375.995. Sex or marital status discrimination as to benefits or coverage prohibited.
Sex or marital status discrimination as to benefits or coverageprohibited.
375.995. 1. As used in this section, the following terms shall mean:
(1) "Contract", any insurance policy, plan, or binder, including anyrider or endorsement thereto, offered by an insurer;
(2) "Insurer", any insurance company, association, reciprocal orinterinsurance exchange, not-for-profit hospital plan, not-for-profitprofessional health service plan, health maintenance organization, fraternalbenefit society, beneficial association, or health services corporation, asdefined in section 354.010, RSMo.
2. The purpose of this section is to eliminate the act of denyinginsurance benefits or coverage on the sole basis of sex or marital status inany terms or conditions of insurance contracts and in the underwritingcriteria of insurance carriers.
3. This section shall apply to all contracts delivered or issued fordelivery in this state by an insurer on or after October 1, 1986, and to allexisting group contracts which are amended on or after October 1, 1986.
4. The availability of any insurance contract shall not be denied to anyinsured or prospective insured on the sole basis of the sex or marital statusof such insured or prospective insured. Neither the amount of benefitspayable under a contract, nor any term, condition, or type of coverage withina contract, shall be restricted, modified, excluded, or reduced solely on thebasis of the sex or marital status of the insured or prospective insuredexcept to the extent such restriction, modification, exclusion, or reductionis a result of the application of rate differentials permitted under theinsurance laws of this state. Nothing in this section shall prohibit aninsurer from taking the marital status of an insured or prospective insuredinto account for the purpose of defining persons eligible for dependents'benefits. Specific examples of practices prohibited by this section include,but are not limited to, the following:
(1) Denying coverage to females gainfully employed at home, employedpart time or employed by relatives when such coverage is offered to malessimilarly employed;
(2) Denying policy riders to females when such riders are available tomales;
(3) Denying maternity benefits to insureds or prospective insuredspurchasing an individual contract when comparable family coverage contractsoffer maternity benefits;
(4) Denying, under group contracts, dependent coverage to husbands offemale employees, when dependent coverage is available to wives of maleemployees;
(5) Denying disability income contracts to employed women when suchcoverage is offered to men similarly employed;
(6) Treating complications of pregnancy differently from any otherillness or sickness under the contract;
(7) Restricting, reducing, modifying, or excluding benefits relating tocoverage involving the genital organs of only one sex;
(8) Offering lower maximum monthly benefits to women than to men who arein the same classification under a disability income contract;
(9) Offering more restrictive benefit periods and more restrictivedefinitions of disability to women than to men in the same classificationsunder a disability income contract;
(10) Establishing different conditions by sex under which thepolicyholder may exercise benefit options contained in the contract;
(11) Limiting the amount of coverage an insured or prospective insuredmay purchase based upon the insured's or prospective insured's marital statusunless such limitation is for the purpose of defining persons eligible fordependents' benefits.
(L. 1985 H.B. 527 § 1)Effective 10-1-86