Ins 3.39(36)(a) (a) In this subsection and for use in policies or certificates:

Ins 3.39(36)(a)1. 1. “Family member” means, with respect to an individual, any other individual who is a first through fourth degree relative of the individual.

Ins 3.39(36)(a)2. 2. “Genetic information” means, with respect to any individual, information about such individual’s genetic tests, the genetic tests of family members of such individual, and the manifestation of a disease or disorder in family members of such individual. Such term includes, with respect to any individual, any request for, or receipt of, genetic services, or participation in clinical research that includes genetic services, by such individual or any family member of such individual. Any reference to genetic information concerning an individual or family member of an individual who is a pregnant woman includes genetic information of any fetus carried by such pregnant woman, or with respect to an individual or family member utilizing reproductive technology, includes genetic information of any embryo legally held by an individual or family member. The term “genetic information” does not include information about the sex or age of any individual.

Ins 3.39(36)(a)3. 3. “Genetic services” means a genetic test, genetic counseling including, obtaining, interpreting, or assessing genetic information, or genetic education.

Ins 3.39(36)(a)4. 4. “Genetic test” means an analysis of human deoxyribonucleic acid, ribonucleic acid or chromosomes, proteins, or metabolites that detect genotypes, mutations, or chromosomal changes. The term “genetic test” does not mean an analysis of proteins or metabolites that does not detect genotypes, mutation, or chromosomal changes; or an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that could reasonably be detected by a health care professional with appropriate training and expertise in the field of medicine involved.

Ins 3.39(36)(a)5. 5. “Issuer of a Medicare supplement policy or certificate” includes third-party administrators, or other person acting for or on behalf of such issuer.

Ins 3.39(36)(a)6. 6. “Underwriting purposes,” means all of the following:

Ins 3.39(36)(a)6.a. a. Rules for, or determinations of, eligibility including enrollment and continued eligibility for benefits under the policy.

Ins 3.39(36)(a)6.b. b. The computation of premium or contribution amounts under the policy.

Ins 3.39(36)(a)6.c. c. The application of any preexisting condition exclusions under the policy.

Ins 3.39(36)(a)6.d. d. Other activities related to the creation, renewal, or replacement of a contract of health insurance or health benefits.

Ins 3.39(36)(b) (b) An issuer of a Medicare supplement policy or certificate may not request or require an individual or a family member of such individual to undergo a genetic test. An issuer may not request, require or purchase genetic information for use in underwriting. An issuer may not request, require or purchase genetic information with respect to any individual prior to such individual’s enrollment under the policy in connection with such enrollment.

Ins 3.39(36)(c) (c) Nothing in par. (b) shall be construed to limit the ability of an issuer, to the extent otherwise permitted by law, from any of the following;

Ins 3.39(36)(c)1. 1. Denying or conditioning the issuance or effectiveness of a policy or certificate or increasing the premium for a group based on the manifestation of a disease or disorder of an insured or applicant.

Ins 3.39(36)(c)2. 2. Increasing the premium for any policy issued to an individual based on the manifestation of a disease or disorder of an individual who is covered under the policy.

Ins 3.39(36)(d) (d) Notwithstanding par. (b), the manifestation of a disease or disorder in one individual cannot also be used as genetic information about other group members to further increase the premium for the group.

Ins 3.39(36)(e) (e) An issuer of a Medicare supplement policy or certificate may not request or require an individual or a family member of such individual to undergo a genetic test. Nothing in this paragraph shall be construed to preclude an issuer of a Medicare supplement policy or certificate from obtaining and using the results of a genetic test in making a payment determination when consistent with the requirements of par. (b). If genetic information is obtained, the request may only include the minimum amount necessary to accomplish the intended purpose.

Ins 3.39(36)(f) (f) If an issuer of a Medicare supplement policy or certificate obtains genetic information incidental to the requesting, requiring or purchasing of other information concerning any individual, such request, requirement or purchase may not be considered a violation of this section.

