or group policy or certificate of insurance may not discriminate based on a persons genetic traits. These entities also may not underwrite or condition coverage on a requirement or agreement to take a genetic test or on genetic information of an individual or his or her family member, and they may not seek genetic information for a purpose that is unrelated to assessing or managing ones health, inappropriate in an asymptomatic individual, or unrelated to research in which a subject is not personally identifiable. These entities may not require an individual to obtain a genetic test also with some exceptions. The law does not apply to life, disability income or long-term care insurance.
Montana State Statute
opens new window Montana: MCA 33-22-514 and 33-22-526
Health Insurance Nondiscrimination A group health plan or a health insurance issuer offering group health insurance coverage may not impose a pre-existing condition exclusion based on genetic information. A group health plan or a health insurance issuer offering group health insurance coverage may not establish rules for eligibility or continued eligibility of any individual to enroll under the terms of the group health plan based on health status-related factors, including genetic information.
Nebraska State Statute
opens new window Nebraska: NRS 44-7
100
Health Insurance Nondiscrimination Any hospital, medical, or surgical expense-incurred policy or certificate and self-funded employee benefit plan to the extent not preempted by federal law may not require a covered person or his or her dependent or an asymptomatic applicant for coverage or his or her asymptomatic dependent to undergo any genetic test before issuing, renewing, or continuing the policy or certificate. This does prohibit requiring an applicant for coverage to answer questions concerning family history.
Nebraska State Statute
opens new window Nebraska: NRS 44-787
Health Insurance Nondiscrimination A health carrier that decides to discontinue offering a particular type of individual policy or contract in the state and offer another option of coverage must act uniformly without regard to health status-related factors related to any covered individual, including genetic information. A health carrier offering a network health plan must terminate coverage uniformly, as permitted, without regard to health status-related factors, including genetic information.
Nebraska State Statute
opens new window Nebraska: NRS 44-5242.02 and 5246.02
Health Insurance Nondiscrimination Under the Small Employer Health Insurance Availability Act, health status-related factor is defined to include genetic information and pre-existing condition is defined to exclude genetic information in the absence of a diagnosis.
Nebraska State Statute
opens new window Nebraska: NRS 44-6910 et seq.
Health Insurance Nondiscrimination A health benefit plan may not treat genetic information as a pre-existing condition in the absence of a diagnosis. A health carrier may not establish rules for eligibility and continued eligibility of any individual to enroll under the terms of the health benefit plan based on a health status-related factor, including genetic information.
Nevada State Statute
opens new window Nevada: NRS 689A.417
689A.545
689A.585
689B.420
689B.450
689B.550
689B.069
689C.076
689C.082
689C.193
689C.198
695B.317
695B.318
695C.207
695C.057
and 687B.402
Health Insurance Nondiscrimination A health maintenance organization, a carrier serving small employers, a corporation that provides health insurance, individual health insurers and group health insurers may not (1) require an insured person or family member to take a genetic test or disclose whether one has been taken or (2) determine the rates or any other aspect of the coverage or benefits based on genetic information or whether the insured person or member of his family has taken a genetic test. These entities may not establish rules of eligibility based on a health status-related factor, including genetic information, or impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis. The provisions to not apply to any of the above entities in terms of the issuance of a policy of health insurance that provides coverage for long-term care or disability income. Insurers or organizations that provide health coverage pursuant to sections 689A, 689B, 689C, 695A, 695B, 695C, 695D, and 695F must comply with the federal law, the Genetic Information Nondiscrimination Act.
New Hampshire State Statute
opens new window New Hampshire: NHS 141-H:1
141-H:4
and 141:H-6
Health Insurance Nondiscrimination A health insurer in connection with providing health insurance may not (1) require or request an individual or family member to undergo genetic testing, whether a test was taken or the results of the testing, (2) condition the provision of health insurance coverage or health care benefits on whether an individual or family member has undergone genetic testing or the results of the testing, or (3) consider in the determination of rates or any other aspect of health insurance coverage or benefits whether an individual or family member has undergone genetic testing or the results of the testing. The statutes establish a right to civil action by aggrieved individuals.
New Hampshire State Statute
opens new window New Hampshire: NHS 420-G:6 and 420-G:7
Health Insurance Nondiscrimination Health carriers may not establish rules of eligibility or continued eligibility for health coverage based on health status related factors of any employee or dependent, including genetic information, or impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis.
