(A) A health insurance issuer when issuing, renewing, or reissuing a policy or contract of health insurance coverage, on the basis of any genetic information obtained concerning an individual or a family member of the individual or on the individual’s request for genetic services, with respect to the policy or contract, may not:

(1) terminate, restrict, limit, or otherwise apply conditions to coverage of an individual or restrict the sale to an individual;

Terms Used In South Carolina Code 38-93-30

  • Contract: A legal written agreement that becomes binding when signed.
  • coverage: means as defined in Sections 38-71-670(6) and 38-71-840(14). See South Carolina Code 38-93-10
  • Family member: means , with respect to an individual:

    (a) a dependent of the individual; and

    (b) any other individual who is a first-degree, second-degree, third-degree, or fourth-degree relative of the individual or his dependent. See South Carolina Code 38-93-10
  • Genetic information: means , with respect to an individual, the:

    (i) individual's genetic tests;

    (ii) genetic tests of the individual's family members; and

    (iii) manifestation of a disease or disorder in family members of the individual. See South Carolina Code 38-93-10
  • Genetic services: means :

    (a) a genetic test;

    (b) genetic counseling, including obtaining, interpreting, or assessing genetic information; or

    (c) genetic education. See South Carolina Code 38-93-10
  • Individual: means an insured, individual enrollee, covered dependent, participant, covered person, beneficiary, eligible employee, dependent of an eligible employee, or applicant for coverage. See South Carolina Code 38-93-10
  • insurance: includes annuities. See South Carolina Code 38-1-20
  • issuer: means an entity that provides health insurance coverage in this State as defined in Sections 38-71-670(7) and 38-71-840(16). See South Carolina Code 38-93-10
  • Policy: means a contract of insurance. See South Carolina Code 38-1-20
  • Premium: means payment given in consideration of a contract of insurance. See South Carolina Code 38-1-20
  • producer: means a person who represents an insurance company and is required to be licensed pursuant to § 38-43-10. See South Carolina Code 38-1-20
  • Terminate: means the cancellation of the relationship between an insurance producer and the insurer or the termination of a producer's authority to transact insurance. See South Carolina Code 38-1-20

(2) cancel or refuse to renew the coverage of an individual;

(3) exclude an individual from coverage or establish rules for eligibility, including continued eligibility, of an individual to enroll for coverage;

(4) impose a waiting period before commencement of coverage of an individual;

(5) impose a preexisting condition exclusion;

(6) require inclusion of a rider that excludes coverage for certain benefits or services; or

(7) adjust premium or contribution amounts or establish a differential in premium rates for coverage.

(B)(1) In the case of group health insurance coverage, a health insurance issuer is prohibited from adjusting premium or contribution amounts for the group covered under a policy or contract of group health insurance coverage on the basis of genetic information.

(2) Nothing in item (1) may be construed to limit the ability of an issuer offering group health insurance coverage to increase the premium for an employer based on the manifestation of a disease or disorder in an individual who is enrolled in the policy or contract of coverage. In this case, the manifestation of a disease or disorder in one individual may not be used as genetic information about other group members and to further increase the premium for the employer.

(C) In addition, discrimination must not be made in the fees or commissions of a producer or agency for an enrollment, application, or the renewal of coverage of an individual or group on the basis of an individual’s genetic information.

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