Health Insurance Enrollment

Kayeh · April 2004

Our insurance agent called stating that to bid our insurance that the insurance companies are asking for the health status of each employee. I told her that I would not comply. She said the problem would be that I will get a quote and then when they do find that we have two employees with major medical problems they will probably raise the rates up to 50%, so we will not be able to get competitive bids since we will not know what the upcharge will be.

Has anyone else been in this situation? If so, what was your upcharge?

neveradull · April 2004

The demographics we have always used for health insurance bids are sex and age. If I were you I would find a different broker. Think Hipa!

POPEYE · April 2004

You may provide "summary" information without violating Hipaa regulations. That might include a composite report of claims either by average dollar amount or frequency average of your enrollees. Your post indicates that you are dealing with your current carrier and they should have or have access to this information. Other than for some possible pre-existing limitations in your coverage, I don't see a need for them to have any additional information on each enrollee.

jrzgrl · April 2004

When our insurance broker gets quotes from different companies, the potential companies know that they cannot get claims experience, either from me or our current carrier (yeah, that HIPPA thing again). All they have to go by are the demographic information mentioned above and our current rates. How do they expect you to obtain the health status of each employee..devise a questionnaire?

Kayeh · April 2004

She just called back and they now want the name of the employees that have had over $5,000 of medical expenses over the last year. She is still saying that if the different companies she is trying to get a bid from do not get this information now, that they will raise their quote when they get the information.

System · April 2004

If she calls again, hang up on her! When we switched carriers all we provided was the gender and age info described above. She should know that you may not release that kind of information.

Sue · April 2004

We experienced this also and we did comply. It is used to get bids and would not have been necessary if we stayed with our current carrier. Each employee had to complete a generic Health Questionnaire - which was very detailed. They were highly cautioned to be honest in their answers. Once completed, employees mailed them directly, in postage paid envelopes directly to our broker. No one at our company saw the information.
And yes, bids received before this information are processed is considered preliminary and can change once unknown health conditions are discovered. It was not easy to do, but we communicated clearly to the employees. They appreciated our efforts to get bids and to keep their information confidential. They were told to expect the same procedure on an annual basis.

SMace · April 2004

We are self-insured with a large deductible plan. We provide this information to re-insurance companies. They need this information because we have $100,000 specific deductible on each "claim". They will not re-insure us without that information. Our NPP addresses that we may give this info out and when we do we will log it on our disclosure list. Our broker and TPA has signed Business Associate agreements with us and will sign one with all the re-insurers that get the specific info. HIPAA will absolutely allow this if it is done the right way.

Health Insurance Enrollment

Comments