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Genetic Test Information Impact on Life Insurance Rates and Privacy

Genetic testing results could possibly affect your premium rate when applying for life insurance, but the conditions that would negatively affect rates appears narrow.

Privacy Trade Off
You may feel inclined not to share genetic information for the sake of privacy or the concern your information will be shared or stolen. Keep in mind obtaining individual life insurance is voluntary. An applicant gives up their health information privacy in order to obtain coverage. The advantage in allowing access to all your information, fully underwritten life insurance, is to get the lowest premium with the broadest most favorable product selection and the highest amounts of coverage. Genetic test information is likely going to get swept up in the process unless you’re young or in excellent health to qualify for expedited underwriting. Life insurance companies have experienced data breaches, but they are part of a wider trend affecting millions across multiple business and government entities. Life carriers have done more to firewall their information, but only time will tell how effective their measures will be.

An applicant for life insurance gives up their health information privacy in order to obtain coverage. It’s voluntary to obtain the lowest premium and most favorable coverage. Genetic test information is likely going to get swept up in the process unless you’re young or in excellent health are allowed expedited underwriting.

Testing the Waters Confidentially
If you’re concerned about how your genetic testing results will affect your application and wish to retain your privacy, try an informal quote request to the major carriers. Brokers like myself can put together an anonymous summary of your information: age, height, weight, medications, health history and life insurance carriers will respond with a tentative rate class in one to two business days. At that point you will know if relinquishing your privacy to obtain coverage is feasible before making a decision to go forward.

Application Step One: Script check, MIB Check
Underwriters first line of review are the prescription databases and the medical information board (MIB) that codes the activity of previous life applications. It helps immensely to avoid medical records requests if you have never taken prescription medications, or your prescription for a common medication is fully explained on the application. Underwriters also review paramed test results and depending on the applicant’s age and information, they decide whether to request medical records from the primary care physician or specialists.

Have you shared your genetic test information with your primary care physician or a specialist? If you have then the carrier will review what you have discussed and if additional genetic tests were recommended. Can that genetic information or discussions be redacted and treated as confidential? No. You can try, but that request is likely to go nowhere.

Will your genetic testing information affect the underwriter’s decision? It’s possible. One can not categorically rule it out. Genetics already plays a part in rate classifications. Each carrier has family history underwriting guidelines for cardiovascular disease and cancer. Generally having a parent under age 60 have had or passed away from one or both of these conditions disallows the preferred best rate. Carriers may consider exceptions on larger premium cases. If you don’t like a decision a carrier has made, the agent can shop your case with a summary to try and get a better offer.

Is a genetic record review valid or necessary? Parsing the following article, though limited in scope there is a sufficient population base per 100,000 to justify life insurance underwriting’s attention: hereditary cancers, early-onset Alzheimer’s Disease, a much smaller subset of amyotrophic lateral sclerosis (ALS). Life carriers don’t want to be stuck assuming unwarranted risks associated with major health conditions omissions and misrepresentations.

Time to End the Use of Genetic Test Results in Life Insurance Underwriting
Mark A. Rothstein, J.D. 
Published in final edited form as: J Law Med Ethics. 2018 Sep; 46(3): 794–801

“Relatively few genetic-related disorders have demonstrable importance for medical underwriting in life insurance because they must have the following six characteristics…..Some conditions meeting these six criteria are early-onset Alzheimer’s disease; some neurodegenerative diseases, such as amyotrophic lateral sclerosis and Huntington disease; some hereditary cancers, such as some breast and colon cancers; and some syndromic conditions, including Li-Fraumeni syndrome and Lynch syndrome.”

