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Determining Compliance with the GINA Provisions in Part 7 of ERISA

Does the plan comply with GINA's limitation on requesting or requiring genetic testing?

A group health plan generally must not request or require an individual or family member of the individual to undergo a genetic test. See 29 CFR 2590.702-1(c) (1).

Exceptions:

  • A health care professional who is providing health care services to an individual can request that the individual undergo a genetic test. See 29 CFR 2590.702-1(c)(2).
  • A plan can obtain and use the results of a genetic test for making a determination regarding payment. However, the plan is permitted to request only the minimum amount of information necessary to make the determination. See 29 CFR 2590.702-1(c)(4).
  • Exception for research: a plan or issuer may request, but not require, that a participant or beneficiary undergo a genetic test if the request is pursuant to research and several conditions are met. See 29 CFR 2590.702-1(c)(5).