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Can my HMO Provider tell my employer?
Apr 29, 1997

Can my health care provider (an HMO) inform my employer of my HIV status? and can the HMO not renew my employer's health care plan based upon this fact? Thanks very much for your help.

Response from Ms. Franzoi

A health care provider cannot inform your employer of your HIV status. Your question re whether or not an HMO can choose not to renew the contract could vary by state and by state insurance law. Currently, there is no federal requirement to force an insurance company to take on risk. However, with the Health Insurance Portability and Accountablity Act ("HIPAA") which is effective 1/1/98 for calendar year plans, an insurer or HMO is required to renew or continue coverage at the option of an employer except in the cases of :

nonpayment of premium, fraud, change of location by the employer outside of the service area,or cessation of operations by the HMO or insurer.

- Lynn Franzoi



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