Utah Admin. Code 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.

Notes

Utah Admin. Code R590-83-4

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