§ 83-71-7. Unfair discriminatory acts; health insurance
It is unfairly discriminatory to:
Deny, refuse to issue, renew or reissue, cancel or otherwise terminate a health benefit plan or restrict or exclude health benefit plan coverage or add a premium differential to any health benefit plan on the basis of the applicant’s or insured’s abuse status; or
Exclude or limit coverage for losses or deny a claim incurred by an insured on the basis of the insured’s abuse status;
When the health carrier or insurance professional has information in its possession that clearly indicates that the insured or applicant is a subject of abuse, the disclosure or transfer of the confidential abuse information by a person employed by or contracting with a health carrier or insurance professional for any purpose or to any person is unfairly discriminatory, except disclosure or transfer:
To the subject of abuse or an individual specifically designated in writing by the subject of abuse;
To a health care provider for the direct provision of health care services;
To a licensed physician identified and designated by the subject of abuse;
When ordered by the commissioner or a court of competent jurisdiction or otherwise required by law; or
When necessary for a valid business purpose to transfer information that includes confidential abuse information that cannot reasonably be segregated without undue hardship. Confidential abuse information may be disclosed only if the recipient has executed a written agreement to be bound by the prohibitions of Sections 83-71-1 through 83-71-15 in all respects and to be subject to the enforcement of Sections 83-71-1 through 83-71-15 by the courts of this state for the benefit of the applicant or the insured and only to the following persons:
A reinsurer that seeks to indemnify or indemnifies all or any part of a policy covering a subject of abuse and that cannot underwrite or satisfy its obligations under the reinsurance agreement without that disclosure;
A party to a proposed or consummated sale, transfer, merger or consolidation of all or part of the business of the health carrier or insurance professional;
Medical or claims personnel contractingwith the health carrier or insurance professional, only where necessary to process an application or perform the health carrier’s or insurance professional’s duties under the policy or to protect the safety or privacy of a subject of abuse (also includes parent or affiliate companies of the health carrier or insurance professional that have service agreements with the health carrier or insurance professional); or
With respect to address and telephone number, to entities with whom the health carrier or insurance professional transacts business when the business cannot be transacted without the address and telephone number;
To an attorney who needs the information to represent the health carrier or insurance professional effectively, if the health carrier or insurance professional notifies the attorney of its obligations under Sections 83-71-1 through 83-71-15 and requests that the attorney exercise due diligence to protect the confidential abuse information consistent with the attorney’s obligation to represent the health carrier or insurance professional;
To the policy owner or assignee, in the course of delivery of the policy, if the policy contains information about abuse status; or
To any other entities deemed appropriate by the commissioner.
It is unfairly discriminatory to request information relating to acts of abuse or an applicant’s or insured’s abuse status or make use of that information, however obtained, except for the limited purposes of complying with legal obligations or verifying a person’s claim to be a subject of abuse.
It is unfairly discriminatory to terminate group coverage for a subject of abuse because coverage was originally issued in the name of the abuser and the abuser has divorced, separated from or lost custody of the subject of abuse or the abuser’s coverage has terminated voluntarily or involuntarily.Nothing in this subsection prohibits the health carrier or insurance professional from requiring the subject of abuse to pay the full premium for coverage under the health plan or from requiring as a condition of coverage that the subject of abuse reside or work within its service area, if the requirements are applied to all insureds of the health carrier or insurance professional.The health carrier or insurance professional may terminate group coverage after the continuation coverage required by this subsection has been in force for eighteen (18) months, if it offers conversion to an equivalent individual plan.The continuation coverage required by this section shall be satisfied by coverage required under Public Law 99-272, the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, provided to a subject of abuse and is not intended to be in addition to coverage provided under COBRA.
Subsection (2) of this section does not preclude a subject of abuse from obtaining his or her insurance records.
Subsection (3) of this section does not prohibit a health carrier or insurance professional from asking about a medical condition or from using medical information to underwrite or to carry out its duties under the policy, even if the medical information is related to a medical condition that the insurer or insurance professional knows or has reason to know is abuse-related, to the extent otherwise permitted under Sections 83-71-1 through 83-71-15 and other applicable law.
