How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask WALLSTREETFIGHTER Your Own Question

WALLSTREETFIGHTER
WALLSTREETFIGHTER, Attorney
Category: Legal
Satisfied Customers: 16006
Experience:  14 years experience in representing clients, current member of legalshield, legal club of america, NYSUT and UFT attorney
16356563
Type Your Legal Question Here...
WALLSTREETFIGHTER is online now
A new question is answered every 9 seconds

My husbands employer ( large group insurance), is considering

Resolved Question:

My husband's employer ( large group insurance), is considering switching to self funded group insurance. They sent a from home from the company itself, asking in depth medical questions about specific medical conditions. Some ask for specific inf0 going back 5 years, and other questions ask if any of us have been advised to seek treatment for any condition over the next 2 years. The form comes from his employer, not from n insurance company. It also asks to list medications, and asks employees to disclose HIV status. My question is: Is this legal? Do we have to disclose this personal medical information? He has been with this company for 22 years, so it's not a new hire situation. We live in NJ. P;ease advise, if possible.
Submitted: 1 year ago.
Category: Legal
Expert:  WALLSTREETFIGHTER replied 1 year ago.

WALLSTREETLAW :

Hello I am a licensed attorney. I am here to help answer your questions. Please do not hesitate to ask for clarification

WALLSTREETLAW :

This is a common issue,

WALLSTREETLAW :

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.

WALLSTREETLAW :

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

Customer:

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.

WALLSTREETLAW :

Only summary information can be asked for

WALLSTREETLAW :

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,

WALLSTREETLAW :

anything about medical conditions, or any diagnosis should not be readily given,

WALLSTREETLAW :

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,

Customer:

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

Customer:

I don't have anything to hide, but it is a matter of principal and privacy

WALLSTREETLAW :

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.

WALLSTREETLAW :

The law makes sure he is using it only for a legitimate purpose, and does not disclose it to unauthorized individuals.

Customer:

So he has the right to ask these questions, and we are obligated to answer them or forfeit out health insurance?

WALLSTREETLAW :

yes,

WALLSTREETLAW :

however he must take steps to make sure it is protected.

Customer:

oy! Ok, just wanted to understand our rights. Thanks so much.

WALLSTREETLAW :

Good luck, and if you have any further questions please do not hesitate to ask.

WALLSTREETLAW :

If satisfied please provide us with positive feedback, so we can receive credit, thank you

WALLSTREETFIGHTER, Attorney
Category: Legal
Satisfied Customers: 16006
Experience: 14 years experience in representing clients, current member of legalshield, legal club of america, NYSUT and UFT attorney
WALLSTREETFIGHTER and 9 other Legal Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • Mr. Kaplun clearly had an exceptional understanding of the issue and was able to explain it concisely. I would recommend JustAnswer to anyone. Great service that lives up to its promises! Gary B. Edmond, OK
< Last | Next >
  • Mr. Kaplun clearly had an exceptional understanding of the issue and was able to explain it concisely. I would recommend JustAnswer to anyone. Great service that lives up to its promises! Gary B. Edmond, OK
  • My Expert was fast and seemed to have the answer to my taser question at the tips of her fingers. Communication was excellent. I left feeling confident in her answer. Eric Redwood City, CA
  • I am very pleased with JustAnswer as a place to go for divorce or criminal law knowledge and insight. Michael Wichita, KS
  • PaulMJD helped me with questions I had regarding an urgent legal matter. His answers were excellent. Three H. Houston, TX
  • Anne was extremely helpful. Her information put me in the right direction for action that kept me legal, possible saving me a ton of money in the future. Thank you again, Anne!! Elaine Atlanta, GA
  • It worked great. I had the facts and I presented them to my ex-landlord and she folded and returned my deposit. The 50 bucks I spent with you solved my problem. Tony Apopka, FL
  • Not only did he answer my Michigan divorce question but was also able to help me out with it, too. I have since won my legal case on this matter and thank you so much for it. Lee Michigan
 
 
 

Meet The Experts:

 
 
 
  • Tina

    Lawyer

    Satisfied Customers:

    8436
    JD, BBA Over 25 years legal and business experience.
< Last | Next >
  • http://ww2.justanswer.com/uploads/MU/multistatelaw/2011-11-27_173951_Tinaglamourshotworkglow102011.64x64.jpg Tina's Avatar

    Tina

    Lawyer

    Satisfied Customers:

    8436
    JD, BBA Over 25 years legal and business experience.
  • http://ww2.justanswer.com/uploads/RA/ratioscripta/2012-6-13_2955_foto3.64x64.jpg Ely's Avatar

    Ely

    Counselor at Law

    Satisfied Customers:

    19941
    Private practice with focus on family, criminal, PI, consumer protection, and business consultation.
  • http://ww2.justanswer.com/uploads/FL/FLAandNYLawyer/2012-1-27_14349_3Fotolia25855429M.64x64.jpg FiveStarLaw's Avatar

    FiveStarLaw

    Attorney

    Satisfied Customers:

    8189
    25 years of experience helping people like you.
  • http://ww2.justanswer.com/uploads/jespoag/2008-12-17_222355_jessepic.jpg JPEsq's Avatar

    JPEsq

    Attorney

    Satisfied Customers:

    2132
    Experience as general attorney, in house counsel, SSDI, Family Law attorney, and law professor
  • http://ww2.justanswer.com/uploads/gsenmartin/2008-04-22_214950_me1.jpg Guillermo J. Senmartin, Esq.'s Avatar

    Guillermo J. Senmartin, Esq.

    Attorney

    Satisfied Customers:

    110
    7+ years of experience handling various legal matters.
  • http://ww2.justanswer.com/uploads/PA/PaulmoJD/2013-10-10_195858_JAImage.64x64.jpg Law Educator, Esq.'s Avatar

    Law Educator, Esq.

    Attorney

    Satisfied Customers:

    31621
    JA Mentor -Attorney Labor/employment, corporate, sports law, admiralty/maritime and civil rights law
  • http://ww2.justanswer.com/uploads/dkaplun/2009-05-17_173121_headshot_1_2.jpg Dimitry K., Esq.'s Avatar

    Dimitry K., Esq.

    Attorney

    Satisfied Customers:

    15975
    Multiple jurisdictions, specialize in business/contract disputes, estate creation and administration.