New Jersey State Statute
opens new window New Jersey: NJS 17B:30-12
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
No person may discriminate against an individual based on genetic information or the refusal of a genetic test with respect to hospital confinement or other supplemental limited benefit insurance. No person may make or permit any unfair discrimination against an individual in the application of the results of a genetic test or genetic information with respect to life insurance, including credit life insurance, an annuity, disability income insurance contract or credit accident insurance coverage, and, if results of a genetic test as permitted by these entities, the insurer must notify the individual who is the subject of the test that it is required and obtain the individual's prior written informed consent. The insurance commissioner has the authority to enforce these provisions.
New Jersey State Statute
opens new window New Jersey: NJS 17:48-6.18
17:48A-6.11
17:48E-15.2
17B-26-3.2
17B-27-36.2
and 26:2J-15.1
Health Insurance Nondiscrimination Individual or group hospital service corporations and individual or group medical or health service corporations providing hospital or medical expense benefits, individual health insurance policies, group health insurance policies, and contracts for health care services may not exclude any person or eligible dependent or establish any rates or terms on the basis of any genetic characteristic.
New Jersey State Statute
opens new window New Jersey: NJS 17B-27-54
17B-27-57 17B-27-64
17B:27A-2 and 17B:27A-17
Health Insurance Nondiscrimination A group health plan may not establish rules for eligibility or continued eligibility based on health status-related factors, including genetic information, or impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis. Health status-related factor also is defined to include genetic information applicable to sections 1 to 15 of chapter 17B:27A, and the definition of pre-existing condition excludes genetic information in the absence of a diagnosis under provisions applicable to small employer health benefit plans.
New Mexico State Statute
opens new window New Mexico: NMSA 24-21-1 et seq.
Employment Nondiscrimination,
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination,
Privacy,
Research
The statutes contain provisions on the acquisition, collection, retention, transmission or use of genetic information. Consent requirements provide an exemption (1) if DNA, genetic information or results of genetic analysis are not identified with the person or person's family members or (2) for the purpose of medical or scientific research and education (including retention of gene products, genetic information or genetic analysis if the identity of the person or person's family members is not disclosed.) Discrimination by an insurer against a person or his/her family member based on genetic analysis, genetic information or genetic propensity is prohibited. Life, disability income or long-term care insurance are exempt if use is based on sound actuarial principles or related to actual or reasonably anticipated experience. Upon request a persons genetic information or samples must be promptly destroyed with some exceptions, including if retention is authorized under a research protocol approved by an institution review board pursuant to federal law. It is unlawful for a person to use genetic information in employment or recruiting. A person whose rights under the provisions of the Genetic Information Privacy Act have been violated may bring a civil action for damages or other relief.
New Mexico State Statute
opens new window New Mexico: NMSA 59A-23C-5.1
59A-23C-7.1
59A-23E-2
59A-23E-11
and 59A-56-14
Health Insurance Nondiscrimination A health benefit plan that is offered by a carrier or an approved health plan offered to a small employer and plans subject to the Health Insurance Portability Act may not impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis. A group health plan and a health insurance issuer offering group health insurance coverage may not establish rules for eligibility or continued eligibility based a health status-related factor, including genetic information. Under the Small Group Rate and Renewability Act, provisions allowing a carrier to use health status in establishing the amount an employer may be charged for coverage under a group health plan exclude genetic information from the definition of health status.
New York State Statute
opens new window New York: NYCL (ISC) 2615
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
No insurer may request or require an individual proposed for insurance coverage to submit to a genetic test without prior written informed consent. Further disclosures require additional consent. If an adverse underwriting decision is based on the results of a genetic test, the insurer must notify the individual. No insurer who lawfully possesses information derived from a genetic test on a biological sample may incorporate the information into the record of a non-consenting individual. Penalties for violations are set forth.
New York State Statute
opens new window New York: NYCL (ISC) 3221
3232
4305
and 4318
Health Insurance Nondiscrimination Insurers or corporations delivering group or blanket health policies that provide hospital, surgical or medical expense coverage may not establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information. Individual and group or blanket health insurance policies or contracts may not impose pre-existing condition exclusions based on genetic information in the absence of a diagnosis.
