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Is paying my HIV-related bills
Jun 25, 1998

On March 6, the company that I was working for eliminated my position. Now, part of my problem, or condern, besides the new job search is this: Seven years ago, when I learned that I was HIV+, I notified my company because our company is self=insured, but underwritten with another company to keep the costs down. (The company that I worked for is extremely cash-rich). The VP and general manager of the place where I was employed chose to pay for all my HIV related expenses directly, without filing any of my expenses, (office visits, blood work, meds, etc) with the insurance group that oversaw and administered our policy. The payments were always made via a cashier's check from the coroporate office (made out the the G.M.'s admin assistant's name), and she in turn would endorse the check and give it to me for remimbursement. I was always paying for my meds on my credit card, and sometimes the remibursement would be late, thus running up my credit card.

There were times that this would seem to me discriminatory, and inconvenient. I live in a small town, and one time I was picking up my meds at one of the local pharmacies, and the clerk was suprised that I was not filing the prescription with our drug card, because she noticed that the cost "was extremely expensive". There was also an occasion that my HIV doctor referred me to a specialist with a problem that was not HIV-related, but the specialist was a member of the same health group. I of course, filed those visits and treatments with our health insurance. Now that the health insurance card was on-file, the subsequent visit and bloodwork done at my HIV doctors office was automatically filed. When someone at the corporate office saw the bill come in, I was delicately admonished for this mistake. I then, on that occassion, made known that I was sometimes uncomfortable with this method of handling my expenses, and asked why they just didn't let me handle this with my insurance. I was told that I should be thankful for the level of support, (and which, of course I am--) but I have always wondered if this method was not some sort of discrimination? Now that my position has been eliminated, they have offered to continue to keep this support up for a period of up to 18 months, or whenever I become employed again with a company or firm that offers health benefits, and if that health insurance program has a pre-existing clause, the company will keep the support up until that clause expires, as long as all of this happens within 18 months. I am also keeping up with my COBRA, which is expensive. I was downsized approximatley one year after I voiced my concerns over the method of handling my expenses. The company is not a small one, they have approximatley 5,000 employees in three states, so I am sure that I was not the only HIV positive empoloyee that they had, but I might have been the only one at any high management level. Now I wonder if this is not some form of discrimination. What do you think? (I had posted this same questin to your panel about a month ago, I was the one who asked the question about the timeliness of your answers)

Response from Ms. Franzoi

This is a very unusual situation. It is not common for a company to pay claims outside of the health plan. If they are self-insured with a group of 5,000 employees, I do not understand why they are doing this. However, it doesn't appear that you have been harmed because they paid for your claims in the same fashion that they would've paid under the plan. Since you have left the company and are covered under COBRA, why aren't you now filing these claims under the plan as a COBRA participant? It sounds as if they are trying to mirror COBRA with their promise to continue payment for 18 months. I don't find any discrimination here but it is strange. In addition, I am not sure how they could be reporting the reimbursements to you for tax purposes.

Lynn Franzoi

Insurance Law Confusion

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