State Genetic Privacy Laws (state by state basic guide)

“State genetic privacy laws typically restrict any or certain parties (such as insurers or employers) from carrying out a particular action without consent. Laws in 16 states require informed consent for a third party either to perform or require a genetic test or to obtain genetic information. Twenty-four states require informed consent to disclose genetic information. In addition, Rhode Island and Washington require written authorization to disclose genetic information. Alaska, Colorado, Florida, Georgia, and Louisiana explicitly define genetic information as personal property. Alaska also extends personal property rights to DNA samples. In 2001 Oregon repealed its property right to DNA samples and genetic information. Four states mandate individual access to personal genetic information, and 18 states have established specific penalties – civil, criminal or both – for violating genetic privacy laws.”


Florida
Florida Law HB 1189 (2020) Genetic Information for Insurance Purposes, Effective date: 7/1/2020
:(2) USE OF GENETIC INFORMATION.—
(a) In the absence of a diagnosis of a condition related to genetic information, health insurers, life insurers, and long-term care insurers authorized to transact insurance in this state may not cancel, limit, or deny coverage, or establish differentials in premium rates, based on such information.
(b) Health insurers, life insurers, and long-term care insurers may not require or solicit genetic information, use genetic test results, or consider a person’s decisions or actions relating to genetic testing in any manner for any insurance purpose.”

California

Senate Bill 41 Genetic Information Privacy Act, Approved by Governor October 6, 2021

“(f) (1) Notwithstanding any other provision in this section, and except as provided in paragraph (2), a direct-to-consumer genetic testing company shall not disclose a consumer’s genetic data to any entity that is responsible for administering or making decisions regarding health insurance, life insurance, long-term care insurance, disability insurance, or employment or to any entity that provides advice to an entity that is responsible for performing those functions.
(2) A direct-to-consumer genetic testing company may disclose a consumer’s genetic data or biological sample to an entity described in paragraph (1) if all of the following are true: (A) The entity is not primarily engaged in administering health insurance, life insurance, long-term care insurance, disability insurance, or employment. (B) The consumer’s genetic data or biological sample is not disclosed to the entity in that entity’s capacity as a party that is responsible for administering, advising, or making decisions regarding health insurance, life insurance, long-term care insurance, disability insurance, or employment. (C) Any agent or division of the entity that is involved in administering, advising, or making decisions regarding health insurance, life insurance, long-term care insurance, disability insurance, or employment is prohibited from accessing the consumer’s genetic data or biological sample.”


Lost Life Insurance Locator by State

How to Use National Association of Insurance Commissioners (NAIC) life insurance policy locator

free tool NAIC life insurance policy locator: NAIC:

National Association of Unclaimed Property US map with links to each state

Alabama: Department of Insurance (link to NAIC)

Alaska: Lost Life Insurance Policy (tips, links) Unclaimed Property

Arizona: Department of Insurance (link to NAIC)

Arkansas: Insurance Department (link to NAIC)

California Locate a Life Insurance Policy (tips link to NAIC) Unclaimed Property

Colorado Life Insurance Policy Locator (link to NAIC)

Connecticut Consumer Alert (link to NAIC)

Delaware Missing Life Insurance/Annuity Search (link to NAIC)

Florida Life Insurance (link to FL unclaimed property) Florida Unclaimed Property

Georgia Life Insurance GA insurance resources website (go to NAIC)

Hawaii Department of Commerce and Consumer Affairs (link to NAIC)

Idaho Life Insurance (link to NAIC) Looking in the Lost and Found (pdf)

Illinois Lost Policy Finder Illinois Department of Insurance

Indiana How to Guide (pdf) (directs to NAIC) Unclaimed Property

Iowa Insurance Division (link to NAIC)

Kansas Insurance Department (link to NAIC)

Kentucky Dept. of Insurance Announcement (link to NAIC)

Louisiana Life Insurance Policy Search (link to NAIC)

Maine Insurance Bureau Announcement (instructs to use NAIC)

Maryland StateMaryland Finding Missing Life Insurance Policy: Video

Massachusetts Mass.gov Annuities and Life Insurance Lost Policy locator (link to NAIC)

Michigan Dept. of Ins. & Financial Services: Life Insurance and Annuity Search Service (LIAS)

Minnesota Locate of Life Insurer (instructs to use NAIC)

