The NYS Department of Financial Services recently issued a letter warning insurers against discrimination when underwriting for New Yorkers using HIV prevention medication, specifically, pre-exposure prophylaxis (PrEP). The warning was issued to insurers who underwrite life, disability, and long-term care insurance.
PrEP is available by prescription in the United States under the Truvada brand. PrEP was first approved by the Food & Drug Administration (FDA) in 2004 to treat HIV in combination with other medications. In 2012, the FDA approved the drug for preventive use by individuals who are considered to be at a high risk for contracting HIV. According to the US Centers for Disease Control and Prevention, the drug is extremely effective, reporting that PrEP reduces the risk of getting HIV from sex by over 90 percent and reduces the risk of infection for intravenous drug users by over 70 percent.
New York’s warning follows several reports that insurers were denying coverage to individuals taking PrEP to prevent getting HIV. The state warned that adverse underwriting decisions based solely on an applicant’s use of PrEP are inconsistent with New York’s Insurance Law prohibiting unfair discrimination. Insurers are allowed to consider increased health risks, but only when they are based on sound actuarial principles or actual experience––they are not allowed to rely solely on one’s use of preventative drugs when denying coverage or determining the cost of premiums.
In response, industry trade group The Life Insurance Council of New York stated that its companies work diligently to comply with all NYS laws and regulations. The group also stated that New York has a robust life insurance market that provides consumers with life insurance, including those living with HIV.
If you have any questions regarding the content of this blog post, please contact Eric Naegley, partner, at enaegley@barclaydamon.com or 716.858.3871.