Sec. 20. Use of genetic testing information for insurance purposes.

370 words·~2 min read·/il/chapter-410/act-513/20

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(a)An insurer may not seek information derived from genetic testing for use in connection with a policy of accident and health insurance. Except as provided in subsection (c), an insurer that receives information derived from genetic testing, regardless of the source of that information, may not use the information for a nontherapeutic purpose as it relates to a policy of accident and health insurance.

(b)An insurer shall not use or disclose protected health information that is genetic information for underwriting purposes. For purposes of this Section, "underwriting purposes" means, with respect to an insurer:

(1)rules for, or determination of, eligibility (including enrollment and continued

eligibility) for, or determination of, benefits under the plan, coverage, or policy (including changes in deductibles or other cost-sharing mechanisms in return for activities such as completing a health risk assessment or participating in a wellness program);

(2)the computation of premium or contribution amounts under the plan, coverage, or

policy (including discounts, rebates, payments in kind, or other premium differential mechanisms in return for activities, such as completing a health risk assessment or participating in a wellness program);

(3)the application of any pre-existing condition exclusion under the plan, coverage, or

policy; and

(4)other activities related to the creation, renewal, or replacement of a contract of

health insurance or health benefits.

"Underwriting purposes" does not include determinations of medical appropriateness where an individual seeks a benefit under the plan, coverage, or policy.

This subsection

(b)does not apply to insurers that are issuing a long-term care policy, excluding a nursing home fixed indemnity plan.

(c)An insurer may consider the results of genetic testing in connection with a policy of accident and health insurance if the individual voluntarily submits the results and the results are favorable to the individual.

(d)An insurer that possesses information derived from genetic testing may not release the information to a third party, except as specified in this Act.

(e)A company providing direct-to-consumer commercial genetic testing is prohibited from sharing any genetic test information or other personally identifiable information about a consumer with any health or life insurance company without written consent from the consumer.