Have Legal Questions? Ask a Lawyer Now.
Hello I am a licensed attorney. I am here to help answer your questions. Please do not hesitate to ask for clarification
This is a common issue,
Under the law, the employer can only ask you this medical information for a legitimate purpose, he can use it to discriminate against you due to a medical condition.
The HIPPA privacy rule does not prevent your employer from asking you for information about your health if your employer needs the information to administer sick leave, workers' compensation, wellness programs, or health insurance. However, to obtain this information your health care provider cannot disclose the information in response to requests from your employer without your authorization. Covered health care providers must have your authorization to disclose this information to your employer, unless other laws require them to disclose it.
Group health plans are covered by HIPAA. The HIPAA Privacy Rule applies as long as the plan has 50 or more participants. If you are a member of a group health plan, your employer pays a premium to the health plan organization to cover your health care costs. In return for the premium paid, the health care plan assumes the risk of paying for health care expenses covered by the plan. The HIPAA Privacy Rule applies to the plan itself, but not your employer.
Self-insured plans are health plans often offered by large employers as an employee benefit. Under self-insured health plans, the employer itself assumes the risk of health care costs and has the responsibility for paying heath care claims out of the company's operating funds. Claims may be processed by company personnel or contracted out to other companies that process and maintain the records.
If your employer is self employed, HIPAA says your employer can get what is called "summary" information to use to obtain premium bids or changes in coverage. If the health information your employer receives goes beyond the basic summary, then HIPAA requires the employer to establish procedures much like that of a covered entity (a medical facility). HIPAA attempts to limit the use of medical information for employment purposes.
Under the HIPAA Privacy Rule, an employer that is also the insurer of health benefits is in a category called a "hybrid" entity. That means the portion of the company's operations that deal with processing health claims is a covered entity. Like any other covered entity, a "hybrid" function must (1) give notice of written privacy procedures, (2) place restrictions on the use of health information, and (3) appoint a privacy officer and train staff.
Under a 2008 law, the Generic Information Nondiscrimination Act (GINA), an employer may not request, require, or purchase genetic information about you. If, like many people, you have health insurance through your employer's group health or self-insured plan, GINA also prohibits your insurer from requesting, requiring, or purchasing genetic information. Further, the insurer cannot use genetic information to adjust your premiums or the premiums of your group plan. For more on GINA and what employers and insurers can and cannot do, see the website for the organization Council for Responsible Genetics at:http://www.councilforresponsiblegenetics.org/geneticprivacy/index.html
His employer states that he is "shopping around" for the best rate, perhaps a self funded plan. Are we required to answer the in depth questions? They do no represent a summary of our health issues, rather they are asking about specifics of disease, illness, all medications , and inquiring whether we have been advised to seek treatment for something in the next 24 months. They are asking us directly, not through our current health provider. It just seems really invasive.
Only summary information can be asked for
if the insurance company requires further clarification you can advise your employer you will sign a HIPPA release form so they can review your information,
anything about medical conditions, or any diagnosis should not be readily given,
If the employer wants this information, advise him to put the request in writing, and you will only answer them if assured it would be protected under the HIPPA rules,
So, it is legal for his company to request in depth medical information? I want to be clear, because I have never seen a questionaire of this detail from anyone outside of a physician
I don't have anything to hide, but it is a matter of principal and privacy
The law only protects the dissemination of the information, and the use of it, if he uses it for personal gain, he can be sued, or if her uses it to discriminate against you he can be liable for discrimination.
The law makes sure he is using it only for a legitimate purpose, and does not disclose it to unauthorized individuals.
So he has the right to ask these questions, and we are obligated to answer them or forfeit out health insurance?
however he must take steps to make sure it is protected.
oy! Ok, just wanted to understand our rights. Thanks so much.
Good luck, and if you have any further questions please do not hesitate to ask.
If satisfied please provide us with positive feedback, so we can receive credit, thank you
DISCLAIMER: Answers from Experts on JustAnswer are not substitutes for the advice of an attorney. JustAnswer is a public forum and questions and responses are not private or confidential or protected by the attorney-client privilege. The Expert above is not your attorney, and the response above is not legal advice. You should not read this response to propose specific action or address specific circumstances, but only to give you a sense of general principles of law that might affect the situation you describe. Application of these general principles to particular circumstances must be done by a lawyer who has spoken with you in confidence, learned all relevant information, and explored various options. Before acting on these general principles, you should hire a lawyer licensed to practice law in the jurisdiction to which your question pertains.
The responses above are from individual Experts, not JustAnswer. The site and services are provided “as is”. To view the verified credential of an Expert, click on the “Verified” symbol in the Expert’s profile. This site is not for emergency questions which should be directed immediately by telephone or in-person to qualified professionals. Please carefully read the Terms of Service (last updated February 8, 2012).