North Carolina State Statute
opens new window North Carolina: NCGA 58-3-215
58-51-45
58-51-95
58-65-70
58-68-30 and 58-68-35
Health Insurance Nondiscrimination A health benefit plan, health maintenance organization or multiple employer welfare arrangement may not raise the premium or contribution rates paid for a group health benefit plan, refuse to issue or deliver a health benefit plan, or charge a higher premium rate or charge because of genetic information. Health benefit plans must comply with all applicable standards of the federal Genetic Information Nondiscrimination Act. Insurers providing accident and sickness policies or hospital, medical, or dental health service may not refuse to issue or deliver any policy that affords benefits or coverage for any medical treatment or service authorized or permitted by specified entities or carry a higher premium rate or charge by reason of the fact that the person to be insured possesses sickle cell trait or hemoglobin C trait. A group health insurer may not establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information, or treat genetic information as a pre-existing condition in the absence of a diagnosis. An individual health insurer may not increase an individual's renewal premium for continued health insurance coverage based on a health statusrelated factors, including genetic information.
North Dakota State Statute
opens new window North Dakota: NDCC 26.1-36.3-01
26.1-36.3-06 and 26.1-36.4-03.1
Health Insurance Nondiscrimination Health benefit plans covering small employers and group policies of hospital and medical insurance may not treat genetic information as a pre-existing condition in the absence of a diagnosis. A health status-related factor is defined to include genetic information in the chapter of the law pertaining to small employer employee health insurance.
Ohio State Statute
opens new window Ohio: ORC 1751.64 and 1751.65
Health Insurance Nondiscrimination A health insuring corporation may not (1) cancel or fail to renew the coverage because of any health status-related factor, including genetic information, (2) require an individual seeking coverage to submit to genetic screening or testing or taken into account or inquire about such testing, (3) make a decision adverse to the applicant based on entries in medical records or other reports of genetic screening or testing, or (4) cancel or refuse to issue or renew coverage for health care services based on the results of genetic screening or testing, or (6) limit benefits of an individual or group policy, contract, or agreement based on the results of genetic screening or testing. A violation of these provisions is an unfair and deceptive act or practice in the business of insurance. Further provisions apply upon the repeal of the current protections, which are in effect until February 9, 2014.
Ohio State Statute
opens new window Ohio: ORC 3901.21
3901.41 and 3901.501
Health Insurance Nondiscrimination It is an unfair and deceptive act or practice in the business of insurance to engage in any underwriting standard or other practice that due solely to any health status-related factor, including genetic information, terminates or fails to renew an existing individual policy, contract, plan of health benefits, or a health benefit plan issued to an employer, for which an individual would otherwise be eligible, or, with respect to a health benefit plan issued to an employer, excludes or causes the exclusion of an individual from coverage under an existing employer-provided policy, contract, or plan of health benefits. Insurers issuing accident and sickness insurance or self-insurers may not consider information obtained from genetic screening or testing in processing an application or in determining insurability or inquire into the results of genetic screening or testing or use such information to cancel, refuse to issue or renew, or limit benefits. The superintendent of insurance has the authority to investigate violations of this provision.
Oklahoma State Statute
opens new window Oklahoma: OS 36-3614.1
Health Insurance Nondiscrimination,
Research
Any individual, corporation, association, partnership, insurance support organization, fraternal benefit society, insurance producer, third-party administrator, self-insurer, or any other legal entity engaged in the business of insurance that issues accident and sickness insurance policies or administers a health insurance plan may not deny or condition the issuance or effectiveness of a policy on a pre-existing condition or genetic information. These entities also may not discriminate with respect to pricing a policy or certificate, including premiums, based on genetic information. A violation is an unfair and deceptive act or practice. An insurer also may not request or require a genetic test with an exception for research. An insurer may request a genetic test if the request is pursuant to research that complies with the Common Rule and other specified criteria are met.
Oklahoma State Statute
opens new window Oklahoma: OS 36-4502
Health Insurance Nondiscrimination Group accident and sickness policies may not treat genetic information as a pre-existing condition or base eligibility or continued eligibility of any individual on health-status-related factors, including genetic information.
Oregon State Statute
opens new window Oregon: ORS 743.730
Health Insurance Nondiscrimination Health benefit plans that apply pre-existing condition exclusions may not do so based on genetic information in the absence of a diagnosis.