Mississippi Insurance Department (link to NAIC)

Missouri Department of Insurance (link to NAIC)

Montana Life Insurance Policy Locator (link to NAIC) Unclaimed Property

Nebraska press release (link to NAIC) Unclaimed Property

Nevada Life Insurance Policy & Annuity Locator (link to NAIC) Unclaimed Property

New Hampshire Life Insurance Policy Locator Service (link to NAIC) Abandoned Property

New Jersey Life Policy Locator Service (link to NAIC) Unclaimed Property Administration

New Mexico Superintendent of Insurance consumers (link to NAIC) Unclaimed Property

New York Lost Policy Finder ….. Find Lost Money

North Carolina Locate a Lost Life Insurance Policy ….. Unclaimed Property

North Dakota Life Dept of Ins. (link to NAIC) Unclaimed Property

Ohio Find Lost Life Insurance Policy (link to NAIC) Unclaimed Funds

Oklahoma Life Insurance Policy Locator (link to NAIC) Unclaimed Property

Oregon Life Insurance Finders Tool …. Unclaimed Property

Pennsylvania Life Insurance (link to NAIC) Unclaimed Property

Rhode Island Insurance Division (link to NAIC) Unclaimed Property

South Carolina How to Use (link to NAIC) Unclaimed Property

South Dakota Division of Insurance (link to NAIC) Unclaimed Property

Tennessee Lost Policy Service & Life Insurance (link to NAIC)

Texas Texas Unclaimed Property

Utah Policy Locator (link to NAIC)

Vermont Life Insurance Policies – Unclaimed Benefits

Virginia Unclaimed Property

Washington How to find an old life insurance policy

West Virginia Offices of Insurance Commissioner (link to NAIC) Unclaimed Property

Wisconsin Commissioner of Insurance Life and Annuities (link to NAIC) Unclaimed Property Search

Wyoming Department of Insurance (link to NAIC) Unclaimed Property

Hybrid Long Term Care Insurance Affordability

The New York Times and KFF Heath News article “Why Long-Term Care Insurance Falls Short for So Many” (no paywall) paints a dismal portrait of long term care (LTC) insurance policy holders, but there are currently viable coverage options for those in their 50s and 60s.

These are life insurance with chronic illness or long term care benefits, hybrid products that offer coverage with premium stability. One of the best is a product from American General called “Value Plus Protector III”

How much LTC or chronic illness coverage will one need ? One benchmark is 3 years: actually longer for women, less for men. The IRS per diem tax deductible limit for 2023 is $420 per day, or $12,775 per month and $153,330 a year. Rounding off that’s a $460,000 benefit for 3 years.

American General “Value Plus Protector III” IUL
$460,000 increasing death benefit life insurance,
increasing chronic illness accelerated benefit rider

Female age 58, preferred non-tobacco
$8,035.28 annual

Female age 63, preferred non-tobacco
$10,042.81 annual

Female age 68, preferred non-tobacco
$13,872.79 annual

Male age 58, preferred non-tobacco
$9,007.07 annual

Male age 63, preferred non-tobacco
$11,479.22 annual

Male age 68, preferred non-tobacco
$16,045.07 annual

Affordability:
Reduce premium by opting for a level benefit instead of increased benefit. Look at two years worth of LTC benefits $305,000 face amount versus three years.

Coverage: The no lapse guarantee (NLG) was set at age 90. One may structure the NLG to age 100 for additional premium, if longevity is a concern. The non guaranteed side, the length of coverage, will change depending on crediting performance. An IUL’s premiums are flexible. One may over fund to extend the non guaranteed coverage or for cash value accumulation; one may fund less than the NLG premium, in effect lowering or forgoing the NLG and have policy cash value accumulation offset premiums.

