Code of Maryland Regulations › Title 31 - MARYLAND INSURANCE ADMINISTRATION › Subtitle 10 - HEALTH INSURANCE-GENERAL › Chapter 31.10.06 - Standards for Medicare Supplement Policies › Section 31.10.06.26 - Prohibition Against Use of Genetic Information and Requests for Genetic Testing

Current through Register Vol. 51, No. 14, July 12, 2024
A. This regulation applies to all policies with policy years beginning on or after July 1, 2009.
B. Definitions.
(1) In this regulation, the following terms have the meanings indicated.
(2) Terms Defined.
(a) "Family member" means, with respect to an individual, any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of the individual.
(b) Genetic Information.
(i) "Genetic information" means, with respect to an individual, information about the individual's genetic tests, the genetic tests of a family member of the individual, and the manifestation of a disease or disorder in a family member of the individual.
(ii) "Genetic information" includes, with respect to an individual, a request for, or receipt of, genetic services, or participation in clinical research that includes genetic services, by the individual or a family member of the individual.
(iii) "Genetic information" includes, with respect to a pregnant woman, genetic information of a fetus carried by the pregnant woman,
(iv) "Genetic information" includes, with respect to an individual or family member utilizing reproductive technology, genetic information of an embryo legally held by the individual or family member.
(v) "Genetic information" does not include information about the sex or age of an individual.
(c) "Genetic services" means:
(i) A genetic test;
(ii) Genetic counseling, including obtaining, interpreting, or assessing genetic information; or
(iii) Genetic education.
(d) Genetic Test.
(i) "Genetic test" means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites that detects genotypes, mutations, or chromosomal changes.
(ii) "Genetic test" does not mean an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes.
(iii) "Genetic test" does not mean an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved.
(e) Issuer of a Medicare Supplement Policy or Certificate.
(i) "Issuer of a Medicare supplement policy or certificate" means an insurance company, fraternal benefit society, nonprofit health service plan, health maintenance organization, or any other entity delivering or issuing for delivery in this State Medicare supplement policies or certificates.
(ii) "Issuer of a Medicare supplement policy or certificate" includes a third-party administrator or other person acting for or on behalf of an entity described in §B(2)(e)(i) of this regulation.
(f) "Underwriting purposes" means:
(i) Rules for, or determination of, eligibility, including enrollment and continued eligibility, for benefits under the policy;
(ii) The computation of premium or contribution amounts under the policy;
(iii) The application of a preexisting condition exclusion under the policy; and
(iv) Other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.