Question:
My employer will get a report form my insurance with my info
My medical insurance is through my employer. They are "self insured". The insurance company sends out reports with each insured member's name and the amount of their claims each month. They also send out a different report that shows the employer the "types" of claims, ex circulatory, digestive, psychological, obesity. Supposedly this helps them identify problem areas with employees so they know which health topic they need to educate them on. I have not seen this "education" yet. They can also call the insurance broker for specific information on members. I do not like the fact that they can find out what problems I have had, what claims I have filed, and how much they were. I will be having surgery in a couple of weeks and this is really bothering me. — lasias (posted on July 24, 2006)
July 24, 2006
I thought things like that were confidential?? There has to be a way that
you can stop them from getting your personal information..That would be
like a Dr calling your employer and giving them info on you...I would check
into it further...Im sorry this is happening to you..I can see why you are
upset, i would be upset also, and I would also be contacting someone..
— [Deactivated Member]
July 24, 2006
Hi,
I truly doubt that they can get specifics on an individual, I work for BCBS
& that type of information cannot be shared. No PHI (personal health
information) can be given to your employer other than as a group, nothing
on the individual. As for the $ of claims that is ok. Nothing specific
should come out of that either. Call HR & ask, any sharing of PHI is
ilegal nation wide.
Best wishes
MaryLyn
— Kriola
July 24, 2006
There is no need to panic or get upset. Our company is self insured and I
used to work for an HMO who dealt with self insured companies.
What they send the employer is a total of the amount of claims per employee
and family unit per month. This is how the employer cuts the payment checks
as they are the ones who actually are paying the bills. The other report,
is based on ALL the employees. It will show the number of people who had
claims for cardiac, the number who had for psych, etc. It won't name
individual names of people who had those claims. By law they aren't allowed
to release names or types of treatment you have. They don't even get claim
numbers or anything, only a total dollar amount that was paid for the month
or period.
So, they can't find out any of that information that you are concerned
about.
Also, we were self insured almost 10 years before they did trends and
introduced some education to the employees.
It may take that long or longer to find out how, and if they will choose to
do education. What they did with our company was that they did a health
fair so you could get information on the things that are wrong with you.
Worry about your surgery, not this. You are worrying for nothing here!
— oceanrayne
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