American General “Value Plus Protector III” IUL
quotes based on guarantee age 90 premium age, 5% S&P 500 high cap rate account all years, increasing death benefit option. Quotes had an age 90 no lapse guarantee, with the non guaranteed side ranging to about age 95 to age 97. Maximum Monthly Benefit Amount: Monthly IRS Maximum Benefit

return of premium surrender option
year 20: up to 50% premium of premium paid
year 25: up to 100% of premium premium paid

An increasing death benefit helps the chronic illness coverage keep pace with inflation. The IRS per diem long term care tax deductible limit for 2024 will decrease to $410 per day, or $12,470 per month. This decrease is highly unusual. The per diem limit generally monthly benefit allowance will help American General’s limit keep pace with inflation.


One Way to Face Down Financial Ruin to the Cost for Elder Care

The New York Times ran a very good article today by Reed Abelson “Facing Financial Ruin as Costs Soar for Elder Care“. There is a silver lining to insurance coverage not mentioned in the article.

Yes, traditional Long Term Care (LTC) insurance went into a tail spin years ago, but hybrid life insurance with a LTC or chronic illness benefit has dual utility, a death benefit or if need be a living benefit, at a reasonable cost. American General Life offers the best hybrid life products. It offers a high end monthly accelerated benefit, currently $12,775 per month, that adjusts upwards, subject to IRS daily per diem limit, currently $420 per day. Their chronic Illness rider covers temporary and permanent activities of daily living conditions. Lock at a fixed premium level or increasing benefits that mitigates soaring costs.

1035 Exchange Example

A life insurance 1035 exchange takes the cash value in your current life policy and rolls it over into a new policy. There are tax considerations, but the primary reason would be to reduce the new policy’s premiums. Go here for further explanation.

Example: female, age 62, preferred non tobacco, $24,800 cash value accumulation, fully underwritten new policy

$100,000 benefit: 1035 exchange $24,800

$244.25 annual American General “Value+ Protector III IUL” age 90 no-lapse guarantee*
$475.00 annual company #2, age 120 no-lapse Guarantee IUL
$614.00 annual company #3, age 121 no-lapse Guarantee UL

$100,000 benefit: (without the 1035 exchange)

$1,485.01 annual American General “Value+ Protector III IUL” age 90 no-lapse guarantee
$1,941.00 annual company #2, age 120 no-lapse Guarantee IUL
$1,749.00 annual company #3, age 121 no-lapse Guarantee UL

The choice is whether to opt for a 1035 exchange or not. The 1035 will structure in lower premiums. The alternative is to directly take the cash surrender value, set it aside in an account to offset premiums, or use the lump sum cash for whatever discretionary purpose.

Contact me for a free policy review and quotes


*Note: one can set American General’s “Value+ Protector III IUL” no-lapse guarantee (NLG) to age 91, 92, or whatever, up to age 100. Below are age NLG 100 quotes. These premiums are higher than the company #2 and #3 age 120 no-lapse guarantee, but American General’s IUL product builds cash value, has a non-guaranteed side that projects it carrying out much further, and has partial return of premium options in year 20 and year 25. The age 90 NLG structure runs strong enough on the non guaranteed side to make it sufficient on its own merits.

$1,082,12 annual $100,000 benefit age 100 no-lapse guarantee, 1035 exchange $24,000
$2,022.34 annual $100,000 benefit age 100 no-lapse guarantee, (no 1035 exchange)

IUL Increasing Death Benefit with Return of Premium

More in this post on American General’s Value+Proctor III Indexed Universal Life (IUL) focusing on the increasing death benefit option rather than level death benefit.

Male 42 years old, preferred plus, $250 per month premium all years, solve face amount, target premium, increasing death benefit, S&P 500 index annual point to point, hypothetical 5.00% interest crediting all years.

