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Department warns insurers against discriminating over HIV prevention medication

News: 2019 Press Release

For Release: June 20, 2019
Media Calls Only: 916-492-3566
Email Inquiries: cdipress@insurance.ca.gov
Department warns insurers against discriminating over HIV prevention medication
Investigation uncovers evidence of denying coverage, charging higher rates to HIV-negative individuals who used PrEP
SACRAMENTO, Calif. – Today California Insurance Commissioner Ricardo Lara warned insurers after an investigation uncovered evidence of discrimination against HIV-negative individuals who used medication to prevent contracting the disease.
 
The Department of Insurance investigation of life, disability income and long-term care insurance companies found that some insurers had denied or limited coverage, restricted products available through accelerated underwriting, placed conditions on coverage, or charged higher rates to users of pre-exposure prophylaxis, or PrEP, medication.
 
The Department of Insurance’s notice advises insurers that under California law, a person’s history of PrEP use cannot be used as a justification to deny life, disability or long-term care insurance coverage or charge higher premiums for that coverage. The notice encourages insurers to review their underwriting guidelines and practices to ensure they are not unlawfully discriminating against applicants
 
With an influential medical panel now recommending daily medication to prevent upwards of 40,000 HIV infections annually in the United States, Insurance Commissioner Ricardo Lara took action to protect patients who could face discrimination from life, disability or long-term care insurers based on a record of taking antiretroviral therapy to prevent HIV.
 
“PrEP prevents HIV, pure and simple, and I will not tolerate insurers violating California law by discriminating against people taking proactive steps to be healthy,” said Commissioner Lara. “The Department of Insurance warns insurers to stop discrimination against PrEP users and review their underwriting rules before we take action. As we celebrate Pride Month, ending HIV infections is within our reach. But first we have to eliminate prejudice and fear that still stands in the way of a cure.” 
 
The notice applies to all companies who sell life, disability and long-term care insurance in the nation’s largest insurance market. During the Department’s investigation, a number of insurers reported that they have discontinued these practices. 
 
The Department will continue to review insurer compliance with the law, and individuals who believe they were subject to discriminatory underwriting practices can contact the Department of Insurance at 800-927-4357 for assistance.
 
The influential U.S. Preventive Services Task Force recommended on June 11 that doctors prescribe daily PrEP medication to those at high risk of HIV infection. Studies show only 17 percent of those eligible for daily PrEP actually take it.
 
The Department of Insurance recently participated in a lawsuit against federal rules that would allow medical providers to deny care to LGBT patients and other vulnerable people.
 
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Media Notes:
  • Notice on Insurer Underwriting Practices for Truvada/PrEP Users
  • California law prohibits unfairly discriminating for life insurance between similar individuals in the rates charged, benefits payable, or any other terms or conditions. California Insurance Code (Ins. Code) §§ 790.01 and 790.3(f)(1).
  • California law also prohibits insurers who write disability income or long-term care from refusing to insure, limiting coverage, or charging different rates because of an impairment unless there is an actuarial basis. Ins. Code §§ 10144 and 106(b)(8).
  • California law prohibits denying insurance coverage, restricting benefits payable, or modifying the terms or conditions of coverage based on the sexual orientation of the insured or prospective insured. Title 10, California Code of Regulations § 2560.3.
 


The California Department of Insurance, established in 1868, is the largest consumer protection agency in California. Insurers collect $310 billion in premiums annually in California. Since 2011 the California Department of Insurance received more than 1,000,000 calls from consumers and helped recover over $469 million in claims and premiums. Please visit the Department of Insurance website at www.insurance.ca.gov. Non-media inquiries should be directed to the Consumer Hotline at 800-927-4357. Teletypewriter (TTY), please dial 800-482-4833.

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