Oregon State Statute
opens new window Oregon: ORS 746.135
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
If a person asks an applicant for insurance to take a genetic test in connection with an application for insurance, the use of the test must be revealed to the person tested and informed consent to conduct testing is required. Favorable genetic information may not be used to induce the purchase of insurance. Genetic information may not be used to reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the terms and conditions of or otherwise affect any policy for hospital or medical expenses, and the genetic information of a persons blood relative may not be used to reject, deny, limit, cancel, refuse to renew, increase the rates of, affect the terms and conditions of or otherwise affect any policy of insurance.
Pennsylvania State Statute
opens new window Pennsylvania: PS Article IV-B Sec. 401-B et seq.
Health Insurance Nondiscrimination A foreign or domestic insurance company, association or exchange, health maintenance organization, hospital plan corporation, professional health services plan corporation, franternal benefit society or risk-assuming preferred provider organization must comply with certain federal acts, including the Genetic Information Nondiscrimination Act.
Rhode Island State Statute
opens new window Rhode Island: RIGL 27-18-52
27-18-52.1
27-19-44
27-19-44.1
27-20-39
27-20-39.1
27-41-53
and 27-41-53.1
Health Insurance Nondiscrimination,
Privacy,
Research
Insurance administrators, health plans and providers of accident and sickness insurance, nonprofit hospital corporations, nonprofit medical service corporations, and HMOs are prohibited from releasing genetic information without prior written authorization. Individuals participating in research settings governed by the Federal Policy for the Protection of Human Research Subjects are exempt. Tests conducted purely for research are excluded from the requirements set forth, as are tests for somatic (as opposed to heritable) mutations, and testing for forensic purposes. An individual or group health insurance contract, plan or policy (excluding disability income, long term care and insurance supplemental policies) may not use a genetic test or genetic information or request for genetic tests or genetic information or the results of a genetic test for specified purposes, including for underwriting. Provisions pertaining to the release the results of a genetic test or genetic information do not apply to releases in a format whereby individual identifiers are removed, encrypted, or encoded so that the identity of the individual is not disclosed. Authorization is required for each re-disclosure except for participating in research settings governed by the Federal Policy for the Protection of Human Research Subjects.
Rhode Island State Statute
opens new window Rhode Island: RIGL 27-18.5-2
27-18.6-2
27-18.6-3
and 27-50-3
Health Insurance Nondiscrimination In the statute sections pertaining to large group, individual health insurance and small employer health insurance a health status-related factor is defined to include genetic information, and pre-existing condition exclusions may not be based on genetic information the absence of a diagnosis.
South Carolina State Statute
opens new window South Carolina: SCCL 38-93 et seq.
Health Insurance Nondiscrimination,
Privacy
Health insurers offering individual health plans may not cancel, deny, adjust premiums or rates or impose pre-existing conditions exclusions based on the genetic information of an individual or family member or based on a request for genetic services. Health insurers offering group health plans may not adjust premiums or contributions based on genetic information. Health insurers may not request or require genetic information or require an individual to undergo a genetic test. The law also prohibits disclosure of genetic information without informed written consent, with some exceptions such as for law enforcement purposes or as allowable under state and federal statutes. It is required to obtain informed consent prior to performing a genetic test, with some exceptions such as for diagnosis or treatment of an individual if performed by a clinical laboratory that has received a specimen referral from the individual's treating physician or another clinical laboratory. Penalties for violations of the law are established and are intended to be in addition to those set forth under the Genetic Information Nondiscrimination Act of 2008, Public Law 110-233.
South Carolina State Statute
opens new window South Carolina: SCCL 38-41-45
38-71-670
38-71-840
38-71-860 and 38-74-10
Health Insurance Nondiscrimination Group health insurers may not establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information or impose a pre-existing condition exclusion based on genetic information. The sections of the statutes pertaining to Individual health insurance and multiple employer self-insured health plans define health status-related factor to include genetic information. Genetic information may not be treated as a pre-existing condition in the absence of a diagnosis within the South Carolina health insurance pool.
South Carolina State Statute
opens new window South Carolina: SCCL 38-93-10 et seq.
