I have been HIV+ for 14 years and on SSDI for the last 8. I started doing better around the turn of the century, went back to school, got a degree, and am looking for work.

I had a good interview with a prospective employer, and I have reason to believe they are going to offer me a position. The problem is my medications: my wife (also HIV+) and I have an annual pharmacy bill around $55K, currently paid for by ADAP. The job will raise our household income above the ADAP limit in our state, but the prospective employer provides good benefits, including medical insurance with a prescription plan.

Here's the issue: they are a small company, around 500 employees total. I am worried that the addition of my medication bill will cause their insurance carrier to drop them, raise their rates, or something like that. I have both ethical and practical qualms about this, and am thinking of confining my job search to large companies in the future.

Any opinion you might have would be welcome.

In a smaller company, the impact of high costs by one claimant can drive that company's health care premium higher. However, I do not consider a 500 life company to be that small. Certainly, in a larger corporation, this would not be an issue.