Employer May Be Violating HIPAA Laws

[she2003]

What is the name of your state (only U.S. law)? California

Hello, I work for a large corporation. This week, all employees received notification that we must complete a health assessment by Oct. 31, "or we will not be eligible to elect medical coverage for 2009". The assessment is to be completed online, through the insurance provider's website. The notification assured us that the site is secure, and that the employer will not see our health information.

Today, employees received another notification. The company has been challenged about the legality (by employees). The employer states that "According to the Dept. of Labor, employers may require individuals to complete a Health Assessment, provided the health information is not used to deny, restrict, delay eligibility or benefits". The employer states that "No information provided on the Health Assessment will be used to deny, restrict, delay eligibility or benefits in any way". The employer stands by the legality of their approach.

To me, they ARE denying benefits if we do not complete the Health Assessment. I just don't understand how this can be legal. Is it?

Thanks

[seniorjudge]

Which section of the law do you think the employer is violating?

[cbg]

This was not a HIPAA violation when you posted it on the Fringe Benefits forum, and it is not a HIPAA violation now.

HIPAA does not, repeat, DOES NOT, prohibit your employer from asking you to provide health information. In the employment relationship, unless you are actually employed by a doctor, hospital, health insurance carrier, medical billing office and so on, HIPAA does not apply. If your health insurance plan is fully insured, HIPAA does not apply there either. ONLY If your group health insurance plan is self-insured does HIPAA even come into the workplace, and in that case only information that is supplied BY the plan (claims etc.) is protected.

With exceedingly rare exceptions that do not apply here, ASKING for information is NEVER a HIPAA violation.

It is completely, totally and 100% legal for an employer to require this health assessment for health insurance purposes. It's not that they are illegally denying you benefits if you do not; it's that if you do not, you are making yourself ineligible for benefits. If the plan document states that to be eligible you must complete this assessment, then failure to do so means that you have chosen to be ineligible.

[cbg]

One point of clarification:

No information provided on the Health Assessment will be used to deny, restrict, delay eligibility or benefits in any way". means that if you provide information suggesting that you are diabetic, for example, they won't deny or restrict benefits for diabetes. If your information suggests that you have kidney trouble, they'll still pay for benefits for kidney trouble.

But if you refuse to complete the Health Assessment, coverage of any kind can be denied because you have not met the eligibility requirements, which include completing the assessment.

[she2003]

Thanks for your feedback. Sounds like I better jump on completing my assessment.