REPORT TITLE:
Genetic Information


DESCRIPTION:
Defines "genetic testing".  Prohibits long-term care insurer from
requiring genetic testing as pre-condition for coverage and
underwriting policy based on genetic information unless based on
actuarial principles.  (SD1)

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
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THE SENATE                              S.B. NO.           S.D. 1
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            
                                                             
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                   A  BILL  FOR  AN  ACT

RELATING TO GENETIC INFORMATION. 


BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

 1      SECTION 1.  Section 431:10A-521, Hawaii Revised Statutes, is
 
 2 amended by adding two new definitions to be appropriately
 
 3 inserted and to read as follows:
 
 4      ""Genetic testing" means any laboratory test of human
 
 5 deoxyribonucleaic acid, ribonucleaic acid, or chromosomes that is
 
 6 used to identify the presence or absence of alterations in
 
 7 genetic material that may be associated with disease or illness."
 
 8      SECTION 2.  Section 431:10A-118, Hawaii Revised Statutes, is
 
 9 amended by amending subsection (a) to read as follows:
 
10      "(a)  No insurer may:
 
11      (1)  Use an individual's or a family member's genetic
 
12           information, or request for genetic services, to deny
 
13           [or] any coverage, limit any coverage except as
 
14           provided in section 431:10A-524(d)(2), or establish
 
15           eligibility, continuation, enrollment, or premium
 
16           payments;
 
17      (2)  Request or require collection or disclosure of an
 
18           individual's or a family member's genetic information;
 
19           or
 

 
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 1      (3)  Disclose an individual's or a family member's genetic
 
 2           information without the written consent of the person
 
 3           affected, the person's legal guardian, or a person with
 
 4           power of attorney for health care for the person
 
 5           affected.  This consent shall be required for each
 
 6           disclosure and shall include the name of each person or
 
 7           organization to whom the disclosure will be made."
 
 8      SECTION 3.  Section 431:10A-118, Hawaii Revised Statutes, is
 
 9 amended by amending subsection (c) to read as follows:
 
10      "(c)  This section shall not apply to any action taken in
 
11 connection with policies of life insurance[,] and disability
 
12 income insurance[, and long-term care insurance] delivered or
 
13 issued for delivery in this State." 
 
14      SECTION 4.  Section 431:10A-524, Hawaii Revised Statutes, is
 
15 amended to read as follows:
 
16      "§431:10A-524  Policy standards.(a)  No long-term care
 
17 insurance policy may:
 
18      (1)  Be canceled, nonrenewed, or otherwise terminated on the
 
19           grounds of the age or the deterioration of the mental
 
20           or physical health of the insured individual or
 
21           certificate holder;
 
22      (2)  Contain a provision establishing a new waiting period
 
23           in the event existing coverage is converted to or
 

 
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 1           replaced by a new or other form within the same
 
 2           company, except with respect to an increase in benefits
 
 3           voluntarily selected by the insured individual or group
 
 4           policyholder; or
 
 5      (3)  Provide coverage for skilled nursing care only or
 
 6           provide significantly more coverage for skilled nursing
 
 7           care in a facility than coverage for lower levels of
 
 8           care.
 
 9      (b)  No long-term care insurance policy or certificate other
 
10 than a policy or certificate thereunder issued to a group meeting
 
11 the requirements of paragraph (1) of the definition of "group
 
12 long-term care insurance" shall use a definition of preexisting
 
13 condition which is more restrictive than the following:
 
14 "preexisting condition" means a condition for which medical
 
15 advice or treatment was recommended by or received from a
 
16 provider of health care services within six months preceding the
 
17 effective date of coverage of an insured person.
 
18      (c)  No long-term care insurance policy or certificate other
 
19 than a policy or certificate thereunder issued to a group meeting
 
20 the requirements of paragraph (1) of the definition of "group
 
21 long-term care insurance" may exclude coverage for a loss or
 
22 confinement which is the result of a preexisting condition unless
 
23 the loss or confinement begins within six months following the
 

 
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 1 effective date of coverage of an insured person.
 
 2      (d)  No long-term care insurer may:
 
 3      (1)  Request or require an individual or the individual's
 
 4           family member to undergo genetic testing to obtain a
 
 5           long-term care insurance policy or certificate; or
 
 6      (2)  Underwrite a long-term care insurance policy or
 
 7           certificate based on genetic test results unless based
 
 8           on actuarially sound principles, or actual or
 
 9           reasonably anticipated experience.
 
10     [(d)] (e)  The commissioner may extend the limitation periods
 
11 in subsections (b) and (c) as to specific age group categories in
 
12 specific policy forms upon findings that the extension is in the
 
13 best interest of the public.
 
14     [(e)] (f)  The definition of "preexisting condition" does not
 
15 prohibit an insurer from using an application form designed to
 
16 elicit the complete health history of an applicant, and, on the
 
17 basis of the answers on that application, from underwriting in
 
18 accordance with that insurer's established underwriting
 
19 standards.  Unless otherwise provided in the policy or
 
20 certificate, a preexisting condition, regardless of whether it is
 
21 disclosed on the application or not, need not be covered until
 
22 the waiting period described in subsection (c) expires.  No long-
 
23 term care insurance policy or certificate may exclude or use
 

 
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 1 waivers or riders of any kind to exclude, limit, or reduce
 
 2 coverage or benefits for specifically named or described
 
 3 preexisting diseases or physical conditions beyond the waiting
 
 4 period described in subsection (c)."
 
 5      SECTION 5.  Statutory material to be repealed is bracketed.
 
 6 New statutory material is underscored.
 
 7      SECTION 6.  This Act shall take effect upon its approval.