Current through Register Vol. 43, No. 39, September 26, 2024
(a) As used in this
regulation, each of the following terms shall have the meaning specified in this
subsection:
(1) "Acquired immunodeficiency
syndrome" and "AIDS" mean one or more opportunistic diseases that are at least
moderately indicative of underlying cellular immunodeficiency, along with the
absence of all known underlying causes of cellular immunodeficiency and all other
causes of reduced resistance reported to be associated with at least one of those
opportunistic diseases.
(2) "Adverse
underwriting decisions" mean the actions described in K.S.A. 40-2,111(a), and
amendments thereto.
(3) "Applicant"
means the individual proposed for coverage.
(b) All individual and group applications for
insurance that require health information or questions shall meet the following
requirements:
(1) When an applicant is requested to
take an HIV antibody test in connection with an application for insurance, the
insurer shall perform the following:
(A) Obtain
written informed consent from the applicant;
(B) reveal the use of the test to the
applicant;
(C)
(i) Provide the applicant with printed material
before testing containing factual information describing AIDS, its causes, symptoms,
the ways it is and can be spread, the tests used to detect the HIV antibody and the
actions to take for a person whose test results are positive; or
(ii) arrange for the applicant to receive relevant
counseling from a qualified practitioner who has had extensive training and
experience in addressing the fears, questions, and concerns of persons tested for
the HIV antibody;
(D)
administer an initial test that meets the test protocol established by the food and
drug administration of the federal department of health and human
services;
(E) administer a second test,
the immunoelectroprecipitate using disrupted whole virus antigen test (western
blot), or any other confirmatory test approved by the food and drug administration
of the federal department of health and human services in accordance with current
centers for disease control and prevention guidelines and protocols, to substantiate
an initial positive test result; and
(F)
disclose the results of the testing in accordance with K.S.A. 40-2,112(b)(2) and
(3), and amendments thereto.
(2) An insurer may ask diagnostic questions on
each application for insurance.
(3) Each
application question shall be worded in a manner designed to elicit specific medical
information and not lifestyle, sexual orientation, or other inferential
information.
(4) Application questions
that are vague, subjective, unfairly discriminatory, or so technical as to inhibit a
clear understanding by the applicant shall be prohibited.
(c) All underwriting decisions shall be based on
individual review of one or a combination of the following categories of
information:
(1) Specific health information
furnished on the application;
(2)
reports provided as a result of medical examinations performed at the insurer's
request; or
(3) medical record
information obtained from the applicant's health care providers.
(d) Adverse underwriting decisions
shall not be based on less than conclusive responses to application
questions.
(e) Each adverse underwriting
decision shall be based on sound actuarial principles pursuant to K.S.A. 40-2,109,
and amendments thereto.