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

[Anonymous]

I'm a self-employed DH with some medical bills. Now I can pay them out-of-pocket. My wife's company's health insurance would cover most the the expenses, but I hesitate to file as her employment position is more insecure than average, and I fear my claims would somehow -- don't ask me how -- adversely effect her employment. I can keep paying but we're not wealthy and it would be nice to have some more money in the household.

Are my fears legitimate?

[Anonymous]

I don't get it....

Are you worried because you are using her insurance your wife will be fired? Or is it something like you want to go check into rehab using her insurance and are worried her employers will see it, think less of her, and fire her?

[Anonymous]

OP here. The worry is the more claims employees have, the greater the cost of the insurance to the company. It's not free. They could see her as more of a financial liability because of me. Or, maybe not. I don't know.

[Anonymous]

I have never heard of companies even looking at claims history by individual to make hiring/firing decisions. It would seem illegal but I don't know that for sure. But even if they did, unless you are having an extraordinarily expensive procedure done that will cost $100s of thousands of dollars, normal claims shouldn't even raise an eyebrow.

[Anonymous]

I think you are way, way overthinking this. She won't get fired for using her insurance.

[Anonymous]

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

[Anonymous]

How big is your wife's company?

[Anonymous]

Use the insurance. That's what it is for. And no company is going to hold the insurance claims against an employee; if they do, they could come under a host of employment issues. Your wife could sue them for sexual discrimination or unfair labor practices. The company does not pay the full $3K, and it could cost them significantly more just in legal fees alone if your wife were to sue them over any bias around using an employee benefit such as insurance. Not only that, but even settling out-of-court could cost them tends to hundreds of thousands of dollars for a few hundred dollars in annual fees. Just not worth it to them.

[Anonymous]

Interesting. I didn't think HR would know the amount of claims by employee if insurance is through an insurance company and not self-funded.

[Anonymous]

You are waaay over thinking this. $3k/yr is a drop in the bucket.

[Anonymous]

We're a self-funding organization, but we don't look at who is responsible for what claim - we just pay it and it gets divided out amongst all the departments and employees in the employee benefits part of the account string.

I wouldn't worry about $3K. (I didn't worry about the $10K or so my labor/delivery and prenatal visits cost my company - that's why we have insurance.) People are having cancer treatments or 3-month-premature babies and racking up $100's of thousands.

[Anonymous]

If your wife's insurance is self-funded, I might worry if I had very high medical expenses, such as a preemie, cancer, etc. But 3k? That's peanuts.

[Anonymous]

Anonymous wrote:You are waaay over thinking this. $3k/yr is a drop in the bucket.

Agreed in theory, although I know my very small company does consider how much they pay out in calculating your "total compensation" for the year, which they use for determining bonuses. I think this practice is unusual (and maybe not kosher).

[Anonymous]

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.

[Anonymous]

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.