Genetic Nondiscrimination in Insurance Act

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  1. (a) This section shall be known and may be cited as the “Genetic Nondiscrimination in Insurance Act”.

  2. (b) For the purposes of this section:

    1. (1) “Disability insurance” means insurance of human beings against bodily injury, disablement, or death by accident or accidental means, or the expense thereof, or against disablement or expense resulting from sickness, and every insurance appertaining thereto, but shall not include disability income or long-term care insurance;

    2. (2) “DNA” means deoxyribonucleic acid;

    3. (3)

      1. (A) “Genetic information” means information derived from the results of a genetic test.

      2. (B) Genetic information shall not include:

        1. (i) Family history;

        2. (ii) The results of a routine physical examination or test;

        3. (iii) The results of a routine chemical, blood, or urine analysis;

        4. (iv) The results of a test to determine drug use;

        5. (v) The results of a test for the presence of the human immunodeficiency virus; or

        6. (vi) The results of any other test commonly accepted in clinical practice at the time it is ordered by the insurer;

    4. (4)

      1. (A) “Genetic test” means a laboratory test of the DNA, RNA, chromosomes, or enzyme activity for genetic disease of an individual for the purpose of identifying the presence or absence of inherited alterations in the DNA, RNA, chromosomes, or enzyme activity for genetic disease that cause a predisposition for a clinically recognized disease or disorder.

      2. (B) “Genetic test” shall not include:

        1. (i) A routine physical examination or a routine test performed as a part of a physical examination;

        2. (ii) A chemical, blood, or urine analysis;

        3. (iii) A test to determine drug use;

        4. (iv) A test for the presence of the human immunodeficiency virus; or

        5. (v) Any other test commonly accepted in clinical practice at the time it is ordered by the insurer;

    5. (5)

      1. (A) “Insurer” means any individual, corporation, association, partnership, insurance support organization, fraternal benefit society, insurance agent, third-party administration, self-insurer, or any other legal entity engaged in the business of insurance which is licensed to do business in or incorporated or domesticated or domiciled in or under the statutes of this state, or actually engaged in business in this state, regardless of where the contract of insurance is written or the plan is administered or where the corporation is incorporated, that issues disability policies or plans or that administers any other type of disability insurance policy containing medical provisions, including, but not limited to, any nonprofit hospital service and indemnity and medical service and indemnity corporation, health maintenance organizations, preferred provider organizations, prepaid health plans, and the State and Public School Life and Health Insurance Plan.

      2. (B) “Insurer” shall not include insurers issuing life, disability income, or long-term care insurance;

    6. (6)

      1. (A) “Policy” or “policy form” means any:

        1. (i) Policy, contract, plan, or agreement of disability insurance, or subscriber certificates of medical care corporations, health care corporations, hospital service associations, or health care maintenance organizations, delivered or issued for delivery in this state by any insurer;

        2. (ii) Certificate, contract, or policy issued by a fraternal benefit society;

        3. (iii) Certificate issued pursuant to a group insurance policy delivered or issued for delivery in this state; and

        4. (iv) Evidence of coverage issued by a health maintenance organization.

      2. (B) “Policy” or “policy form” shall not include life, disability income, and long-term care insurance policies; and

    7. (7) “RNA” means ribonucleic acid.

  3. (c) No insurer, for the purpose of determining eligibility of any individual for any insurance coverage, establishing premiums, limiting coverage, renewing coverage, terminating coverage, or any other underwriting decision in connection with the offer, sale, or renewal or continuation of a policy, except to the extent and in the same fashion as an insurer limits coverage or increases premiums for loss caused or contributed to by other medical conditions presenting an increased degree of risk, shall:

    1. (1) Require or request, directly or indirectly, any individual or a member of the individual's family to obtain a genetic test; and

    2. (2) Condition the provision of the policy upon a requirement that an individual take a genetic test.

  4. (d) Nothing in this section shall limit an insurer's right to decline an application or enrollment request for a policy, charge a higher rate or premium for such a policy, or place a limitation on coverage under such a policy, on the basis of manifestations of any condition, disease, or disorder.

  5. (e)

    1. (1) Any violation of subsections (c) and (d) of this section by an insurer shall be deemed an unfair practice pursuant to § 23-66-206.

    2. (2) In addition, any individual who is damaged by an insurer's violation of this section may recover in a court of competent jurisdiction equitable relief, which may include a retroactive order, directing the insurer to provide insurance coverage to the damaged individual under the same terms and conditions as would have applied had the violation not occurred.

  6. (f) Notwithstanding any language in this section to the contrary, this section shall not apply to an insurer or to an individual or third-party dealing with an insurer in the ordinary course of underwriting, conducting, or administering the business of life, disability income, or long-term care insurance.


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