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CONFIDENTIALITY
Mar 25, 1998

I am the person who posted the resent question on cost of health insurance premiums.

I forgot to mention ( actualy I forgot) that about a year ago I applied for some long term disability insurance at work. It was a policy written by Standard Insurance. When I applied I was under the mistaken belief that since it was a group type thing they would be required to accept my application. It soon became apparent to me that I should have never applied, because now they know my hiv status and ofcourse I was denied.

I spoke to someone at Standard and they said that the information is held in the strictest of confidence, execpt for any insurer who request the information (I had to laugh).

I understand there is some sort of central health reporting agency kind of like your credit report but its for your health. I don't know if my hiv status has been passed on to this health reporting agency.

My question is by disclosing to Standard Insurance my hiv+ status, could this some how affect my premiums somtime down the road when I am trying to purchase my own medical insurance.

Thanks again!

Response from Ms. Franzoi

It is important to remember that if an employee enrolls when he is first eligible for benefit plans such as medical, life insurance and long term disability, there is usually no requirement for evidence of good health. However, if an employee wants to enroll after that date, he will have to provide evidence and runs the risk of being denied coverage.

With respect to purchasing a medical policy in the future, this information should have no impact. Let me explain why. Under HIPAA, an individual who has had continuous coverage without a break in coverage of greater than 63 days and who (i) was covered under a group health plan, a government plan or a church plan; (ii) has at least 18 months of creditable coverage, i.e. coverage under another group health plan, Medicare, Medicaid, public health plans, federal employees plan, without a break in coverage of greater than 63 days; (iii) who is not eligible for coverage under any group health plan, Medicare or Medicaid,: (iv) who does not have any other health insurance; and (iv) who has exhausted COBRA, is eligible to purchase an individual policy from any insurer who is in the market. This can be done without submitting any evidence of good health. However, the insurer will probably charge a premium of 60% -75% more than the standard premium. Your other option is to submitt evidence. If you pass evidence, you will get the coverage at the more favorable rates. If not, you will still be able to purchase the coverage at the higher rates. There is no way to apply for medical coverage on an individual basis without completing a medical questionnaire except for this option under HIPAA. Therefore, whatever information that is there will not affect your ability to purchase coverage. The cost will depend on whether or not you satisfy evidence of good health.

Lynn Franzoi



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