Ins 3.39 Note Note: This rule requires the use of a rate change transmittal form which may be obtained from the Office of the Commissioner of Insurance, P.O. Box 7873, Madison, WI 53707-7873.

Ins 3.39 Note Note: The rule revisions published in June, 1994 first apply to any policy issued, renewed or solicited on or after September 1, 1994.

Ins 3.39 Note Note: For a complete history of s. Ins 3.39 from July 1977 to October 31, 2001, see the History note following s. Ins 3.39 as published in Register October 2001 No. 550.

Ins 3.39 History History: CR 00-133: am (2) (a) (intro.), (3) (cm), (4) (intro.), (a), (b) 2., (34) (b) 5. a., 6., (c) 1. and Appendix 1, cr. (4) (a) 18p., (34) (b) 2. b., 2. f. and (c) 3., r. (7) (b),(c), (7) (g), (21) (f), r. and recr. (7) (d), (13) and (34) (b) 2.a., renum (7) (e) to be (7) (c) and am., renum. (7) (f) to be (7) (d), (34) (b) 2. b. to be 2. c., 2. c. to be 2. d and 2. d. to be 2. e.,Register October 2001 No. 550, eff. 11-1-01; corrections in (34) (b) 2. and 3., made under s. 13.93 (2m) (b) 1., Stats., Register October 2001 No. 550; emerg. am. eff. 12-16-02; corrections in (2) (a), (4), (7) (b) and (c), (13) and (33) made under s. 13.93 (2m) (b) 7., Stats., Register December 2002 No. 564; CR 02-118: am. (4) (a) 18p., (5) (c) 4., (34) (a) 1. and 2., (b) (intro.), 2. (intro.), a., b., 3. (intro.), a. and c., 4. (intro.), 5. a. and 6., r. (34) (b) 2. f. and fm., renum. (34) (c) and (d) to be (34) (e) and (f), cr. (34) (c) and (d) Register April 2003 No. 568, eff. 5-1-03; CR 04-121: am. (1) (c), (4) (intro.), (a) 1. to 3., 6., 12., 18m. and 18r. b., (4m) (a), (b) and (d), (5) (c) 6., 12. to 15., (i) (intro.) and 7., (j), (k) (intro.), (m) (intro.), (14) (a), (c) 6., (j), (m), (15), (16) (a), (c) (intro.), 1., 3. and (e), (21) (a) and (e), (22) (a), (b), (d), (e), (f) (intro.) and 1., (23) (a) (intro.), 1., 3., 4. and (c), (25) (a) to (c), (26) (a) (intro.), (27), (29), (30) (a), (b) 1. to 7., (c), (d), (e) (intro.) and 1. e., (f) 1., (g) (intro.), (h), (i) (intro.), 1. (intro.) and b., 3., 7., and 9., (j), (k) (intro.), (L) to (o), (p) (intro.) and 8., (34) (a), (b) 1., 1m., 2. (intro.) and a., 3. d., 4. (intro.), 5. a., 6., (c) 1. (intro.) and a., 2., 4., (e) and (f), and Appendices 5 and 8, cr. (2) (f), (4) (a) 20., 21., (5) (n), (o), (23) (a) 5., (30) (q), (r), (34) (b) 1r., 7., 8., and (c) 5., r. and recr. (3), (7), (22) (i) and Appendices 1, 3, 4, and 6, renum. (23) (a) 5., (30) (q) and (r) and (34) (c) 5. to be (23) (a) 6, (30) (s) and (t) and (34) (c) 6. and am. (23) (a) 6., (30) (s) and (t), r. (33) Register June 2005 No. 594, eff. 7-1-05; CR 08-112: am. (1) (a), (b), (3) (q), (v), (w), (4) (intro.), (a) 3., 8., 