EE Statement of Health

NeedCoffee

We are in the process of shopping for new insurance carriers. A little over a year ago, we had EEs fill out Statements of Health when doing our 2007 renewal. All EEs had to fill them out.

We have had one carrier come back and state they would reconsider their position if they had updated health information on one specific EE.

I know I could get around this issue by having all EEs fill out new statements, but honestly, we do not have the time to get that done, not to mention all the "soap"ing and moaning done by the EEs about "invasion of privacy" and "big brother."

My question is, is it within our rights to discriminately ask EEs to fill out statements of health?

stilldazed

You can't discriminate in the administration (including cost or denial of coverage) in your group benefits plan, so I would refrain from asking select individuals to complete the questionnaire. You can ask your insurance company to quote based on the information that have, and if the cost comes in a little high, all participants in the group will be subjected to the same cost--not discriminating. Then, an option would be to look at a wellness program of some sort whereby employees are offered opportunities to voluntarily participate and receive some sort of $$ incentive (doesn't have to be much). The end result might accomplish what your company is trying to do and keep you legal.

I think if you ask select individuals to complete a questionnaire and the information is used by your insurance company to formulate what the ins. co. believes is a minimally risky quote, you will have crossed the line. Remember that you and your insurance company have different agendas in the quoting process. Your insurance company is trying to minimize risk to preserve profits. You are trying to get and keep insurance for your workers without risking the costs of litigation from missteps along the way.

Let us know what you decide.

SMace

To answer your question, I wouldn't touch it with a ten foot pole.

I thought they could get the necessary info from your current carrier. In my experience they look for canned census data.

NeedCoffee

It's a long story, but no, they cannot get that data from the current carrier. Don't get me wrong, I completely DO NOT want to do this, but it's a weird situation, which is why I'm even considering it.

I hate benefits renewal.

Thanks for the advice!

Beverlee

I certainly would NOT. Your current experience report is probably showing one extremely high claim for this person. What the insurance company is trying to find out is- if it is an ongoing condition or something that may be coming to an end; such as a heart attack/by pass that is now over.

That insurance company certainly should know better than to even ask that of you- what does your broker say? (if you have one)