Utah Admin. Code 590-83-4

Current through Bulletin 2024-19, October 1, 2024
Section R590-83-4 - Availability Requirements and Prohibited Transactions
(1) An insured or prospective insured may not be denied coverage on the basis of gender or marital status .
(a) The amount of benefits payable, or any term, condition, or type of coverage may not be restricted, modified, excluded, or reduced on the basis of gender or marital status .
(b) Marital status may not be considered when defining eligibility for dependent or family coverage.
(2) Prohibited practices include:
(a) denying, canceling or refusing to renew coverage, or providing coverage on different terms, because the insured or prospective insured is residing with another person not related by blood or marriage;
(b) offering coverage to an individual of a particular gender gainfully employed at home, employed part-time, or employed by relatives while denying or offering reduced coverage to an individual of a different gender similarly employed;
(c) reducing disability benefits for an individual of a particular gender who becomes disabled while not gainfully employed full-time outside the home when a similar reduction is not applied to an individual of a different gender;
(d) denying an individual of a particular gender a waiver of premium provisions that are available to an individual of a different gender, or offering the provisions to an individual of a particular gender only for contract limits that are lower than those available to an individual of a different gender;
(e) refusing to offer maternity benefits to an insured or prospective insured purchasing an individual contract when a comparable family coverage contract offers maternity benefits;
(f) denying, under a group contract, dependent coverage to the spouse of an employee of a particular gender when dependent coverage is available to the spouse of an employee of a different gender;
(g) offering coverage to an individual of a particular gender in certain occupations while denying coverage or offering more limited coverage to an individual of a different gender in the same occupational categories;
(h) offering an individual of a particular gender higher benefit levels or longer benefit periods, or both, than are offered to an individual of a different gender in the same classifications;
(i) offering a contract containing different definitions of disability for an individual of a particular gender and an individual of a different gender in the same classifications;
(j) offering a contract containing different waiting and elimination periods for an individual of a particular gender and an individual of a different gender;
(k) requiring an applicant of a particular gender to submit to a medical examination while not requiring an applicant of a different gender to submit to a medical examination for the same coverage;
(l) establishing different benefit options for an individual of a particular gender and an individual of a different gender;
(m) denying to a divorced or a single person coverage available to a married person;
(n) limiting the amount of coverage available to an insured or prospective insured based upon the person's marital status;
(o) denying an employee of a particular gender insurance benefits that are offered to a dependent who is of the same gender as the employee;
(p) denying a married or separated individual of a particular gender the right to obtain or continue coverage in the individual's own name when the same does not apply to an individual of a different gender;
(q) establishing different issue age requirements for an individual of a particular gender and an individual of a different gender;
(r) establishing different occupational classifications for an individual of a particular gender and an individual of a different gender;
(s) denying coverage to an unwed person or their dependent, or both.

Utah Admin. Code R590-83-4

Amended by Utah State Bulletin Number 2021-24, effective 12/9/2021