Medical and Legal Ramifications of
Genetic Testing in LTCi
Wednesday, December 8, 2021
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Genetic risks important to the LTC industry will be reviewed. The dementias, particularly early onset Alzheimer's disease (EOAD), presents a particular challenge. The genetics of dementias, including EOAD will be reviewed. Genetic principals such as patterns of inheritance, penetrance, expressivity, along with the important concepts of family history will be discussed. Tools for risk assessment will be presented, including how to research a variant for updated medical risk information, and how to think about the risk for a variant of uncertain significance.

The discussion will also include a review of the legal and regulatory guardrails around the use of genetic information, including some of the recent developments in Florida and elsewhere. We will cover how various states regulate insurers use of genetic information and talk generally about what types of use are permitted and what is restricted. Finally, we will discuss the legal and regulatory issues around direct to consumer genetic testing.


Gregory T Soltner, DO FMLI Joined Northwestern Mutual in March of 2019. In addition to writing medical underwriting standards, he provides medical consultations in life underwriting, disability income underwriting, LTC underwriting and disability claims with special interest in genetic underwriting risks. Before joining Northwestern Mutual, Dr. Soltner was in private practice for 24 years in suburban Philadelphia. He is board certified in Family Medicine. While in private practice, he took care of all age groups. Dr. Soltner attended medical school at the Philadelphia College of Osteopathic Medicine. He completed his family medicine residency at Chestnut Hill Hospital in Philadelphia. As an undergraduate, he attended the University of the Sciences and earned a BS degree in Pharmacy and worked as a registered pharmacist prior to attending medical school.


Nolan Tully assists life, long-term care, and disability insurers as well as annuity issuers with product development, regulatory compliance, and dispute resolution and litigation.

As co-chair of the firm’s long-term care insurance (LTCi) practice, Nolan assists clients with issues relating to product development and marketing, policy wording, regulatory approval, claims review, complaint handling, premium rate issues, block closure, market conduct exams, litigation avoidance and predispute consulting, individual and class action litigation, and insolvency/liquidation issues. He also represents carriers in the sale, acquisition, or reinsurance of long-term care insurance blocks. Additionally, Nolan assists carriers with life insurance and annuity combination products that include chronic illness coverage. He also represents third-party administrators in all aspects of LTCi administration.

Nolan frequently writes about LTCi issues and is asked to present to carriers and industry groups. Active in industry groups, Nolan consults with clients on innovations in care delivery and management, proactive policyholder engagement to improve health outcomes, regulatory and legislative changes to allow the market to respond better to the elder-care population, improvements to the rate increase application and approval process, and new concepts for effectively covering the next generation of long-term care needs.

Nolan also assists life insurers and annuity issuers with regulatory compliance, dispute resolution and litigation. He counsels clients on fraud detection and investigation policies and procedures, suitability issues, fraud reporting requirements, and a variety of other topics including financial, compliance, and privacy related issues.

Prior to joining the firm, Nolan worked as a law clerk for the Hon. Eduardo C. Robreno at the United States District Court for the Eastern District of Pennsylvania.