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Info provided to firm can reveal status?
Jul 26, 1999

First, this is a great resource, thank you. I have been offered a new job with a new firm, and from reading your previous answers I understand that if I sign up for health benefits within the time alloted (say, 30 days) often there are no questions to be answered. (Please correct me if that's wrong!) I am on (successful) triple therapy, overall my health is great. Now, the problem is, my potential new employer is a very small firm, under 20 employees. At the end of the year, when the insurance company gives the firm an update and maybe raises the price due to an increase in expenditures (which would be me and my drugs!) I can't help but think they'll automatically know it's the new guy, mainly, me. Can they know that the meds are HIV meds? Can they figure it out? I'd really like to keep my status private. Any help is appreciated. I live and work in Missouri, if that matters. Thank you.

Response from Ms. Franzoi

First, you need to check the Summary Plan Description (SPD) for the health plan to determine when you become eligible, i.e. is there any waiting period, and how to enroll. It is in this section that you will typically find language that states if you do not enroll within a certain number of days, usually 31 days, you will have to provide evidence of good health in order to obtain coverage. So review this in your SPD to determine how the plan works.

With respect to renewal on the policy for your employer, it is difficult to say what will happen at renewal time. Much depends on the insurance policy. If it is an HMO or a community-rated policy, the renewal rate won't depend entirely on the experience of the company. In addition, other employees or their dependents could have medical conditions that impact the cost. This information is confidential and cannot be shared by the insurer with the employer. The insurer might share the dollar amount of the claims but not the medical condition.

Lynn Franzoi



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