Life Insurance Coverage and AIDS

Yes. Insurers may ask on the application for any type of life insurance coverage if you have ever been diagnosed by a member of the medical profession or treated for AIDS (acquired immunodeficiency syndrome) or ARC (AIDS-related complex).

If you are applying for individual life insurance, the insurer may: • Ask you if you have been tested for the HIV virus and for the results of those tests. • Require you be tested, at the insurer’s expense, for the presence of HIV, antigen or nonantigenic products of HIV, or an antibody to HIV. Note: For life insurance applications including a question about previous tests, an insurer may not require or request the disclosure of any information as to whether you have been tested at an anonymous counseling and testing site in Wisconsin or another state, or through the use of an anonymous home test kit, or to reveal the results of such a test. If you apply for coverage under a group life insurance policy subject to Wisconsin law, the insurer may not: • Ask you any questions concerning whether you have been tested for the presence of HIV, antigen or nonantigenic products of HIV, or an antibody to HIV as part of the underwriting process or what the results of the test were; • Condition the provision of insurance coverage on whether you have obtained a test for the presence of HIV, antigen or nonantigenic products of HIV, or an antibody to HIV, or what the results of this test were; or • Consider in the determination of rates or any other aspect of insurance coverage provided to you whether you have obtained a test for the presence of HIV, antigen or nonantigenic products of HIV, or an antibody to HIV, or what the results of this test were. The provisions listed above apply to group life insurance policies where prospective applicants are individually medically underwritten and where there is no individual underwriting, such as in guarantee issue situations.

Insurers may ask you about or require you to take only tests the state epidemiologist finds are "medically significant and sufficiently reliable to detect the presence of HIV, antigen or nonantigenic products of HIV, or an antibody to HIV." Insurers may ask you about or require you to take only tests meeting the following criteria: • A single specimen repeatedly reactive using any Food and Drug Administration (FDA)-licensed enzyme immunoassay (EIA) HIV antibody test and confirmed positive using an FDA-licensed HIV antibody confirmatory test. • A single specimen repeatedly reactive using any FDA-licensed HIV antigen test and an FDA-licensed EIA HIV antibody test. A specimen which is repeatedly reactive to an FDA-licensed HIV antigen test shall be confirmed through a neutralization assay. A specimen which is repeatedly reactive to an FDA-licensed EIA HIV antibody test shall be tested with an FDA-licensed HIV antibody confirmatory test. • A single specimen tested for the presence of HIV using a molecular amplification method for the detection of HIV nucleic acids consistent with National Committee for Clinical Laboratory Standards. • A single specimen tested for the presence of HIV using viral culture methods.

Yes. The insurer must obtain prior to testing a signed consent form from you or from one of the following: • The person's parent or guardian if the person is under 14 years of age. • The person's guardian if the person is adjudged incompetent under ch. 880, Wis. Stat. • The person's health care agent, as defined in s. 155.01 (4), Wis. Stat., if the person has been found to be incapacitated under s. 155.05 (2), Wis. Stat. The insurer must provide a copy of the consent form to the person who signed the form and must maintain a copy of the consent form for at least one year. A sample format of the consent form is included at the back of this publication. The insurer must provide, with the consent form, a copy of the document "Resources for Persons with a Positive HIV Test/The Implications of Testing Positive for HIV." This document (OCI 17-001) is included in the back of this publication.

If you are required by the insurer to be tested, the test results described in the consent form signed prior to the testing may be released only as described in the consent form, or upon your written consent, or that of a person authorized to give consent.

Yes. If an insurer medically underwrites your application for group life insurance, the insurer may not use or obtain from any source, including the Medical Information Bureau, Inc., information regarding the following: • The results of your test for the presence of HIV, antigen or nonantigenic products of HIV, or an antibody to HIV. • Any other information on whether you have been tested for the presence of HIV, antigen or nonantigenic products of HIV, or an antibody to HIV. A life insurance policy may not deny or limit benefits solely because death is caused, directly or indirectly, by HIV infection or any illness or medical condition arising from or related to HIV infection.

If a test is positive and affects the issuance or terms of the policy, the insurer must provide written notice to you or the person who signed the consent form on your behalf that you do not meet the insurer's usual underwriting criteria because of a test result. The insurer must request you to provide informed consent for disclosure of the test result to a health care provider with whom you choose to discuss the test result. Upon receipt of the informed consent for disclosure, the insurer must provide your designated health care provider with the test result. If you refuse to give informed consent for disclosure, the insurer must, upon your request, provide you or the person who signed the consent form on your behalf with the test result. The insurer must include with the report of the test result all of the following: • A statement that you should contact a private health care provider, a public health clinic, an AIDS service organization, or the AIDS Resource Center of Wisconsin (ARCW) for information on the medical implications of a positive test, the desirability of further independent tests, and the availability of anonymous testing. • The toll-free telephone number of the ARCW, the statewide AIDS information and medical referral service. • A copy of the document "Resources for Persons with a Positive HIV Test/The Implications of Testing Positive for HIV." The Wisconsin Department of Health Services (DHS) has two programs helping people with HIV infection. The Wisconsin AIDS/HIV Drug Assistance Program (ADAP) (www.dhs.wisconsin.gov/aids-hiv/adap.htm) and the Wisconsin AIDS/HIV Health Insurance Premium Subsidy Program (www.dhs.wisconsin.gov/aids-hiv/hipsp.htm) can help Wisconsin residents with HIV infection obtain certain HIV drugs and maintain (or obtain) health insurance.