(A) A health insurance issuer may not request or require an individual or a family member of an individual to undergo a genetic test. However, nothing in this subsection may be construed so as to limit the authority of a health care professional who is providing health care services to an individual to request that the individual undergo a genetic test.

(B) Notwithstanding subsection (A), a health insurance issuer may request, but not require, that an individual or a family member of the individual undergo a genetic test if each of the following conditions is met:

Terms Used In South Carolina Code 38-93-60

  • 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 test: means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites that detects genotypes, mutations or chromosomal changes. 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
  • Person: means a corporation, agency, partnership, association, voluntary organization, individual, or another entity, organization, or aggregation of individuals. 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
  • Secretary: means the Secretary of the United States Department of Health and Human Services. See South Carolina Code 38-93-10
  • Underwriting purposes: means :

    (a) rules for, or determination of, eligibility including enrollment and continued eligibility for benefits under the policy or coverage;

    (b) the computation of premium or contribution amounts under the policy or coverage;

    (c) the application of any preexisting condition exclusion under the policy or coverage; and

    (d) other activities related to the creation, renewal, or replacement of a policy or contract of health insurance coverage. See South Carolina Code 38-93-10

(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 law or regulations for the protection of human subjects in research;

(2) the issuer clearly indicates to each individual, or a person legally authorized to consent on behalf of the individual, to whom the request is made that:

(i) compliance with the request is voluntary; and

(ii) noncompliance will have no effect on enrollment or coverage status or premium or contribution amounts;

(3) no genetic information collected or acquired under this chapter may be used for underwriting purposes;

(4) the issuer notifies the Secretary in writing that the issuer is conducting activities pursuant to the exception provided in this subsection, including a description of the activities conducted; and

(5) the issuer complies with other conditions as the secretary may require by regulation for activities conducted under this subsection.

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