Texas Administrative Code › Title 28 - INSURANCE › Part 1 - TEXAS DEPARTMENT OF INSURANCE › Chapter 3 - LIFE, ACCIDENT, AND HEALTH INSURANCE AND ANNUITIES › Subchapter T - MINIMUM STANDARDS FOR MEDICARE SUPPLEMENT POLICIES › Section 3.3326 - Prohibition Against Use of Genetic Information and Requests for Genetic Testing in Medicare Supplement Policies

Current through Reg. 49, No. 28; July 12, 2024
This section applies to all Medicare supplement policies
					 and certificates with policy years beginning on or after July 1, 2009.
(1) The definitions in subparagraphs (A) -
				  (F) of this paragraph apply to this section only.
(A) "Issuer of a Medicare supplement policy
				  or certificate" includes a third-party administrator, or other person acting
				  for or on behalf of such issuer.
(B) "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.
(C) "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. Such term 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.
(D) "Genetic services"
				  means a genetic test, genetic counseling (including obtaining, interpreting, or
				  assessing genetic information), or genetic education.
(E) "Genetic test" means an analysis of human
				  DNA, RNA, chromosomes, proteins, or metabolites, that detect genotypes,
				  mutations, or chromosomal changes. The term "genetic test" does not mean an
				  analysis of proteins or metabolites that does not detect genotypes, mutations,
				  or chromosomal changes; or 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.
(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 any pre-existing
				  condition exclusion under the policy; and
(iv) other activities related to the
				  issuance, renewal, or replacement of a contract of health insurance or health
				  benefits.