Genetic Information

Defines "board certified genetics professional" and "genetic
testing".  Prohibits long-term care insurer from requiring
genetic testing as pre-condition for coverage and underwriting
policy based on genetic information unless board certified
genetics professional confirms actual risk to potential insured.

THE SENATE                              S.B. NO.           136
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 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      ""Board certified genetics professional" means a person who
 5 has board certification from the American Board of Medical
 6 Genetics or the American Board of Genetic Counseling.
 7      "Genetic testing" means any laboratory test of human
 8 deoxyribonucleaic acid, ribonucleaic acid, or chromosomes that is
 9 used to identify the presence or absence of alterations in
10 genetic material that may be associated with disease or illness."
11      SECTION 2.  Section 431:10A-118, Hawaii Revised Statutes, is
12 amended by amending subsection (a) to read as follows:
13      "(a)  No insurer may:
14      (1)  Use an individual's or a family member's genetic
15           information, or request for genetic services, to deny
16           [or] any coverage, limit any coverage except as
17           provided in section 431:10A-524(d)(2), or establish
18           eligibility, continuation, enrollment, or premium
19           payments;

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                                     S.B. NO.           136

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

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                                     S.B. NO.           136

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

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                                     S.B. NO.           136

 1 long-term care insurance" may exclude coverage for a loss or
 2 confinement which is the result of a preexisting condition unless
 3 the loss or confinement begins within six months following the
 4 effective date of coverage of an insured person.
 5      (d)  No long-term care insurer may:
 6      (1)  Request or require an individual or the individual's
 7           family member to undergo genetic testing to obtain a
 8           long-term care policy or certificate; or
 9      (2)  Underwrite a long-term care insurance policy or
10           certificate based on genetic information or genetic
11           test results of an individual unless the actual risks
12           to the individual are confirmed by a board certified
13           genetics professional.  After any confirmation, the
14           insurer may apply established underwriting standards
15           based on the individual's risks.
16     [(d)] (e)  The commissioner may extend the limitation periods
17 in subsections (b) and (c) as to specific age group categories in
18 specific policy forms upon findings that the extension is in the
19 best interest of the public.
20     [(e)] (f)  The definition of "preexisting condition" does not
21 prohibit an insurer from using an application form designed to
22 elicit the complete health history of an applicant, and, on the
23 basis of the answers on that application, from underwriting in

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                                     S.B. NO.           136

 1 accordance with that insurer's established underwriting
 2 standards.  Unless otherwise provided in the policy or
 3 certificate, a preexisting condition, regardless of whether it is
 4 disclosed on the application or not, need not be covered until
 5 the waiting period described in subsection (c) expires.  No long-
 6 term care insurance policy or certificate may exclude or use
 7 waivers or riders of any kind to exclude, limit, or reduce
 8 coverage or benefits for specifically named or described
 9 preexisting diseases or physical conditions beyond the waiting
10 period described in subsection (c)."
11      SECTION 5.  Statutory material to be repealed is bracketed.
12 New statutory material is underscored.
13      SECTION 6.  This Act shall take effect upon its approval.
15                           INTRODUCED BY:  _______________________