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Job probationary period and Manditory Health Insurance benefits
Jul 23, 1997

I have recently been seeking employment and have found the practice of requiring me to sign up for Group Health insurance benefits before the probationary period (90 days) expires allows the employer to find out about my Aids history during the probationary period and to fire me without cause during this period. I know that the Insurance company calls the Administrator when they discover that a person has any illness and usually upon verbal request,the insurance company will tell the Administrator that the person has Aids. Will the new portability laws change this discriminatory practice? Can an employer legally force you to sign up for the group insurance? I am covered by Medicare and TennCare.

Response from Ms. Franzoi

I am not sure why you think that the reason an employer has you sign up for medical coverage during the probationary period is to find out about your medical history. An employee is required, by the terms of the insurance contracts, to sign up within 30 days of becoming eligible for benefits. Failure to do this results in the insurance company requiring the employee to answer a medical questionnaire and/or take a physical exam in order to determine his or her insurability. At this time, coverage might or might not be provided. It's up to the insurance company to determine this.

Once enrolled in the plan, the insurance company does not have access to your prior medical history. Although insurance carriers do provide employers with information on a dollar amount of claims, amount and no. of claims by diagnosis, and other information, they do not typically provide information regarding a specific employee's health condition. In fact, with HMO coverage, employers have difficulty getting any information on total claims and certainly cannot get any information on a specific individual. In addition, any information revealed to the company is provided to the Benefits Dept. and cannot be shared with others within the company nor used as a reason to terminate someone within the probationary period. Even during the probationary period, the employee is protected under the ADA. If an employee signs up for medical coverage and does not use the plan during the probationary period, there would be no information on file with the insurance company to share with the employer.

The new portability laws under HIPAA require plans to recognize prior periods of coverage toward any preexisting condition waiting period unless the employee had a break in coverage of at least 63 consecutive days. This does help employees who move from one job to another if they have a preexisting condition.

An employer cannot force you to sign up for coverage if you are charged a fee to have the coverage. However, if the coverage is provided by the employer at no cost to all employees, you will be automatically covered and will probably not have the option of waiving coverage.

-- Lynn Franzoi



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