Code Section Group

Insurance Code - INS

DIVISION 1. GENERAL RULES GOVERNING INSURANCE [100 - 1879.8]

  ( Division 1 enacted by Stats. 1935, Ch. 145. )

PART 2. THE BUSINESS OF INSURANCE [680 - 1879.8]

  ( Part 2 enacted by Stats. 1935, Ch. 145. )

CHAPTER 1. General Regulations [680 - 1113]

  ( Chapter 1 enacted by Stats. 1935, Ch. 145. )

ARTICLE 6.9. The Equal Insurance HIV Act [799 - 799.11]
  ( Article 6.9 added by Stats. 2020, Ch. 184, Sec. 3. )

799.
  

(a) The Legislature finds and declares all of the following:

(1) Article 6.9 (commencing with Section 799) of Chapter 1 of Part 2 of Division 1 of the Insurance Code was originally enacted in 1988 and was last amended in 1997. These laws require an update to reflect advancements in testing and medical treatments for individuals living with the human immunodeficiency virus (HIV).

(2) When the HIV/AIDS epidemic began in the United States, HIV was considered a life-threatening condition because relatively little was known at the time about HIV detection, transmission, or treatment. Today, however, just as with other chronic health conditions, HIV can be effectively managed.

(3) According to data collected by the Antiretroviral Therapy Cohort Collaboration from 1996 to 2013, inclusive, modern antiretroviral therapy (ART) is more sophisticated than original treatments, causes fewer adverse effects, and results in a life expectancy similar to people not living with HIV.

(4) The National Institutes of Health notes that ART can suppress an individual’s viral load to a point where HIV is undetectable in the blood, and the chance of HIV developing into AIDS is reduced.

(5) Research shows that in recent years, people living with HIV who are receiving treatment have a life expectancy of approximately 70 to 78 years or more, depending on other determinants of health and how early treatment was commenced, compared to a life expectancy of 39 years in 1996. The risk of death due to AIDS-related causes has declined dramatically.

(6) It is now possible for HIV-positive individuals to have an average life expectancy. They should have the same opportunities as other individuals with chronic medical conditions to purchase life insurance and disability income insurance.

(b) It is, therefore, the intent of the Legislature to ensure the equitable health and well-being of all people living in California.

(c) The purposes of this article are to do all of the following:

(1) Establish standards that prevent life or disability income insurers from making or permitting unfair distinctions between individuals of the same class in underwriting life insurance or disability income insurance for individuals living with HIV.

(2) Require the maintenance of strict confidentiality for personal information obtained through testing.

(3) Require informed consent before a life or disability income insurer tests for HIV.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.01.
  

As used in this article, the following terms have the following meanings:

(a) “AIDS” means acquired immunodeficiency syndrome.

(b) “Certificate” means a certificate of group life insurance or a certificate of group disability income insurance delivered in this state, regardless of the situs of the group master policy. A certificate of life insurance benefits or disability income insurance benefits issued or delivered in this state by a fraternal benefit society is a “policy” as defined in subdivision (h).

(c) “Disability income insurance” means insurance against loss of occupational earning capacity arising from injury, sickness, or disablement.

(d) “HIV” or “human immunodeficiency virus” means the etiologic virus of AIDS.

(e) “HIV test” means any clinical test, laboratory or otherwise, used to identify HIV, a component of HIV, or antibodies or antigens to HIV.

(f) “Life or disability income insurer” means an insurer licensed to transact life insurance or disability insurance in this state that is transacting life insurance or disability income insurance in this state, or a fraternal benefit society licensed in this state that is transacting life insurance or disability income insurance in this state.

(g) “Life insurance” means the class of coverage described in Section 101, but, as used in this article, excludes annuities.

(h) “Policy” means an individual life insurance policy or individual disability income insurance policy issued or delivered in this state, or a certificate of life insurance benefits or disability income insurance benefits issued or delivered in this state by a fraternal benefit society.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.02.
  

(a) A life or disability income insurer shall not decline an application or enrollment request for coverage under a policy or certificate for life insurance or disability income insurance based solely on the results of a positive HIV test, regardless of when or at whose direction the test was performed.

(b) Notwithstanding any other law, this article does not prevent or otherwise restrict a life or disability income insurer from refusing to insure an applicant that is HIV positive, limiting the amount, extent, or kind of coverage for an applicant that is HIV positive, or charging a different rate to an applicant that is HIV positive, if the refusal, limitation, or charge is based on sound actuarial principles and actual or reasonably anticipated experience.

(c) Transferring an applicant from a simplified, expedited, accelerated, or algorithmic underwriting process to a traditional medical underwriting process, based solely on the results of a positive HIV test, does not constitute a denial of the application or a violation of this section.

(d) This section applies to a policy, certificate, application, or enrollment request that meets both of the following requirements:

(1) It is issued, delivered, or received on or after January 1, 2023.

(2) In order to be effective, its issuance, delivery, or granting is contingent upon medical review for other diseases or medical conditions.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.03.
  

(a) A life or disability income insurer shall not require a test for HIV or for the presence of antibodies to HIV for the purpose of determining insurability other than in accordance with the informed consent, counseling, and privacy protection provisions of this article and Article 6.6 (commencing with Section 791). Notwithstanding any other law, this constitutes the exclusive requirements for counseling, informed consent, and privacy protection for that testing.