17., (5) (title), (intro.), (6) (intro.), (7) (a), (d), (8) (c), (9) (b), (14) (title), (a), (d) 3., (15), (23) (d), (24) (g), (26) (b), (30) (a) 1., 2., (b) (intro.), (31) (a) and (34) (e) (title), renum. (1) (c) to be (1) (d), cr. (1) (c), (3) (ce), (cs), (4s), (5m), (14m), (17), (18), (30m), (34) (ez), (35) and (36) Register June 2009 No. 642, eff. 7-1-09; CR 09-076: am. (5m) (e) (intro.), 5., (6) (intro.), (7) (a) (intro.), (8) (a) (intro.), (14m) (d) (intro.), (34) (b) 1., (c) 1., (ez) 1. and Appendix 3, cr. (5m) (k), (7) (cm), (dm), (30m) (p) 6., (34) (b) 1. c., 1s. and (f) 3., r. (30m) (q) 1., renum. (30m) (q) 2. and 3. to be (30m) (q) 1. and 2. Register May 2010 No. 653, eff. 6-1-10; correction in (7) (cm) made under s. 13.93 (2m) (b) 7., Stats., Register, May 2010 No. 653; CR 19-036: am. (1) (a), (b), r. (1) (c), am. (1) (d), (2) (a) (intro.), 1. to 3., r. (2) (a) 4., am. (2) (a) 5., (b), consol. (2) (c) (intro.) and 2. and renum. 3.39 (2) (c) and am., r. (2) (c) 1., am. (2) (d) (intro.), r. (2) (d) 4., am. (2) (e) (intro.), 1., (3) (c) (intro.), 1., (ce), (e), (f), cr. (3) (fm), am. (3) (g), cr. (3) (gm), am. (3) (i) 1. c., d., 5. a., cr. (3) (jm), (pm), renum. (3) (r) (intro.) to (3) (r) and am., r. (3) (r) 1. to 3., cr. (3) (um), am. (3) (v), cr. (3) (ve), (vm), (vs), am. (3) (w), cr. (3) (we), (wm), (ws), am. (3) (y), (za), cr. (3) (zag), (zar), am. (3) (zb), cr. (3) (zbm), (zcm), (3g), am. (4) (intro.), (a) (intro.), 1. to 7., 9. to 12., 16., 18., 18p., r. (4) (a) 18r. (intro.), renum. (4) (a) 18r. a. to c. to (4) (a) 18s., 18u., 18x. and am., am. (4) (b) (intro.), 1. to 7., (c), (e), (g), renum. (4m) to (3r) and as renum. am. (3r) (a) (intro.), (b), (d), renum. (4s) (intro., (a) (intro.), 1. to 20. to (4m) (intro.), (a) (intro.), 1. to 20. and as renum. am. (4m) (title), (intro.), (a) (intro.), 1., 3., 6., 11., 12., r. (4s) (a) 21. (intro.), renum. (4s) (a) 21. a., b., c. to (4m) (a) 21e., 21m., 21s. and am., renum. (4s) (a) 22., (b) to (f) to (4m) (a) 22., (b) to (f) and as renum. am. (4m) (a) 22., (b) 5., 7., (c) (intro.), 1., 2., (d) to (f), cr. (4t), am. (5) (intro.), (c) (intro.), (n) 12., (o) 12., (5m) (title), cr. (5m) (a) (intro.), renum. (5m) (a) 1. to (5m) (a) 1. (intro.) and am., cr. (5m) (a) 1. b., am. (5m) (a) 2. (intro.), renum. (5m) (b), (c) to (5m) (a) 2. a., b. and as. renum. am. (5m) (a) 2. b., am. (5m) (e) (intro.), (g) 12., (h) 12., (k) 4., cr. (5t), am. (6) (intro.), (7) (title), (a) (intro.), (b) (intro.), 1. (intro.), c., 2., (c), (cm), cr. (7) (ct), am. (7) (dm), cr. (7) (dt), am. (8) (title), (a) (intro.), (c), (e), (10) (a), (d) 1., (13), (14) (a), (c) (intro.), 1. to 6., (d) (intro.), 1., 2., (i) (intro.), (L), (14m) (title), (a), (c) 1. to 