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Insurance company notifying Employer
May 10, 2006


I have been recently diagnosed and my doctor said that I don't have to start medication right away (CD4 974, CD4% 40, viral load < 400) and I should go for bloodwork every 3 months.

My question is, will the insurance company notify my employer that some employee is routinely going for CD4 and viral load checkup? Or will my employer be notified only when I start medication? I work for a very small company and we are only 7 employees. My fear is my boss will find out about me.

Thanks, R

Response from Ms. Franzoi

The insurance company has a legal responsibility to keep your medical information confidential. Although they won't (or should not) share information specific to you, they do report to employers in gross dollars, the amount spent on different illnesses such as heart disease, ms, diabetes, AIDS, cancer, maternity, etc. In addition, an employer frequently can get a breakdown of information on specific drugs and the associated gross cost under a plan. What I am describing here is what happens in a self-insured plan where the insurance company adjudicates the claim and the employer reimburses the insurance company for all claims paid. In an insured arrangement, the employer often cannot get this information.

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