R590. Insurance, Administration.R590-83. Unfair Discrimination on the Basis of Gender or Marital Status.
R590-83-1. Authority.
This rule is promulgated by the commissioner pursuant to Sections 31A-2-201 and 31A-23a-402.
R590-83-2. Purpose and Scope.
(1) The purpose of this rule is to identify and define certain practices that the commissioner finds are unfair and discriminatory.
(2) This rule applies to an insurer engaged in the business of insurance.
R590-83-3. Definitions.
Terms used in this rule are defined in Section 31A-1-301.
R590-83-4. Availability Requirements and Prohibited Transactions.
(1) An insured or prospective insured may not be denied coverage on the basis of gender or marital status.
(a) The amount of benefits payable, or any term, condition, or type of coverage may not be restricted, modified, excluded, or reduced on the basis of gender or marital status.
(b) Marital status may not be considered when defining eligibility for dependent or family coverage.
(2) Prohibited practices include:
(a) denying, canceling or refusing to renew coverage, or providing coverage on different terms, because the insured or prospective insured is residing with another person not related by blood or marriage;
(b) offering coverage to an individual of a particular gender gainfully employed at home, employed part-time, or employed by relatives while denying or offering reduced coverage to an individual of a different gender similarly employed;
(c) reducing disability benefits for an individual of a particular gender who becomes disabled while not gainfully employed full-time outside the home when a similar reduction is not applied to an individual of a different gender;
(d) denying an individual of a particular gender a waiver of premium provisions that are available to an individual of a different gender, or offering the provisions to an individual of a particular gender only for contract limits that are lower than those available to an individual of a different gender;
(e) refusing to offer maternity benefits to an insured or prospective insured purchasing an individual contract when a comparable family coverage contract offers maternity benefits;
(f) denying, under a group contract, dependent coverage to the spouse of an employee of a particular gender when dependent coverage is available to the spouse of an employee of a different gender;
(g) offering coverage to an individual of a particular gender in certain occupations while denying coverage or offering more limited coverage to an individual of a different gender in the same occupational categories;
(h) offering an individual of a particular gender higher benefit levels or longer benefit periods, or both, than are offered to an individual of a different gender in the same classifications;
(i) offering a contract containing different definitions of disability for an individual of a particular gender and an individual of a different gender in the same classifications;
(j) offering a contract containing different waiting and elimination periods for an individual of a particular gender and an individual of a different gender;
(k) requiring an applicant of a particular gender to submit to a medical examination while not requiring an applicant of a different gender to submit to a medical examination for the same coverage;
(l) establishing different benefit options for an individual of a particular gender and an individual of a different gender;
(m) denying to a divorced or a single person coverage available to a married person;
(n) limiting the amount of coverage available to an insured or prospective insured based upon the person's marital status;
(o) denying an employee of a particular gender insurance benefits that are offered to a dependent who is of the same gender as the employee;
(p) denying a married or separated individual of a particular gender the right to obtain or continue coverage in the individual's own name when the same does not apply to an individual of a different gender;
(q) establishing different issue age requirements for an individual of a particular gender and an individual of a different gender;
(r) establishing different occupational classifications for an individual of a particular gender and an individual of a different gender;
(s) denying coverage to an unwed person or their dependent, or both.
R590-83-5. Class Rating Differentials.
(1) The establishment of reasonable and consistently applied class rating differentials does not constitute a practice prohibited by Section R590-83-3.
(2) Unless otherwise prohibited by law, this rule permits charging different premium rates on the basis of gender.
R590-83-6. Severability.
If any provision of this rule, Rule R590-83, or its application to any person or situation is held invalid, such invalidity does not affect any other provision or application of this rule that can be given effect without the invalid provision or application. The remainder of this rule shall be given effect without the invalid provision or application.
