Hesitant to make health claims on my wife's insurance as it might adversely affect her employment

[Anonymous]

I'd be surprised if the statements go to HR when organized by a normal insurance company - is that even legal? They're to you and your provider. Your employer doesn't pay per visit. They pay their part of the premium and that's it, regardless of how much you utilize your benefits or not. That's how insurance works.

BTW - 3k is nothing. My c/s was 18k.

[Anonymous]

She is paying for you to be on her insurance so use it. $3,000 a year is not a big deal.

[Anonymous]

Anonymous wrote:OP here. OK, I appreciate the comments. We're just talking $3,000 or so over a year.

That's a drop in the bucket.

I have 3 chronic conditions. Two are complex. In a good year, my insurance pays out roughly $16,000. If I have a lot of tests and hospitalizations, over $40k is the norm. And that's just for me. Add in my two kids, the younger of which has food allergies and a digestive disorder and we can cost the insurance $50k.

If you had a million dollar preemie, maybe you might worry. But $3k is small beans.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I worked in HR for a mid-size company. I don't know if it was self insured, but we received a copy of every EOB and knew exactly who was getting treated by whom and how much it cost.

We didn't see private medical information like a diagnosis, but when someone submits multiple claims from a dialysis center or a Counseling Center or a cancer treatment facility, it isn't hard to figure out.

I can think of at least two instances when an employee's health costs may have figured into employment decisions (I can't be sure). And we all knew exactly who was submitting the most medical claims, because we filed the EOBs in a separate set of employment records.

In this case, however, OP can relax. $3K in annual claims is nothing. Our "high volume" claimants incurred hundreds of thousands in medical bills.

Wondering what year this was when you worked.

For many years, my DH's company was self-funded. But, in the last year or two, we got a notice that all health issues now had to be handled by an outside broker and the HR people could no longer be involved. I had the impression from what I was given at the time, that the change was due to need to comply with law.

You're right - this was more than 10 years ago. HIPAA must have changed things.

[Anonymous]

HIPAA has significantly changed things. The only people in our (self-funded) HR department who can handle this stuff are HIPAA trained/certified and there are significant confidentiality issues involved.