Iowa Administrative Code › Agency 191 - Insurance Division › Life and Health Insurance › Chapter 37 - Medicare Supplement Insurance › Rule 191-37.34 - Prohibitions Against Use of Genetic Information and Against Requests for Genetic Testing

Current through Register Vol. 47, No. 3, July 24, 2024
This rule applies to all Medicare supplement policies or
				  certificates with policy years beginning on or after May 21, 2009.
(1)
Definitions.
For the
				purposes of this rule, the following definitions shall apply:
"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 such individual.
"Genetic information"
means, with respect to
				  any individual, information about such individual's genetic tests, the genetic
				  tests of family members of such individual, and the manifestation of a disease
				  or disorder in family members of such individual. "Genetic information"
				  includes, with respect to any individual, any request for, or receipt of,
				  genetic services, or participation in clinical research which includes genetic
				  services, by such individual or any family member of such individual. Any
				  reference to genetic information concerning an individual or family member of
				  an individual who is a pregnant woman includes genetic information of any fetus
				  carried by such pregnant woman or, with respect to an individual or family
				  member utilizing reproductive technology, includes genetic information of any
				  embryo legally held by an individual or family member. The term "genetic
				  information" does not include information about the sex or age of any
				  individual.
"Genetic services"
means a genetic test,
				  genetic counseling (including obtaining, interpreting, or assessing genetic
				  information), or genetic education.
"Genetic test"
means an analysis of human
				  DNA, RNA, chromosomes, proteins, or metabolites that detects genotypes,
				  mutations, or chromosomal changes. The term "genetic test" does not
				  mean:
1. An analysis of proteins or
				metabolites that does not detect genotypes, mutations, or chromosomal changes;
				or
2. 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.
"Issuer of a Medicare supplement policy or
				  certificate"
means the same as "issuer" as defined in rule
				  191-37.3(514D) and includes a third-party administrator, or other person acting
				  for or on behalf of such issuer.
"Underwriting purposes"
means:
1. Rules for or determination of eligibility
				(including enrollment and continued eligibility) for benefits under the
				Medicare supplement policy or certificate;
2. The computation of premium or contribution
				amounts under the Medicare supplement policy or certificate;
3. The application of any preexisting
				condition exclusion under the Medicare supplement policy or certificate;
				and
4. Other activities related to
				the creation, renewal, or replacement of a contract of health insurance or
				health benefits.