Back 

Genetic Nondiscrimination in Health Insurance Laws

 Genetics and Health Insurance State Anti-Discrimination Laws

Table of Contents

Additional Resources

ARCHIVE REPORT:  This report was prepared based on actions through January 2008
and has not been updated or revised since the date listed.

Updated January 2008

The table below provides a current summary of state laws pertaining to the use of genetic information in health insurance. Restrictions on the use of genetic information in health insurance may address the use of genetic information in individual insurance, group insurance or both. These laws may restrict health insurers from engaging in certain activities, including using genetic information to determine eligibility or set premiums, requiring genetic testing of applicants, or disclosing genetic information without consent. The laws listed below do not govern the use of genetic information in employer-sponsored health benefit plans, which are under the purview of the federal government, and certain exceptions may apply. The states with genetics and health insurance laws listed below also may have laws related to other genetics policy issues, such as genetic privacy or genetic discrimination in other settings. The legislature may have addressed these issues in conjunction with or separately from genetics and health insurance.

State

Citation

Type of Insurance Policy

May not Establish Rules for Eligibility based on Genetic Information

May not Require Genetic Tests/Genetic Information

May not Use Genetic Information for Risk Selection or Risk Classification Purposes

May not Disclose Information Without Informed Consent

Alabama

§§27-53-1et seq.

Individual and Group

X1

 

X1

 

Alaska

§§21.54.100, et seq.

Group

X

 

X2

 

Arizona

§§20-448, 448.02

Individual and Group

X4

 

X3

X

Arkansas

23§§86-304 et seq., 23§66-320

Individual and Group

X

X

X2

 

California

Insurance Code: §§742.405, 7, 10140, 3, 6 to 9, 9.1

Individual and Group

X

X

X

X

Colorado

§10-3-1104.7

Individual and Group

X

X

X

X

Connecticut

38a§§ 816, 476

Individual and Group

X

 

X

 

Delaware

§§16-1220, 18-2317

Individual and Group

X

 

X

X

District of Columbia §§2-1401.01 et seq.  Individual and Group

 X

 X

 X

 

Florida

§§627.4301, 627.6419, 636.0201, 641.31071, 641.31073, 641.438

Individual and Group

X

X

X

 

Georgia

§§33-54-1 to 8

Group or Individual

X

X

X

X

Hawaii

§§431:10a-118 and 404.5, 432:1-607 and 404.5, 432d-26

Individual

X

X

X

X

Idaho

§§41-2221, 41-3940, 41-4708

Group
Individual

X

 

 

X

 

Illinois

215-97/20, 97/25, 410-513/10 to 45

Individual and Group

X

X

x2,4

X

Indiana

27§§4-1-4(23), 8-26-1 et seq.

Individual and Group

X

X

X4,5

 

Iowa

§513b.9a, 10(4)(a)(1)

Group

X

 

X2

 

Kansas

§40-2259

Individual and Group

X

X

X

 

Kentucky

§§304.12-085, 304.17a-200 et seq.

Individual and Group

X

 

X

X

Louisiana

22§213.7

Individual and Group

X

 

X

X

Maine

24A§§2159-C(2), 2204, 2850-C, 22§1711-C

Individual and Group

X

 

X

X

Maryland

Ins §27-208, 909

Individual and Group

X

X

X6

X

Massachusetts

111§70G; 175§120E; 176§3B; 176B§5B; 176G§24; 176I§4A

Individual and Group

X

 

X4

X

Michigan

§§550.1401, 3407(b)

Individual and Group

 

X

 

X

Minnesota

§72a.139

Individual and Group

X

X

X

 

Mississippi

 

 

 

 

 

 

Missouri

§§375.1300 et seq.

Individual and Group

X

X

X4

X

Montana

§§33-18-901 et seq.

Individual and Group

X

X

X6

 

Nebraska

§§44-787, 524.02, 6910, 15, 16

Individual

 

X

 

 

Nevada

§§689a.417, 689b.069, 689c.076, 198

Individual and Group

X

 

X

X

New Hampshire

§§141-H:1 et seq.

Individual and Group

X

X

X

X

New Jersey

10:5-43 et seq., §17B:30-12

Individual and Group

X

 

X

X

New Mexico

§§24-21-1 et seq.

Individual and Group

X

X

X

X

New York

Ins §2612

Individual and Group

X

X4

X4

X

North Carolina

§§58-3-25, 215

Individual and Group

X

 

 

 

North Dakota

§§26.1-36.3-01 et seq.

