(b) Written informed consent to an HIV related test shall consist of a written authorization that is dated and includes at least the following:

1. (1) a general description of the test;
2. (2) a statement of the purpose of the test;
3. (3) a statement that a positive test result is an indication that the individual may develop AIDS and may wish to consider further independent testing;
4. (4) a statement that the individual may identify on the authorization form the person to whom the specific test results may be disclosed in the event of an adverse underwriting decision, which person may be the individual or a physician or other designee at the discretion of the individual proposed for insurance;
5. (5) the department of health's statewide toll-free telephone number that may be called for futher information about AIDS, the meaning of HIV related test results, and the availability and location of HIV related counseling services; and
6. (6) the signature of the applicant or individual proposed for insurance, or if such individual lacks capacity to consent, the signature of such other person authorized to consent for such individual.

(d) As used in this section, the following terms shall have the following meanings:

1. (1) "Adverse underwriting decision" means:

   1. (A) a declination of insurance coverage as applied for; or
   2. (B) an offer to issue insurance coverage at a higher than standard rate.
2. (2) "AIDS" means acquired immune deficiency syndrome, as may be defined from time to time by the centers for disease control of the United States public health service.
3. (3) "HIV infection" means infection with the human immunodeficiency virus or any other related virus identified as a probable causative agent of AIDS.
4. (4) "HIV related test" means any laboratory test or series of tests for any virus, antibody, antigen or etiologic agent whatsoever thought to cause or to indicate the presence of AIDS.