Insurance

2025-2026 Bill 5399: Insurance - South Carolina Legislature Online

South Carolina General Assembly
126th Session, 2025-2026
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H. 5399
STATUS INFORMATION
General Bill
Sponsors: Reps. King, Cobb-Hunter, Waters, J.L. Johnson, Hart, Gilliard and Henderson-Myers
Document Path: LC-0238PH26.docx
Introduced in the House on March 24, 2026
Currently residing in the House Committee on
Labor, Commerce and Industry
Summary: Insurance
HISTORY OF LEGISLATIVE ACTIONS

Date

Body

Action Description with journal page number

3/24/2026

House

Introduced and read first time (
House Journal-page 37
)

3/24/2026

House

Referred to Committee on
Labor, Commerce and Industry
(
House Journal-page 37
)

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legislative information
at the website
VERSIONS OF THIS BILL
03/24/2026

A bill

TO AMEND THE SOUTH CAROLINA CODE OF LAWS
BY ADDING SECTION
38-71-270
SO AS TO PROHIBIT DISCRIMINATION IN INSURANCE
POLICIES REGARDING HIV STATUS AND PREVENTION AND TO DEFINE TERMS.

B
e it enacted by the General Assembly of the State of South Carolina:

S
ECTION 1.
A
rticle 1, Chapter 71, Title
38 of the S.C. Code is amended by adding:

S
ection
38-71-270
.
(
A) In determining
whether to issue, cancel, or renew insurance coverage, an insurer may not:

(
1) use age, marital status,
geographic area of residence, occupation, sex, sexual orientation, gender
identity or expression, or any similar factor or combination of factors for the
purpose of seeking to predict whether any individual may in the future develop
AIDS or ARC; or

(
2) take into consideration an
individual's use of HIV prevention treatment when taken pursuant to a valid
prescriber's order.

(
B) In determining rates, premiums,
dues, assessments, benefits covered, or expenses reimbursable, or in any other
aspect of insurance marketing or coverage, an insurer may not:

(
1) use age, marital status,
geographic area of residence, occupation, sex, sexual orientation, gender
identity or expression, or any similar factor or combination of factors for the
purpose of seeking to predict whether any individual may in the future develop
AIDS or ARC; or

(
2) take into consideration an
individual's use of HIV prevention treatment when taken pursuant to a valid
prescriber's order.

(
C) No health or disability insurance
policy or contract issued in this State may contain any exclusion, reduction,
other limitation of coverage, deductibles, or coinsurance provisions related to
HIV prevention treatment or the care and treatment of AIDS, ARC, HIV infection,
or any illness or disease arising from these medical conditions, unless the
provisions apply generally to all benefits under the policy or contract.

(
D) A named insured who tests positive
for AIDS, ARC, or HIV may appeal to the director to review the testing
procedures and results, and may present additional medical evidence, including
the results of similar tests for exposure to the probable causative agent of
AIDS that the named insured independently obtains, to rebut the positive test
results. If the director determines that the result of the test of the proposed
insured is not a true positive, the director must order the insurer from which
the applicant sought coverage to disregard the positive test result. The director
must, when necessary, request the advice of the Director of Public Health in
making this determination.

(
E) An insurer may not impose cost
sharing, require prior authorization, or impose any medically unnecessary
restrictions or delays for the coverage of HIV prevention services, PEP, or any
formulation of PrEP.

(
F) No health plan issued in this
State or insurer offering health insurance in this State may use prescription
information indicating the use of HIV prevention treatment to medically
underwrite premiums for specific enrollees.

(
G) For purposes of this section:

(
1) "Director" means the Director of
the Department of Insurance.

(
2) "HIV prevention services" means medical
services to prevent HIV and AIDS, including baseline assessments, initial and
follow-up appointments and services, medication for the management of side
effects associated with PrEP and PEP, and medication self-management or
adherence counseling.

(
3) "HIV prevention treatment" means
medical treatment used to prevent HIV, including PrEP, PEP, and HIV prevention
services.

(
4) "PEP" means post-exposure
prophylaxis antiretroviral medication approved by the FDA used to prevent HIV
in a person without HIV who may have been recently exposed to HIV.

(
5) "PrEP" means pre-exposure
prophylaxis antiretroviral medication approved by the U.S. Food and Drug
Administration used to prevent HIV in a person without HIV.

S
ECTION
2. This act takes effect upon approval by the Governor.

----XX----

This web page was last updated on March 24, 2026 at 1:02 PM