Health Insurance Nondiscrimination,
Privacy
An accident and health insurer providing hospital, medical and surgical, or major medical coverage on an expense incurred basis, providing a corporate health services plan, or providing a health care plan for health care services by a health maintenance organization may not (1) terminate, restrict, limit, or otherwise apply conditions to coverage or restrict the sale to an individual, (2) cancel or refuse to renew the coverage of an individual, (3) exclude an individual from coverage, (4) impose a waiting period, (5) impose a pre-existing condition exclusion; (6) require inclusion of a rider that excludes coverage for certain benefits and services, or (7) adjust premium contribution amounts or establish differential in premium rates for coverage based on genetic information or a request for genetic services. Additional provisions address consent to disclose genetic information and consent to perform genetic testing. An aggrieved individual may bring civil action. he penalties and enforcement provisions of subsections (A) and (B) are in addition to penalties and enforcement provisions of federal law, including those set forth in the Genetic Information Nondiscrimination Act of 2008.
South Dakota State Statute
opens new window South Dakota: SDCL 58-1-24
58-1-25
58-17-84
58-18-45
58-18-87
and 58-18B-27
Health Insurance Nondiscrimination A health carrier may not require or request an individual or his/her blood relative to take a genetic test or consider the fact that a genetic test was refused in determining eligibility for coverage, establishing premiums, limiting coverage, renewing coverage, or any other underwriting decision in connection with the offer, sale, or renewal of health insurance. The insurance director may promulgate rules concerning genetic information and group health benefit plans. In individual, group and blanket health insurance plans, genetic information may not be treated as a pre-existing condition in the absence of a diagnosis. Small employer carriers may not establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information.
Tennessee State Statute
opens new window Tennessee: TC 56-7-2701 et seq.
Health Insurance Nondiscrimination An insurance provider may not deny or cancel health insurance coverage or vary the premiums, terms, or conditions for health insurance coverage for an individual or his or her family member on the basis of a request or receipt of genetic services. An insurer may not request or require an individual to whom it provides health insurance coverage or an applicant to disclose to the insurer genetic information about the individual or family member of the individual. Life insurance, disability income, long-term care, accident only, hospital indemnity or fixed indemnity, dental or vision policies are exempt from the law.
Tennessee State Statute
opens new window Tennessee: TC 56-7-2802 and 56-7-2804
Health Insurance Nondiscrimination Under the Health Insurance Portability, Availability and Renewal Act group health plans and other issuing group health insurance coverage may not base rules for eligibility or continued eligibility on a health status-related factor, including genetic information.
Texas State Statute
opens new window Texas: TS (Insurance) Code 546.001 et seq.
Health Insurance Nondiscrimination,
Privacy,
Research
Individual and group health benefit plans that request an applicant for coverage to submit to a genetic test for a permissible purpose must notify the applicant that the test is required, disclose to the applicant the proposed use of the results, and obtain prior written informed consent. A health benefit plan issuer may not use genetic information or the refusal of an applicant to submit to a genetic test to reject, deny, limit, cancel, refuse to renew, increase the premiums for, or otherwise adversely affect eligibility for or coverage under the plan. Genetic material obtained from an individual for a genetic test must be destroyed promptly after the purpose for which it was obtained with some exceptions, including (1) authorized retention of the sample for medical treatment or scientific research or (2) if the sample was obtained for research that is cleared by an institutional review board, and retention of the sample is under a requirement the institutional review board imposes on a specific research project or authorized by the research participant with institutional review board approval under federal law. A health benefit plan issuer may redisclose genetic information without authorization for actuarial or research studies if the tested individual could not be identified in any actuarial or research report and any materials that identify a tested individual are returned or destroyed as soon as reasonably practicable.
Texas State Statute
opens new window Texas: TS (Insurance) Code 846.01 and 1501.001 et seq.
Health Insurance Nondiscrimination Pre-existing conditions and health status-related factors are defined to include genetic information with respect to multiple-employer welfare arrangements and the health insurance portability and accountability act.
Utah State Statute
opens new window Utah: UC 26-45-101 et seq.
Employment Nondiscrimination,
Health Insurance Nondiscrimination,
Privacy
An employer may not in connection with a hiring, promotion, retention, or other related decision access or (1) take into account genetic information, (2) request or require an individual to consent to release genetic information, (3) submit to a genetic test, or (4) inquire or take into account that an individual or blood relative of that person has taken a genetic test. An employer may compel disclosure of genetic information for specified reasons. A health care insurer may not in connection with the offer or renewal of an insurance product or in the determination of any underwriting decision access or otherwise (1) take into consideration private genetic information about an asymptomatic individual, (2) request or require an asymptomatic individual to consent to a release for the purpose of accessing private genetic information, (3) request or require an asymptomatic individual or his blood relative to submit to a genetic test, or (4) inquire into or otherwise take into consideration the fact that an asymptomatic individual or his blood relative has taken or refused to take a genetic test. An individual whose rights have been violated bring civil action.
