Private Health Insurance
Private health insurance and your business
Approximately 75 percent of businesses in Massachusetts surveyed in 2007 offered health insurance to their employees.1
What’s more, three-fourths of employees who were eligible for employer-sponsored health coverage enrolled.
HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) protects individuals from discrimination of health insurance coverage due to health status-related factors.2
The coverage includes employer-sponsored health plans and protects individuals from being either denied eligibility or being subject to higher premiums because of a health status-related factor. These include health factors such as the individual’s:
- health status
- medical history or medical condition (physical or mental)
- claims history
- receipt of health care
- genetic information
- evidence of insurability and disability2
Group health plans, such as an employer-sponsored plan, are prohibited from requiring individuals to pass a physical exam in order to enroll for health coverage.2
HIPAA also applies to individual insurance policies sold by insurance companies.3
Costs
The impact of a person’s disability, or association with a disabled person, on an employer’s health plan should not be a determinant of employment. Employees with disabilities must be allowed equal access to the employer’s health insurance coverage that is provided to other employees.
An employer cannot refuse to hire an otherwise qualified individual with a disability based on the fear that the company’s health insurance premium will increase.4
Poor health and disability are not necessarily one and the same. There are many disabilities with little or no health effects.4
Health insurance functions on the theory that the health care needs of any given group will range from none at all to ongoing medical visits. The impact on premiums could be minimal.
Next Steps
Be sure that your human resources benefits and compensation staff are knowledgeable about HIPAA and its nondiscrimination laws.
Are you hiring? Your company’s hiring staff must also be aware of HIPAA and its nondiscrimination laws.
Educate yourself and your staff on the facts of the often minimal impact of a person’s disability on health insurance premiums.
Resources
The United States Department of Labor, Office of Disability Employment Policy (ODEP) has several fact sheets to help you learn more about HIPAA:
- Fact Sheet: The Health Insurance Portability and Accountability Act
- Frequently Asked Questions about Portability of Health Coverage and HIPAA
- FAQs About The HIPAA Nondiscrimination Requirements
For more information about your company’s health insurance costs in relation to hiring a person with a disability, see these ODEP fact sheets:
1Executive Office of Health and Human Services, Division of Health Care Finance and Policy, Massachusetts Employer Survey, 2007
2United States Department of Labor, Frequently Asked Questions About the HIPAA Nondiscrimination Requirements, 2009
3United States Department of Labor, Frequently Asked Questions About Portability of Health Coverage and HIPAA, 2009
4United States Department of Labor, Office of Disability Employment Policy, Insurance and Benefits, 1996
