Iowa Administrative Code › Agency 191 - Insurance Division › Unfair Trade Practices › Chapter 15 - Unfair Trade Practices › Rule 191-15.11 - Unfair Discrimination

Current through Register Vol. 47, No. 3, July 24, 2024
(1)
Sex
				discrimination.
a. A contract shall
				not be denied to an individual based solely on that individual's sex or marital
				status. No benefits, terms, conditions or type of coverage shall be restricted,
				modified, excluded, or reduced on the basis of the sex or marital status of the
				insured or prospective insured except to the extent permitted under the Iowa
				Code or Iowa Administrative Code. An insurer may consider marital status for
				the purpose of defining individuals eligible for dependents' benefits. This
				subrule does not apply to group life insurance policies or group annuity
				contracts issued in connection with pension and welfare plans that are subject
				to the federal ERISA.
b. Specific
				examples of practices prohibited by this subrule include, but are not limited
				to, the following:
(1) Denying coverage to
				individuals of one sex employed at home, employed part-time or employed by
				relatives when coverage is offered to individuals of the opposite sex similarly
				employed.
(2) Denying policy riders
				to persons of one sex when the riders are available to persons of the opposite
				sex.
(3) Denying a policy under
				which maternity coverage is available to an unmarried female when that same
				policy is available to a married female.
(4) Denying, under group contracts, dependent
				coverage to spouses of employees of one sex, when dependent coverage is
				available to spouses of employees of the opposite sex.
(5) Denying disability income coverage to
				employed members of one sex when coverage is offered to members of the opposite
				sex similarly employed.
(6)
				Treating complications of pregnancy differently from any other illness or
				sickness under the contract.
(7)
				Restricting, reducing, modifying, or excluding benefits relating to coverage
				involving the genital organs of only one sex.
(8) Offering lower maximum monthly benefits
				to members of one sex than to members of the opposite sex who are in the same
				underwriting and occupational classification under a disability income
				contract.
(9) Offering more
				restrictive benefit periods and more restrictive definitions of disability to
				members of one sex than to members of the opposite sex in the same underwriting
				and occupational classifications under a disability income contract.
(10) Establishing different contract
				conditions based on gender that limit the benefit options a policyholder may
				exercise.
(11) Limiting the amount
				of coverage due to an insured's or prospective insured's marital status unless
				such limitation applies only to coverage for dependents and is uniformly
				applied to males and females.
c. When rates are differentiated on the basis
				of sex, an insurer must, upon the request of the commissioner of insurance,
				justify the rate differential in writing to the satisfaction of the
				commissioner. All rates shall be based on sound actuarial principles or a valid
				classification system and actual experience statistics, if available.
d. This subrule shall not affect the right of
				fraternal benefit societies to determine eligibility requirements for
				membership. If a fraternal benefit society does, however, admit members of both
				sexes, this subrule is applicable to the insurance benefits available to its
				members.