- (a) The amount of benefits payable, or any term, condition, 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.
(b) Specific practices prohibited by this rule shall include but not be limited to the following:
(1)
- (A) Treatment of complications of pregnancy on a different basis from any other illness or sickness under the contract.
- (B) Pregnancy on the effective date of the contract may be considered a preexisting condition to the complication of pregnancy;
- (2) Restriction, reduction, modification, or exclusion of benefits for disorders of the genital organs of only one (1) sex;
- (3) Application of arbitrary waiting period to maternity benefits in such a way as to exclude coverage for premature births when normal maternity benefits are included in the contract;
- (4) Offering of lower maximum benefits to females than to males who are in the same risk classifications, solely because of sex;
- (5) Providing more restrictive benefit periods or more restrictive definitions of the risk assumed under the contract to one (1) sex than to the other;
- (6) Establishing different conditions under which the policyholder may exercise benefit options contained in a contract where the differences are determined by the sex of the insured;
- (7) Limiting the amount of coverage an insured or prospective insured may purchase based on the insured's or prospective insured's marital status; and
(8)
- (A) Denying benefits for normal pregnancy to an unmarried female when such benefits are available to a married female.
- (B) However, this does not mandate coverage for normal pregnancy benefits for dependent children.