Group

 

 

 

 

Ohio

§§1751.65, 3901.491 et seq.

Individual and Group

X

X

X

 

Oklahoma

§36-3614.1

Individual and Group

X

X

X

 

Oregon

§746.135

Individual and Group

X

X4

X6

X

Pennsylvania

 

 

 

 

 

 

Rhode Island

§§27-18-52 et seq., 19-44 et seq., 20-39 et seq., 41-53 et seq.

Individual and Group

X

X

X

X

South Carolina

§§38-93-10 to 60

Individual and Group

X

 

X

X

South Dakota

§§58-18-45, 58-18B-27

Group

X

X

X

 

Tennessee

§§56-7-2701 to 08

Individual and Group

X

X

X

X

Texas

Ins §546.001 et seq.

Individual and Group

X

 

X6

X

Utah

§26-45-101 to 106

Individual and Group

X

X

 X

 

Vermont

§§8:4724, 18:9334

Individual and Group

X

 

X3

X

Virginia

§§38.2-508.4, 613

Individual and Group

X

 

X

X

Washington

§70.02.010

 

 

 

 

X

West Virginia

§§33-15-2(a), (b)

Individual

X

 

X3

 

Wisconsin

§§631.89, 632.746, 8

Individual and Group

X

X

X

 

Wyoming

§26-19-102(g), 22-502

Group

X

 

 

 

NOTES

1 Alabama only prohibits the use of genetic information for denying coverage for applicants with sickle cell anemia and outlaws the considering a predisposition for cancer in risk selection or risk classification.
2 Prohibits the use of genetic information for the establishment of a premium, contribution, or policy fee greater than a similarly situated individual already enrolled in the plan on the basis of a health status factor.
3 Prohibits the use of genetic information without actuarial justification.

4 Permits the use of genetic information only when voluntarily submitted.

5 Permits the use of genetic information only when favorable to the individual.

6 Prohibits the use of an individual's genetic information to increase his policy rates.

Sources: National Conference of State Legislatures, Westlaw, StateNet

 

Enforcement Provisions

Updated January 2008

The majority of state legislatures have enacted measures to prohibit genetic discrimination in some or all forms of health insurance. Under state genetic nondiscrimination statutes, a state insurance commissioner's power to enforce the law ranges from the ability to suspend an insurer's license to the authority to impose heavy administrative fines. In addition, some state statutes specifically provide individuals who are damaged as a result of genetic discrimination the right to sue an insurer in civil court. Finally, penalty provisions in state genetic nondiscrimination laws often permit the insurance officials to promulgate additional regulations within the limits set forth by the statute.
 

State

License Revoked or Suspended

Private Right of Action

Authorizes Regulatory Penalties

Civil Liability, Criminal Penalties and Administrative Fines

Alabama

v

 

v

 

Alaska

 

 

 

Up to $2,500 fine

Arizona

v

 

 

Up to $1,000 for each violation or up to aggregate of $10,000 for six month period of unintentional violations; up to $5,000 for each violation or up to aggregate of $50,000 for six month period of intentional violations

Arkansas

v

v

 

Equitable relief; up to $1,000 fine for each violation or up to aggregate of $10,000 for unintentional violations; up to $5,000 for each violation or up to aggregate of $50,000 for intentional violations; up to $10,000 for each violation for failure to obey a cease and desist order

California

 

 

v

Up to $2,500 for the first unintentional violation and not more than $5,000 for each subsequent violation; Not less than $15,000 and not more than $100,000 for each intentional violation

Colorado

v

v

v

Equitable relief or the greater of an amount equal to actual damages or $10,000 per violation; prevailing party can recover costs & reasonable attorney's fees Up to $1,000 for each violation or up to aggregate of $10,000 for unintentional violations; up to $10,000 for each intentional violation but not more than an aggregate of $150,000 in a six month period; payment of claims that insurer failed to pay as a result of the violation unless civil action is pending; for failure to obey a cease and desist order, up to $10,000 for each violation of an insurer or up to $500 for each violation of an individual

Connecticut

 

 

v

Commissioner can through the Attorney General enjoin and restrain violators from engaging in genetic discrimination

Delaware

 

 

v

Commissioner can through the Attorney General enjoin and restrain violators from engaging in genetic discrimination