(b) A life or disability income insurer that asks an applicant to undergo an HIV test shall obtain the applicant’s written informed consent for the test. Written informed consent shall include a description of the test to be performed, including its purpose, potential uses, and limitations, the meaning of its results, procedures for notifying the applicant of the results, and the right to confidential treatment of the results. Before the applicant signs the consent, the insurer shall provide the applicant with both of the following, on paper or electronically, whichever the applicant chooses, but not by telephone:

(1) Material describing HIV, its causes and symptoms, the manner in which it is spread, the test or tests used to detect HIV or the HIV antibody, and what a person can do whose test results are positive or negative.

(2) A list of counseling resources available, where the applicant can obtain assistance in understanding the meaning of the test and its results. The list shall be provided from publicly available information or internet websites, and shall include resources available from the State Department of Public Health and the federal Centers for Disease Control and Prevention.

(c) The life or disability income insurer that asks an applicant to undergo an HIV test shall notify an applicant of a positive test result by notifying the applicant’s designated physician. If the applicant tested has not given written consent authorizing a physician to receive the test results, the applicant shall be urged, at the time the applicant is informed of the positive test results, to contact a private physician, the county department of health, the State Department of Public Health, local medical societies, or alternative test sites for appropriate counseling.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.04.
  

A life or disability income insurer shall not require an applicant to undergo an HIV test unless the cost of the test is borne by the insurer.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.05.
  

A life or disability income insurer shall not consider the marital status, actual or perceived sexual orientation, gender, gender identity, gender expression, race, color, religion, national origin, ancestry, living arrangements, beneficiary designation, or ZIP Codes or other territorial classification within this state, or any combination thereof, of an applicant for life insurance or disability income insurance in determining whether to require an HIV test of that applicant.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.06.
  

All underwriting activities undertaken by life or disability income insurers pursuant to this article shall be subject to all applicable provisions of Article 6.6 (commencing with Section 791). An application or enrollment request for life insurance or disability income insurance shall not contain a question pertaining to prior HIV tests unless the question is limited in scope to prior testing for the purpose of obtaining insurance.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.07.
  

If an applicant has had a positive HIV test, a life or disability income insurer shall not report a code to an insurance support organization as defined in Section 791.02 or another insurer unless a nonspecific test result code is used that does not indicate that the individual was subject to an HIV test.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.08.
  

A policy or certificate shall not limit benefits otherwise payable if loss is caused or contributed to by HIV or AIDS unless the life or disability income insurer could have declined the application or enrollment request of the insured as provided in Section 799.02.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.09.
  

A life or disability income insurer shall not require an applicant to take an HIV test if the results of the test would be used exclusively or nonexclusively for the purpose of determining eligibility for hospital, medical, or surgical insurance coverage or eligibility for coverage under a nonprofit hospital service plan or health care service plan.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.10.
  

(a) This section applies to the disclosure of the results of HIV tests requested by a life or disability income insurer pursuant to this article and, notwithstanding Section 120980 of the Health and Safety Code, Section 120980 of the Health and Safety Code does not apply to the disclosure of the results of HIV tests conducted pursuant to this article.

(b) A person who negligently discloses results of an HIV test to a third party, in a manner that identifies or provides identifying characteristics of the person to whom the test results apply, except pursuant to a written authorization, as described in subdivision (g), or except as provided in this article or in Section 1603.1, 1603.3, or 121022 of the Health and Safety Code, or in any other law that expressly provides an exemption to this section, shall be assessed a civil penalty in an amount not to exceed two thousand five hundred dollars ($2,500) plus court costs, as determined by the court, which penalty and costs shall be paid to the subject of the test.

(c) A person who willfully or maliciously discloses the results of an HIV test to a third party, in a manner that identifies or provides identifying characteristics of the person to whom the test results apply, except pursuant to a written authorization, as described in subdivision (g), or except as provided in this article or in Section 1603.1, 1603.3, or 121022 of the Health and Safety Code, or in any other law that expressly provides an exemption to this section, shall be assessed a civil penalty in an amount not less than five thousand dollars ($5,000) and not more than ten thousand dollars ($10,000) plus court costs, as determined by the court, which penalty and costs shall be paid to the subject of the test.

(d) A person who willfully, maliciously, or negligently discloses the results of an HIV test to a third party, in a manner that identifies or provides identifying characteristics of the person to whom the test results apply, except pursuant to a written authorization, as described in subdivision (g), or except as provided in this article or in Section 1603.1, 1603.3, or 121022 of the Health and Safety Code, or in any other law that expressly provides an exemption to this section, that results in economic, bodily, or psychological harm to the subject of the test, is guilty of a misdemeanor punishable by imprisonment in a county jail for a period not to exceed one year, or by a fine not to exceed twenty-five thousand dollars ($25,000), or by both that fine and imprisonment.

(e) A person who commits any act described in subdivision (b) or (c) shall be liable to the subject for all actual damages, including damages for economic, bodily, or psychological harm that is a proximate cause of the act.

(f) Each disclosure made in violation of this section is a separate and actionable offense.

(g) “Written authorization,” as used in this section, applies only to the disclosure of test results by a person responsible for the care and treatment of the person subject to the test. Written authorization is required for each separate disclosure of the test results, and shall include to whom the disclosure would be made.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021. Operative January 1, 2023, pursuant to Section 799.11.)

799.11.
  

This article shall become operative on January 1, 2023.

(Added by Stats. 2020, Ch. 184, Sec. 3. (SB 1255) Effective January 1, 2021.)

INSInsurance Code - INS6.9.