While life insurance companies have different approaches to how gender impacts your rate, you will not be automatically declined if you are transgender. 

Likewise, life insurance companies also differ on how they treat HIV status. If you are a person living with HIV, you might not be automatically disqualified from getting coverage.

Knowing how life insurance is underwritten, and that companies are not all the same, may help you find one that is willing and able to provide you with life insurance coverage to meet your needs. 

Gender Identity on a Life Insurance Application

Most life insurance applications will ask you to identify your gender using binary male/female choices without more inclusive gender identity options. As a part of the underwriting process, the life insurance company may want to review some medical records in order to rate a policy based on your health. During this process it is possible they will learn the gender you were assigned at birth. Some life insurance companies will then automatically rate you based on your assigned gender at birth. Other companies will proceed to rate you based on the gender listed on the application. When shopping around for life insurance, you can ask how the company approaches gender and gender identity to help you find a company that’s right for you.

How Gender Impacts Life Insurance Premiums

Gender or sex is one of many factors life insurance companies use to determine the premium you pay for your policy, and it is legal for life insurance companies to charge different premiums based on gender. This is because there is a statistical correlation between being male or female and life expectancy. 

Life Insurance for People Living with HIV

Due to medical advancements improving life expectancies for people living with HIV, some life insurance companies have updated their underwriting guidelines to allow some clients who are living with HIV to qualify for coverage. Almost all life insurance applications ask if you have HIV. You should know that you will likely be asked to provide details about your HIV status by the agent or representative taking your application.

Factors Involved in Life Insurance Underwriting

Life insurance underwriting looks at many factors to determine if the applicant can be approved for a policy and then determines the underwriting rate class which is used to calculate the premium.

Factors involved in underwriting a life insurance policy may include, but are not limited to:

• Age
• Gender/sex
• Physical measurements and lab results
• Tobacco or nicotine use
• Medical history
• Mental health history
• Prescription history
• Surgical history
• Family health history
• Chronic health conditions 

Underwriting guidelines vary from insurance company to insurance company. But it’s important to remember that all life insurance applicants need to meet all of the company’s underwriting guidelines in addition to any single criteria. Not everyone will qualify.

The underwriting of a specific condition, like HIV, may depend on many additional factors to determine if a policy can be approved and at what premium. For example:

• When was the original diagnosis
• Medications and treatment history
• Additional physical or mental health factors

Guaranteed Issue Life Insurance Options

Some life insurance companies may have what is known as a “guaranteed issue” life insurance policy available for clients who cannot be approved through standard life insurance underwriting (or those who would prefer not to answer health questions or be medically underwritten). If you have concerns about any of the factors listed above, or other circumstances, you can ask your insurance agent or broker if their company has a guaranteed issue policy. Even with these options, there may be some requirements or limitations, such as:

• Age
• Death benefit amount available
• Waiting period for coverage
• Type of policy allowed (term life vs whole life) 

A guaranteed issue life insurance policy costs more for the same amount of coverage because there is less underwriting involved in the application process and the policy is designed for applicants who are in poor health and present a higher risk to the insurance company.  

Other Tips When Shopping or Applying for Life Insurance  

There are many life insurance policies available on the market and choosing the right policy for you may seem confusing. Here are some additional factors to consider:

Term Life vs Whole Life

Term life insurance is a type of policy that is designed to provide you lower-cost coverage for a specific period of time (the “term”). Most term life policies do not build a cash value. Because you are only covered for the duration of the term and there is no cash value, term life insurance is lower in cost compared to other types of life insurance like whole life. 

Whole life is another common type of life insurance and is designed to provide coverage for your “whole life” and build a cash value over time. The cash value in the policy may be withdrawn if the policy is surrendered early, borrowed-against or used to purchase paid-up insurance. Be aware that loans taken from your life insurance policy may accrue interest. Any outstanding loan balance (loan plus interest) could be deducted from the death benefit at the time of claim or from the cash value at the time of surrender. If the loan balance grows too large for the cash value to support it, the policy could terminate. Because whole life has a lifetime benefit (subject to policy terms and conditions such as the timely payment of premiums), the premium is higher compared to term insurance.

Evaluating Your Life Insurance Needs

There are several factors to consider when evaluating the death benefit amount needed for life insurance. These factors may include: 

• Debt you’d like paid-off
• Income you’d like replaced for a surviving spouse or partner
• Childcare expenses
• College or other tuition and education expenses
• Final (funeral) expenses 

In addition to talking to an agent, many life insurance companies have an online life insurance calculator or tool to help you determine a total benefit amount that is appropriate for you and your family.

Know What You Can Afford to Pay

When shopping for life insurance, or working with an agent or broker, it’s often helpful to know how much of a premium will fit your budget. This may help you determine the type of policy, benefit amount, and any additional features you might want. Make sure to know if the policy has a fixed premium or if and when the premium changes.

Choosing a Beneficiary

A beneficiary is the person(s) or organization(s) that you identify to receive the death benefit of your life insurance policy when you pass away. You may list more than one beneficiary, and you may be able to list a contingent beneficiary(ies) if your primary beneficiary(ies) is not living when your policy benefit is paid. The life insurance application will likely need some information for the person(s) or organization(s) you name as beneficiary, including: full name, date of birth, address, contact information, and maybe even a Social Security or Tax Identification Number. 

Review Your Life Insurance Program Every Few Years

As your life changes, so does your need for life insurance. That is why it is important to review your life insurance program with your agent/broker, financial advisor or life insurance company representative every few years. Common elements of a life insurance review include:

• Have your life insurance premiums or benefits changed since the policy was issued?
• Are there any deadlines for coverage or options approaching in your policy?
• Does the death benefit still meet your needs? Or does the policy now exceed your needs?
• What recent life events may have impacted your coverage needs, including: marriage or divorce, birth or adoption, or job changes?
• Are the beneficiaries listed correct? Or do you need to update them?

David Ryan-Sukup is an American Family Insurance agency owner in Madison. As an American Family agent, David specializes in helping clients with their Home, Auto, Business, Farm, and Life insurance needs. David and his husband Justin live in Fitchburg.

Colleen Frentzel is an American Family Insurance agency owner since 2014 and has 25 years in the business She is licensed for multiple states including AZ, GA, IA, IL, OH, NV, UT, and WI. She and her wife Kimberly reside in Janesville.