Group Health - Excluding Member Based on Health Screening

[kittsi]

[FONT='Arial','sans-serif']Question about dropping a member from group health insurance plan based on health screening.[/FONT]

[FONT='Arial','sans-serif']Some background - member has worked at employer for 4+ years. He and his wife are both covered under the plan.[/FONT]

[FONT='Arial','sans-serif']This year the insurance company is implementing a health screening for both member and spouse. [/FONT][FONT='Arial','sans-serif']Apparently this health screening entails doing a BMI, blood pressure check, probably cholesterol. If the member or spouse is over the limits on any part of the health screen (weight too high, blood pressure too high, etc.) they can be "written up" and if they do not show progress by the end of the year, they can be dropped from the group insurance plan.[/FONT]

[FONT='Arial','sans-serif']My question is, is this even legal to not offer insurance to an employee based on weight or blood pressure? Wouldn't this be considered a pre-existing condition?[/FONT]

 

[ABC]

I do not think that is legal.

 

[stuy119]

Write an email (yes, put it in writing) that the owner should check with his lawyer before taking this step and that you feel it could open him up for a lawsuit. Protect yourself so you don't look like you endorsed the move and get sued as well.

 

[leevena]

This is definitly not allowed, see HIPAA regulations. By the way, this is such a blatant "no-no" I would wonder if in fact the employer is really doing this. I am not dismissing Kittsi outright, just wondering if there is a mis-understanding.

 

[junkman]

People need to post their states. The employer can make the screening mandatory. They can also charge more for certain lifestyle conditions smoking, BP, weight etc.

Normally it is couched as a carrot instead of a stick - giving discounts from the base rate to those that meet certain requirements. A better way to implement is voluntary screenings with incentives. Make it mandatory after a year or so.

The objective is to change behavior which is difficult. The 1st step is to gather data about what conditions are out there. What size group is this? What carrier? I take it that it isn't your case?

 

[leevena]

People need to post their states. The employer can make the screening mandatory. They can also charge more for certain lifestyle conditions smoking, BP, weight etc.

Normally it is couched as a carrot instead of a stick - giving discounts from the base rate to those that meet certain requirements. A better way to implement is voluntary screenings with incentives. Make it mandatory after a year or so.

The objective is to change behavior which is difficult. The 1st step is to gather data about what conditions are out there. What size group is this? What carrier? I take it that it isn't your case?

Sorry, but what did you mean by "post states" in your opening statement?

Also, no one is debating the value of screenings and the use of the information. What the question posed was if the employer could use that information to drop them from coverage, which cannot happen.