Utah State Statute
opens new window Utah: UC 31A-1-301
31A-22-620
31A-22-1602
Health Insurance Nondiscrimination Genetic information may not be treated as a pre-existing condition in the absence of a diagnosis. The genetic testing privacy act, which prohibits health insurance discrimination, is applicable to insurers except as permitted under the Medicare Supplement Minimum Standards Act. The insurance commissioner may adopt rules regarding nondiscrimination for genetic testing or genetic information in Medicare supplement policies and certificates.
Vermont State Statute
opens new window Vermont: VSA 18 9331 et seq.
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
A policy of insurance may not be underwritten or conditioned on a requirement to undergo genetic testing or the results of genetic testing. Civil and criminal penalties are set forth for violations.
Vermont State Statute
opens new window Vermont: VSA 8 4724
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
It is an unfair method of competition or unfair and deceptive act or practice to (1) make or permit any unfair discrimination against any individual by conditioning insurance rates, the provision or renewal of insurance coverage, or other conditions of insurance based on the results of genetic testing where there is not a relationship between the information and the cost of the insurance risk that the insurer would assume by insuring the proposed insured or (2) to violate the Title 18 9334.
Virginia State Statute
opens new window Virginia: Code of Va. 38.2-3431
Health Insurance Nondiscrimination In the statutes pertaining to group health plans, health status-related factors are defined to include genetic information, and pre-existing condition exclusion may not be based on genetic information in the absence of a diagnosis.
Virginia State Statute
opens new window Virginia: Code of Va. 38.2-508.4 and 38.2-613
Health Insurance Nondiscrimination,
Privacy
A person proposing to issue, re-issue, or renew accident and sickness insurance, excluding disability income insurance, issued by any insurer providing hospital, medical and surgical or major medical coverage on an expense incurred basis, a corporation providing a health services plan, or an HMO providing a health care plan may not on the basis of any genetic information or a request for genetic services (1) terminate, restrict, limit, or otherwise apply conditions to coverage of an individual or restrict the sale to an individual, (2) cancel or refuse to renew the coverage of an individual, (3) exclude an individual from coverage, (4) impose a waiting period, (5) require inclusion of a rider that excludes coverage for certain benefits and services, (6) establish differentials in premium rates for coverage, or (7) disclose any genetic information about an individual or his/her family member collected or received in connection with any insurance transaction unless the disclosure is made with the written authorization of the individual.
West Virginia State Statute
opens new window West Virginia: WVC 33-15-2a
33-16-1a
and 33-16-3k
Health Insurance Nondiscrimination A health benefit plan issued in connection with a group health plan may not impose a pre-existing condition exclusion based on genetic information in the absence of a diagnosis. A health status-related factor is defined to include genetic information as defined in section of the statutes pertaining to individual group accident and sickness insurance.
Wisconsin State Statute
opens new window Wisconsin: WSA 942.07
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
An insurer offering group health insurance coverage may not use genetic information as the basis for a pre-existing condition exclusion in the absence of a diagnosis or establish rules for eligibility or continued eligibility based on health status-related factors, including genetic information. An insurer with respect to a self-insured health plan, or a county, city, village or school board that provides health care services for individuals on a self-insured basis, may not (1) require or request any individual or a member of the individual's family obtain a genetic test or reveal whether a test was taken or the results or (2) condition coverage or health care benefits on or use in the determination of rates whether an individual or his/her family member has taken a genetic test or what the results of the test were. Life insurance or income continuance insurers are not subject to the above provisions but may not provide rates or aspects of coverage that are contrary to the risk involved.
Wyoming State Statute
opens new window Wyoming: WSA 26-19-107 and 26-19-306
Health Insurance Nondiscrimination,
Other Lines of Insurance Nondiscrimination
A policy of group or blanket disability insurance or health benefit plan covering small employers may not treat genetic information as a pre-existing condition in the absence of a diagnosis or establish rules for eligibility or continued eligibility based on a health status-related factor, including genetic information. These entities also may not deny eligibility, or adjust premium or contribution rates based on genetic testing information of an individual or family member or request or require predictive genetic testing information about an individual or family member except as needed for diagnosis, treatment, or payment purposes.

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Last Reviewed: January 8, 2013