Monthly premiums: $250
Initial Death Benefit: $344,756

Year 25 Total premium outlay: $75,000
Year 25 Guaranteed Return of Premium: $75,000
Year 25 Guaranteed Death Benefit: $366,063

5.00% hypothetical
Year 25 Non-Guaranteed Cash Surrender Value: $93,252
Year 25 Non-Guaranteed Death Benefit: $438,009

3.70% hypothetical
Year 25 Non-Guaranteed Cash Surrender Value: $78,848
Year 25 Non-Guaranteed Death Benefit: $423,604

age 83 no-lapse guarantee (NLG, ULSG)

Guideline level premium: $18,895.80
7-pay premium: $23,855.94

The guideline level premium in monthly premiums is $1,574.65 (18,895.80 divided by 12). Here’s looking at this same basic structure: same initial death benefit with this maximum non-MEC premium. MEC stands for Modified Endowment Contract, the maximum allowed under IRS rules for favorable tax consideration.

Monthly premiums: $1,574.65
Initial Death Benefit: $344,756

Year 25 Total premium outlay: $472,395
Year 25 Guaranteed Cash Value Accumulation: $351,631
Year 25 Guaranteed Death Benefit: $696,390

5.00% hypothetical
Year 25 Non-Guaranteed Cash Surrender Value: $732,360
Year 25 Non-Guaranteed Death Benefit: $1,077,120

3.70% hypothetical
Year 25 Non-Guaranteed Cash Surrender Value: $612,491
Year 25 Non-Guaranteed Death Benefit: $957,251

age 103 no-lapse guarantee (NLG, ULSG)

Guideline level premium: $18,895.80
7 pay premium: 23,855.88

Comments: The strategy is to begin the policy at an affordable level $250 a month and at some point go up higher, to $500 a month or whatever, up to $1,574 a month, the guideline level. Premiums can fluctuate up and down at any time. The 7-pay premium limit could boost that $1,574 monthly figure even higher. Just monitor premium limit by either the guideline level or 7-pay test. Increasing premiums may negate the full return of premium (ROP) option in year 25 but would help maximize cash value accumulation, as much as possible without the policy becoming a MEC. Note the 5.00% and 3.70% interest crediting are truly hypothetical for illustrations. No market index performs with steady results each and every year, and averages may vary given changes to participation rates, caps, and cost of insurance charges. What’s notable with this American General IUL product are the guarantees.

IUL with return of premium

American General’s Value+Proctor III Indexed Universal Life (IUL) is an excellent life insurance product for its guarantees and potential cash value accumulation. For example:

Male 42 years old, preferred plus, $250 per month premium all years, solve for face amount, guarantee face, guarantee age 100, level death benefit, S&P 500 index annual point to point, assuming 5.00% interest crediting all years.

Death Benefit: $289,819
Year 25 Total premium outlay: $75,000
Year 25 Guaranteed Return of Premium: $75,000
Year 25 Non-Guaranteed Cash Surrender Value: $96,051 (5.00% all years)
Year 25 Non-Guaranteed Cash Surrender Value: $89,584 (4.50% all years)
age 100 no-lapse guarantee

Comments: IUL illustrations assume interest crediting each and every year at the the same interest rate, not in any way mirroring real world index fluctuations so results are highly speculative. Value+Protector III has the a year return of premium (ROP) option.

Note: return of premium, The Enhance Surrender Value, is limited to a maximum cap of the specified face amount of 40% for issue age 41 and older. For example for a $1,000,000 face amount the limit is $400,000 return of premium.

One can structure the policy to have a higher death benefit. Here’s the same example but changing the guarantee age from age 100 to age 90.

Male 42 years old, preferred plus, $250 per month premium all years, solve for face amount, guarantee face, guarantee age 90, level death benefit, S&P 500 index annual point to point, assuming 5.00% interest crediting all years.

Death Benefit: $446,269.76
Year 25 Total premium outlay: $75,000
Year 25 Guaranteed Return of Premium: $75,000
Year 25 Non-Guaranteed Cash Surrender Value: $81,533 (5.00% all years)
Year 25 Non-Guaranteed Cash Surrender Value: $78,060 (4.50% all years)
age 90 no-lapse guarantee

Unfortunately life carriers no longer offer Return of Premium (ROP) term, but there is ROP Indexed Universal Life (IUL), and it’s a very worthwhile product. With American General there is a top flight chronic illness benefit rider option as well.

