Section R20-6-207. Gender Discrimination

A.      The following definitions apply to this Section:

1.        “Applicant” means a person who is applying for a policy.

2.        “Policy” means an insurance policy, plan, contract, certif- icate, evidence of coverage, subscription contract, or binder, including a rider or endorsement offered by an insurer.

3.        “Insurer” means any company that issues a policy.

B.       Applicability and scope. This Section applies to any policy or certificate delivered or issued for delivery in this state.

C.      Availability requirements.

1.        An insurer shall not deny availability of any insurance policy on the basis of the gender or marital status of the insured or prospective insured.

2.        An insurer shall not restrict, modify, exclude, reduce, or limit the amount of benefits payable, or any term, condi- tions or type of coverage on the basis of an applicant’s or insured’s gender or marital status, except to the extent the amount of benefits, term, conditions, or type of coverage vary as a result of the application of rate differentials per- mitted under A.R.S. Title 20.

3.        An insurer may consider marital status to determine whether a person is eligible for dependent coverage or benefits.

D.      Prohibited practices. The following practices and any other practice that treats similarly situated persons differently based on gender unless the different treatment is specifically allowed by law, is prohibited.

1.        Denying coverage to a person of one gender who is self- employed, employed part-time, or employed by relatives, if coverage is offered to a person of the opposite gender who is similarly employed;

2.        Denying a policy rider to a person of one gender if the rider is available to a person of the opposite gender;

3.        Denying maternity benefits to an applicant or insured who buys a policy for individual coverage if the insurer offers comparable family coverage policies with mater- nity benefits;

4.        Denying, under group policies, dependent coverage to an employee of one gender if dependent coverage is avail- able to an employee of the opposite gender;

5.        Denying a disability income policy to an employed per- son of one gender if a policy is offered to a person of the opposite gender who is similarly employed;

6.        Treating complications of pregnancy differently from any other illness or sickness covered under a policy;

7.        Restricting, reducing, modifying, or excluding benefits relating to coverage involving the genital organs of only one gender;

8.        Offering lower maximum monthly benefits to a person of one gender than to a person of the opposite gender who is in the same classification under a disability income pol- icy;

9.        Offering more restrictive benefit periods or more restric- tive definitions of disability to a person of one gender than to a person of the opposite gender who is in the same classification under a disability income policy;

10.     Establishing different conditions for a policyholder of one gender to exercise benefit options contained in the policy than for a person of the opposite gender;

11.     Limiting the amount of coverage an insured or prospec- tive insured may purchase based upon the insured’s or prospective insured’s marital status unless the limitation is for the purpose of defining persons eligible for depen- dent’s benefits; and

12.     Otherwise restricting, modifying, excluding or reducing the availability of any insurance contract, the amount of benefits payable, or any term, condition or type of cover- age on account of gender or marital status in all lines of insurance.

Historical Note

Former General Rule Number 73-32. R20-6-207 recodi- fied from R4-14-207 (Supp. 95-1). Former R20-6-207 renumbered to R20-6-206; new R20-6-207 renumbered from R20-6-209 and amended by final rulemaking at 13

A.A.R. 2061, effective August 4, 2007 (Supp. 07-2).