Florida

v

 

v

Commissioner also may suspend enrollment of new subscribers

Georgia

 

v

 

Provides an individual with a cause of action against the person whose violation caused harm; an insurer is liable for equitable relief; individual can recover costs & reasonable attorney's fees

Hawaii

 

 

v

 

Idaho

 

 

v

For Managed Care Organizations, up to $15, 000 fine for each violation

Illinois

 

 

v

 

Indiana

v

 

v

Commissioner can order insurer to cease and desist genetic discrimination; fine of up to $25,000 for each unintentional violation; up to $50, 000 for an intentional violation; for failure to comply with cease and desist order, violator is subject to fine of up to $25,000 for each violation and/or suspension or revocation of insurance license

Iowa

 

 

v

 

Kansas

v

 

 

Commissioner may impose a fine of up to $1,000 for each unintentional violation; up to $2,000 for each intentional violation; commissioner can order to cease and desist genetic discrimination; for failure to respond to report to commissioner, fine of up to $500 for each violation, along with an additional penalty of up to $100 for each week thereafter

Kentucky

v

 

 

Fine of up to $100 or twice the amount of gain from the commission of the act, whichever is greater

Louisiana

 

v

 

Individual can recover between up to $100,000 in actual damages from a person whose disclosure, collection, analysis or storage of genetic information results in insurance discrimination; reasonable attorney's fees also recoverable

Maine

v

v

 

Upon action brought by the Attorney General, a fine of up to $500 and not more than $5,000 for each violation in the case of an individual and up to $2,000 and not more than $15,000 for each violation in the case of a corporation or other entity other than an individual; following a hearing, up to $500 for each violation in the case of an individual and a civil penalty of up to $10,000 for each violation in the case of a corporation or other entity other than an individual; in addition to fines, the Superior Court may award equitable relief to an injured individual, who is represented by the Attorney General; superintendent may order regular cease and desist order or emergency cease and desist order; superintendent may send letter of reprimand, order refund of overcharges, and/or order restitution following a hearing

Maryland

v

 

v

Commissioner may notify a person of hearing and the charges; hold the hearing; make a report of findings; and through the Attorney General, enjoin or restrain an insurer from engaging in genetic discrimination; the court may order an injunction or restraining order; rather than suspending or revoking an insurer's license, the commissioner may impose a fine of not less than $100 up to $125,000 for each violation and require the holder of the license to make restitution to any person who has suffered financial injury because of the violation

Massachusetts

v

 

 

Commissioner may order insurer to cease and desist genetic discrimination; for failure to comply with, fine of up to $10,000 for each violation, which may be recovered in a civil action

Michigan

 

 

v

 

Minnesota

 

 

v

 

Mississippi

No provision

Missouri

v

 

 

Director may arrange for a hearing and order an insurer to cease and desist genetic discrimination after hearing; fine of up to $1,000 for each violation but not to exceed an aggregate penalty of $100,.000 in 12 month period; for a flagrant, intentional violation up to $25,000 per violation but not to exceed $250,000 in a 12 month period; for failure to cease and desist genetic discrimination, fine of up to $25,000 per violation but not to exceed $250,000 in a 12 month period

Montana

 

 

 

Commissioner may arrange for a hearing and file a report of charges; enjoin and restrain insurer from engaging in genetic discrimination; and issue a cease and desist order; for failure to cease and desist, fine of up to $1,000; each day of violation constitutes separate violation; aggregate fine may not exceed $10,000

Nebraska

 

 

v

Class III misdemeanor, maximum of up to three months imprisonment or a fine of up to $500 or both

Nevada

v

 

 

Commissioner may file charges for unfair trade practices; may order insurer to cease and desist engaging in genetic discrimination; for failure to comply with order, fine of up to $5,000

New Hampshire

 

 

v

Aggrieved individual may bring civil action; court may award special or general damages of not less than $1,000 for each violation, and costs and reasonable legal fees

New Jersey

v

 

 

Commissioner may hold hearing, issue cease and desist order, and impose fine of up to $1,000 per unintentional violation or $5,000 per intentional violation; for failure to comply with cease and desist order, fine of up to $5,000 per violation

 

 

 

 

 

New Mexico

 

 

 

District Attorney may bring civil action for a violation; court may require compliance and appropriate relief; health insurer may be required to provide health insurance under terms and conditions if violation had not occurred; court may award actual damages, damages of up to $5,000 over economic loss in cases of willful or grossly negligent conduct, reasonable attorney's fees and court costs; each instance is a separate, actionable violation