6., renum. (14m) (d) (intro.), 1. to 3. to (14m) (d) 1. to 4. and as renum. am. 1., 3., am. (14m) (i) (intro.), cr. (14t), am. (15), (16) (a), (c), (d) (intro.), 1., renum. (16) (d) 3. to. (16) (d) (3) (intro.) and am., cr. (16) (d) 3. a. to g., am. (16) (e), (17), (21) (a), cr. (21) (f), am. (22) (d), (f), (intro.), 1., (23) (a) (intro.), (c), (e), (24) (a) (intro.), 3., cr. (24) (a) 4., am. (25) (a) to (c), (26) (a) (intro.), 1., cr. (26) (a) 3. to 6., am. (26) (b), (27), (28) (title), (a) (intro.), (b) 2., (c), (29) (a), (b) 1., (30) (a), r. (30) (b), am. (30) (k) (intro.), (n) (intro.), (q) 12., (r) 12., (30m) (a) 1., r. (30m) (b), am. (30m) (i) 1. (intro.), 8., (k) (intro.), (n) (intro.), (q) (intro.), (r) 12., (s) 12., cr. (30t), r. and recr. (31) (a), (b), r. (31) (bm), am. (34) (a) 1., 2., (b) (intro.), 1s., 2. (intro.), (e) 4., 5., renum. (34) (ez) to (34) (em) and am., cr. (34) (et), am. (34) (f) 1., 2., (35) (intro.), (a), am. Appendix 1, renum. Appendix 2 to Appendix 2m and am., cr. Appendix 2t, renum. Appendix 3 to Appendix 3m and am., cr. Appendix 3t, renum. Appendix 4 to Appendix 4m and am., cr. Appendix 4t, renum. Appendix 5 to Appendix 5m and am., cr. Appendix 5t, am. appendix 6, cr. Appendices 6m, 6t, am. Appendix 7, r. Appendices 8, 9 Register December 2019 No. 768, eff. 1-1-20; renum. (3) (fm), (gm), (u), (um) to (3) (gg), (gr), (wg), (rm) under s. 13.92 (4) (b) 1., Stats., and correction in (3) (f), (g), (ws) 2., (y), (zar), (3r) (a) (intro.), (4) (a) 5., 18u., 18x., (e) 1., (4m) (intro.), (a) 21m., 21s., (b) 5., (4t) (a) (intro.), 21m., 21s., (b) 1., 4., (c) 1., (d), (5) (intro.), (5m) (a) (intro.), 1., (5t) (b) 1., (d) 5., (f), (g) 10., (h) 10., (L), (6) (intro.), (7) (a) (intro.), (10) (d) 1., (13) (intro.), (14) (c) 5., (d), (L), (14m) (d) 3., (14t) (d) 3., (k), (21) (f), (22) (d), (f), (23) (c), (30t) (c), (m) 2., (n) 2., (q) (intro.), (r) 10., (s) 10., (34) (e) 4., (et) 1., 3., 4. made under s. 35.17, Stats., and correction in (10) (d) 1. made under s. 13.92 (4) (b) 4., Stats., Register December 2019 No. 768.

Ins 3.39 APPENDIX 1

For policies with an effective date prior to June 1, 2010 the following information shall be inserted prior to each outline of coverage provided to an insured and include the information specific to the plan type.

PREMIUM INFORMATION

We can only raise your premium if we raise the premium for all policies like yours in this state. [Include information specifying when premiums will change.]

If your policy was issued as an under age 65 policy due to disability, when you turn 65 premiums will remain at the disabled rates. [Include this statement within premium information when issuer does not change premium to age 65 rate.]

DISCLOSURES