§ 27-18.6-4 - Discrimination prohibited.
SECTION 27-18.6-4
§ 27-18.6-4 Discrimination prohibited.– (a) Notwithstanding any of the provisions of this title to the contrary, agroup health plan and a health insurance carrier offering group healthinsurance in connection with a group health plan may not establish rules foreligibility (including continued eligibility) of any individual to enroll underthe terms of the plan based on health status-related factors in relation to theindividual or dependent of the individual.
(2) Rules for eligibility to enroll under a plan includerules defining any applicable waiting periods for enrollment.
(b) Subsection (a) of this section shall not be construed:
(1) To require a group health plan or group health insurancecoverage to provide particular benefits other than those provided under theterms of the plan or coverage; or
(2) To prevent a plan or coverage from establishinglimitations on the amount, level, extent, or nature of the benefits or coveragefor similarly situated individuals enrolled in the coverage.
(c) A group health plan and a health insurance carrieroffering health insurance coverage in connection with a group health plan maynot require any individual (as a condition of enrollment or continuedenrollment under the plan) to pay a premium or contribution which is greaterthan the premium or contribution for a similarly situated individual enrolledin the plan on the basis of any health status-related factor in relation to theindividual or to an individual enrolled under the plan as dependent of theindividual.
(2) Nothing contained within this subsection shall beconstrued to:
(i) Restrict the amount that an employer may be charged forcoverage under a group health plan; or
(ii) Prevent a group health plan and a health insurancecarrier offering group health insurance coverage from establishing premiumdiscounts or rebates or modifying applicable copayments or deductibles inreturn for adherence to programs of health promotion and disease prevention.