Whole Life vs IUL: case study age 50

Whole Life: #1 performing carrier

design: Male, age 50, preferred non-tobacco, $250 monthly planned premium, for maximum cash value accumulation

The best way to solve for maximum cash value accumulation is to do a limited pay. For $250 monthly premiums a lifetime guarantee it solves at 11 years.

11 pay

Initial death benefit: $53,964
premium outlay: $3,000 annual

non guaranteed values: year 15 based on current dividends
cash value $43,879
death benefit $73,975
premium outlay $33,000
dividend year 16: $1,378 annual
dividend year 21: $1,735 annual
age 121 guarantee

15 pay

Initial death benefit: $68,928
premium outlay: $3,000 annual

non guaranteed values: year 15 based on current dividends
cash value $53,207
death benefit $89,650
premium outlay $45,000
dividend year 16: $1,742 annual
dividend year 21: $2,112 annual
age 121 guarantee

20 pay comparison Whole Life vs. Indexed Universal Life (IUL)

Whole Life: $250/month 20 years

Initial death benefit: $84,592

non guaranteed values: year 20
cash value: $80,158
death benefit: $121,536
premium outlay $60,000
age 121 guarantee


IUL: $250/month 20 years

Initial death benefit: $50,000

non guaranteed values: year 20 @5.75% all years
cash surrender value $81,301
death benefit $131,301
premium outlay $60,000
age 96 guarantee

Comments: Makes sense at age 50 to solve the whole life product for 15 years to build cash value and higher dividends for retirement income, but an 11 pay is all that’s required to lock in a lifetime guarantee. IUL needs longer funding, more like a 20 pay than 15 pay. IUL advantage is in premium flexibility. Whole Life requires a longer commitment to premium payments before sufficient dividends can offset premiums. Whole Life offers a better lifetime revenue stream with annual dividends than an IUL with loans or partial withdrawals.

Cap rate changes to older IUL products

Carriers periodically send notices for cap rate changes to older Indexed Universal Life products, for example lowering cap rates 50 basis points (0.50%), while keeping their currently offered products the same. The difference in cap rates for legacy products as opposed to new for one carrier is 400 basis points (4.00%). Carriers routinely close an IUL product offering after a couple of years to offer a newer version. These lower cap rates call into question the long term support of certain carriers to their IUL policyholders and whether the crediting returns will come anywhere near those projected on current illustrations.

Indexed Universal Life (IUL) case study age 50

Indexed Universal Life (IUL) #1 carrier

design: Male, age 50, preferred non-tobacco, $250 monthly planned premium, solve for minimum face amount (no MEC or guideline premium violation), index strategy: S&P 500 cap rate account, 100% allocation, assuming 5.00% all years (maximum illustrative rate 6.27%); death benefit option: increasing; death benefit compliance test: guideline; no optional riders.

Initial death benefit: $50,000
premium outlay: $3,000 annual

Initial Guideline Level Premium: $3,575.61
Initial Guideline Single Premium: $19,939.36
Seven Pay Premium: $4,000.56

Results

non guaranteed values: year 20 @5.00% all years
cash surrender value $74,991
death benefit $124,991
total premium outlay $60,000 ($250/month)

non guaranteed values: year 20 @5.50% all years
cash surrender value $79,132
death benefit $129,132
premium outlay $60,000 ($250/month)

non guaranteed values: year 20 @6.00% all years
cash surrender value $83,539
death benefit $133,539
premium outlay $60,000 ($250/month)

Maximum non-MEC results

Guideline Level Premium: $3,575.61 annual
non guaranteed values: year 20 @5.00% all years
cash surrender value $91,039
death benefit $141,039
premium outlay $71,510 ($297.96/month) (297.96 x 12 = 3,575.52 no MEC)

Guideline Level Premium: $3,575.61
non guaranteed values: year 20 @6.00% all years
cash surrender value $101,434
death benefit $151,434
premium outlay $71,510 ($297.96/month)