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6.6.1203    PROHIBITED PRACTICES

(1) Availability shall not be denied to an insured or prospective insured on the basis of sex or marital status of the insured or prospective insured. The amount of benefits payable or any term, conditions or type of coverage shall not be restricted, modified, excluded or reduced on the basis of the sex or marital status of the insured or prospective insured except to the extent the amount of benefits, term, conditions or type of coverage vary as a result of the application of rate differentials permitted under the Montana Insurance Code. However, nothing in 6.6.1202 and 6.6.1203 shall prohibit an insurer from taking marital status into account for the purpose of defining persons eligible for dependents coverage.

(2) Specific examples of practices prohibited by this rule include but are not limited to the following:

(a) Denying, cancelling or refusing to renew coverage, or providing coverage on different terms, because the insured or prospective insured is residing with another person or persons not related to him or her by blood or marriage;

(b) Offering coverage to members of one sex gainfully employed at home, employed parttime or employed by relatives while denying or offering reduced coverage to those of the opposite sex similarly employed;

(c) Reducing disability benefits for members of one sex who become disabled while not gainfully employed full-time outside the home while not applying a similar reduction to those of the opposite sex;

(d) Denying members of one sex waiver of premium provisions that are available to those of the opposite sex or offering such provisions to members of one sex only for contract limits that are different from those available to those of the opposite sex;

(e) Refusing to offer maternity benefits to insureds or prospective insureds purchasing individual contracts when comparable family coverage contracts offer maternity benefits;

(f) Denying, under group contracts, dependent's coverage to spouses of employees of one sex when dependent's coverage is available to spouses of employees of the opposite sex;

(g) Denying coverage to employed members of one sex while offering coverage to those of the opposite sex similarly employed;

(h) Offering contracts containing different definitions of disability different benefit levels, or different benefit periods for members of one sex than for those of the opposite sex in the same classifications;

(i) Offering contracts containing different waiting and elimination periods for members of one sex than for members of the opposite sex;

(j) Requiring applicants of one sex to submit to medical examinations while not requiring those of the opposite sex to submit to such examinations for the same coverage;

(k) Establishing different benefit options for those of the opposite sex;

(l) Denying or limiting the amount of coverage available to an insured or prospective insured based upon marital status;

(m) Denying employees of one sex insurance benefits that are offered to dependents who are of the same sex as the employees;

(n) Denying a married or separated female the right to obtain coverage in her own name;

(o) Establishing different issue age requirements for members of one sex than for those of the opposite sex;

(p) Refusing to continue coverage on a spouse or ex-spouse while continuing coverage on the other spouse or ex-spouse following separation or dissolution of a married couple previously covered under a family or household contract.

History: Sec. 33-1-313, MCA; IMP, Sec. 33-18-206, 33-18-210, 33-7-519, 33-30-306 MCA; NEW, 1978 MAR p. 1615-1617, Eff. 2/1/79.

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