As part of their experiential learning, students in Insurance Law at the University of Iowa College of Law completed group white papers addressing a policy question at the intersection of genetics and insurance. These projects were developed as part of a grant from the National Human Genome Research Institute (NHGRI) examining life, long-term care, and disability insurer use of genetic information. For the projects, student groups often paired with genetic counselors from across the country to assist with questions about genetic testing and the implications of laws on the genetics community.

Disclaimers:

- These white papers are not meant to provide legal advice nor be a comprehensive assessment of the state laws regulating insurer use of genetic information. The white papers are intended to provide policy research and to illustrate students’ recommendations developed as part of a semester-long class project. Therefore, the white papers do not replace detailed fact and situation specific research.

- Research reported in this publication was supported by the National Human Genome Research Institute of the National Institutes of Health under Award Number R00HG008819. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Prompt: State insurance commissioners employ different mechanisms for reviewing the proposed rates of insurance companies. Given the rapidly changing knowledge about genetic testing and risk, how do insurance companies balance between making these decisions at the underwriting versus rate-making level?
Prompt: How do state and federal laws address insurers’ concerns of informational asymmetry in the context of genetic information? Informational asymmetry could lead to adverse selection. In what contexts might genetic-based adverse selection be an issue for insurers and what policy options could be leveraged to address these concerns?
Prompt: There has been increasing discussion among regulators regarding the use of big data in insurance underwriting. How is or how could genomic information be incorporated into big data in the context of insurance? What regulatory options discussed are available to consider implications for big data uses of genomic information?
Prompt: What are policy options for state regulation of life, long-term care, or disability insurer use of genetic information? What are the implications of these policy options for the state? How does or could policy implementation in states differ as compared to other states or geographic areas?
Prompt: Life, long-term care, and disability insurers are generally allowed to use genetic test results when underwriting, but state laws place some limits on this use. Which states have adopted these ‘unfair discrimination’ laws and how have they been enforced/litigated in practice? How should they be enforced/litigated in practice?