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How Employers Can Determine Your HIV status
Jan 31, 2012

Dear Doctor:

I know insurance companies are not allowed to disclose the name of an employee but they are allowed to share information about medical costs for a specific employee. Given the high cost for HIV treatment.(on average $20K per year and mainly due to a prescription drug cost of $1800.00 per month) how can an HIV+ employee's medical condition remain confidential? It seems as if the cost of treatment will eventually enable an experienced HR professional to figure out that a specific employee has a serious medical condition? It seems that the high cost of treatment is a dead giveaway, particularly if the employee is a "gay" male. Can you please share you thoughts?

Thank you

Response from Mr. Chambers

I understand your point, and an employer can certainly speculate on why an employee has such high medical bills, even more so if it a person who is out at work. However, it is all speculation.

How many employers (and other ignorant people) assume many, most or, all LGBT persons are HIV+ without even knowing the size of their medical bills? Again, it is speculation and they do not really know for sure.

As long as you are totally private and do not reveal your status to anyone at the company including co-workers, it would be very difficult for an employer to find out.

Be aware, also, that small groups do not get to see a listing of medical claims by employee. Groups up to 50 employees and even larger with many carriers are pooled with many other groups for purposes of rate increases, so even the insurance company doesn't readily know what one employer had in medical costs.

Very large groups, especially those that are self-funded (usually 1,000 or more employees, occasionally over 500 employees) do get such reports but they know the legal problems they could encounter if they know a person's medical condition and act on it, so they usually are careful not to get enough information to know a person's diagnosis. Further, groups that size pay so much for the employees' health insurance, claims of over $20,000 and even $50,000 are expected, and don't change their overall experience even 1/10 of 1%.

There are no real guarantees on much of anything, but I really believe that employers really only find out a person's status by the employee saying something to someone and the word gets out. I also think there are a lot of employers out there (but not enough) who would understand that HIV is not a stigma that needs to be dealt with.

I hope that helps a little.

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