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OAC 365:10

INSURANCE DEPARTMENT

(f)

For purposes of carrying out Subsection (d), an issuer of a Medicare supplement policy or

certificate may request only the minimum amount of information necessary to accomplish the intended purpose. (g) Notwithstanding Subsection (c), an issuer of a Medicare supplement policy may request, but not require, that an individual or a family member of such individual undergo a genetic test if each

of the following conditions is met:

    • (1)

      The request is made pursuant to research that complies with part 46 of title 45, Code of Federal Regulations, or equivalent Federal regulations, and any applicable State or local law or regulations for the protection of human subjects in research.

    • (2)

      The issuer clearly indicates to each individual, or in the case of a minor child, to the legal guardian of such child, to whom the request is made that:

      • (A)

        compliance with the request is voluntary; and

      • (B)

        non-compliance will have no effect on enrollment status or premium or contribution amounts.

    • (3)

      No genetic information collected or acquired under this Subsection shall be used for underwriting, determination of eligibility to enroll or maintain enrollment status, premium rates, or the issuance, renewal, or replacement of a policy or certificate.

    • (4)

      The issuer notifies the Secretary in writing that the issuer is conducting activities pursuant to the exception provided for under this Subsection, including a description of the activities conducted.

    • (5)

      The issuer complies with such other conditions as the Secretary may by regulation require for activities conducted under this Subsection.

  • (h)

    An issuer of a Medicare supplement policy or certificate shall not request, require, or

purchase genetic information for underwriting purposes.

(i)

An issuer of a Medicare supplement policy or certificate shall not request, require, or

purchase genetic information with respect to any individual prior to such individual’s enrollment under the policy in connection with such enrollment. (j) If an issuer of a Medicare supplement policy or certificate obtains genetic information incidental to the requesting, requiring, or purchasing of other information concerning any individual, such request, requirement, or purchase shall not be considered a violation of Subsection (h) if such

request, requirement, or purchase is not in violation of Subsection (g).

  • (k)

    For the purposes of this Section only:

    • (1)

      “Issuer of a Medicare supplement policy or certificate” includes third-party administrator, or other person acting for or on behalf of such issuer.

    • (2)

      “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.

    • (3)

      “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

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