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Can my employer discover my HIV status through repeated billing for HIV drugs?
May 26, 1997

I may soon have to start taking drugs for HIV. I have insurance through a large provider, but I am worried that my employer my find out my HIV status through billing or office personnel. I want to keep my status totally to myself. And since these drugs are so expensive, would that be another reason to believe my employer might find out from the insurance company?

Response from Ms. Franzoi

An insurance company cannot legally share that information with the employer. However, it is important to know whether the plan is insured or self-insured. In an insured plan, the insurer would not share this with the employer. Under a self -insured arrangement, it might be possible for the Group Insurance Department to find out information with respect to an individual's illness through reports provided to them, such as utilization review reports. However, most of the reports provided to an employer by the administrator in a self-insured arrangement are total dollars spent on claims by inpatient vs. outpatient treatment, by diagnosis, by type of service including dollars spent on prescriptions, total dollars spent per covered employee or dependent for claims in excess of a certain dollar amount but without any diagnosis, etc. The simple answer is, legally, no. The practical answer is, it is possible.

- Lynn Franzoi



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