New York

 

 

 

Misdemeanor; superintendent may maintain a civil action in the name of the people of the state to recover a judgment for a money penalty imposed by law fine of up to $5,000 if genetic information is used for underwriting purposes without consent; superintendent may hold hearing and issue cease and desist order; for failure to cease and desist, fine of up to $5,000 per violation; if violation is determined, court may enjoin insurer from engaging in use of genetic information and on motion and affidavits grant a preliminary injunction and interlocutory injunction

North Carolina

v

 

 

Following a hearing, commissioner may impose fine of not less than $100 and up to $1,000; upon the request of the commissioner the court may order restitution to the individual harmed

North Dakota

v

 

 

If commissioner determines a violation occurred, a fine of up to $1,000 per unintentional violation and an aggregate of up to $10,000 in a six month period; for intentional violation, a fine of up to $5,000 per violation and an aggregate of up to $50,000 in a six month period; commissioner may order insurer to cease and desist genetic discrimination; for failure to cease and desist, fine of up to $10,000 for each day of violation

Ohio

 

 

v

Superintendent may administer oaths, summons or subpoena to investigate violations or initiate criminal proceedings by providing evidence of criminal misconduct

Oklahoma

 

v

 

Harmed individual may recover equitable relief, which may include a retroactive order, directing the insurer to provide insurance coverage to the damaged individual under the same terms and conditions had the violation not occurred; punishable as misdemeanor; commissioner may hold a hearing and issue cease and desist order; if commissioners findings are supported by evidence, court can enjoin or restrain insurer from engaging in genetic discrimination; for failure to cease and desist, fine of not less than $100 and up to $1,000 per day of violation

Oregon

 

 

v

Authorizes commissioner to examine and investigate violations

Pennsylvania

No provision

Rhode Island

 

 

v

Fine of up to $100 per violation; state may recover fine through civil action

South Carolina

v

v

 

Harmed individual may recover equitable relief, which may include a retroactive order, directing the person to provide health insurance appropriate to the injured individual under the same terms and conditions had the violation not occurred and actual damages; prevailing party may recover reasonable attorney's fees and court costs; fine of up to $5,000 per willful violation

South Dakota

v

 

v

Director may institute proceedings for a potential violation and issue temporary cease and desist order; director may enjoin insurer for failure to comply with cease and desist order; fine of up to $5,000 for insurance producer or $25,000 for insurer, administrator or HMO may take place of licensure penalty

Tennessee

 

 

v

 

Texas

v

 

 

Commissioner may issue cease and desist order for use of genetic information

Utah

 

v

 

Harmed individual may recover equitable relief, actual damages, $100,000 for intentional violation, punitive damages for malicious violation, and reasonable attorney's fees; attorney general may enjoin or restrain use of genetic information and impose fine of up to $25,000 for each intentional violation and require payment of reasonable attorney's fees

Vermont

v

 

 

Commissioner may examine and investigate potential violations; fine of up to $1,000 for each unintentional violation or $10,000 for each intentional violation

Virginia

v

 

 

Commissioner may examine and investigate potential violations

Washington

No provision

West Virginia

 

 

 

Misdemeanor punishable by fine of up to $1,000; each day of violation is a separate offense

Wisconsin

 

 

v

Authorizes commissioner to enforce genetic nondiscrimination statute, including conducting examinations; examination costs to be paid by examinee unless commissioner finds that it is an unreasonable burden

Wyoming

 

 

 

Punishable as misdemeanor with fine of up to $1,000 or by imprisonment for up to six months or both; fine of up to $2,500 for each offense by insurers or an aggregate of $25,000 over three months; for a violation by an agent, fine of up to $500 or an aggregate of $5,000 over three months; state may recover fines through civil action

Total

21

8

22

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Source: National Conference of State Legislatures (NCSL), West Group.

Share this: 
We are the nation's most respected bipartisan organization providing states support, ideas, connections and a strong voice on Capitol Hill.

NCSL Member Toolbox

Denver

7700 East First Place
Denver, CO 80230
Tel: 303-364-7700 | Fax: 303-364-7800

Washington

444 North Capitol Street, N.W., Suite 515
Washington, D.C. 20001
Tel: 202-624-5400 | Fax: 202-737-1069

Copyright 2014 by National Conference of State Legislatures