HIPA and small biz medical coverage

Stonehenge · #1 (**permalink**) 10-28-2003, 11:33 PM

Do you know the latest about HIPA? It is putting all kinds of restrictions, possible fines and jail time for employers who offer medical bennies to employees.

When I have a chance I'll root out a link and post it.....

Stonehenge · #2 (**permalink**) 10-29-2003, 09:32 PM

Oops - it's HIPAA.

Here's a link: http://www.hhs.gov/ocr/hipaa/

The gist of it is this - The gov't doesn't want a business owner making decisions about an employee because of something discovered in the course of offering medical coverage.

To prevent it, there must be steps taken to prevent yourself from getting information about any health conditions your employees might have. The gov't will penalize biz owners who do not insulate themselves from this info with fines, jail time or both.

My personal opinion is this is insanity - nothing is going to do more to make the employer-employee relationship an adversarial one than by heaping requirements upon the biz owner, because there is a remote chance an employee might be inconvenienced.

So if you are generous enough to offer medical benefits, the financial burden is not enough; you must now also find some way to make sure you don't find out about their medical conditions that you are covering.

scl · #3 (**permalink**) 10-30-2003, 01:27 AM

I saw a leader for a show tonight, but I can't remember which one, asking whether people should pay for their own health coverage or should the boss foot it. They basically are trying to make it sound like if you as a business owner don't pay for health coverage you are the scum of the earth! I'm a believer in the idea that if I gotta pay, you gotta pay! Maybe off topic but it made me think of it.

PSUscaper · #4 (**permalink**) 11-01-2003, 10:22 PM

I've always had great, great issues with health coverage.

I only insure myself at the momment, but will say that it is a unbelievable expense.

For anything close to decent coverage, it is just rediculous.

My coverage alone is over $400. I think about how much money this is sometimes and almost get sick (which heaven forbid I do, as it will probably raise my rates!!!......hmm....maybe a little scheme going on here............) Many employees don't even make this a week............and to think that I am going to pay someone basically a extra week salary a month for free.........I'm not too sure on that one.

While working at the airport.........I always had a hugh, hugh problem with health care. I knew a few people, and was let in on a little insider information. I got to see what healthcare cost as per employee.

What I saw kind of left me puzzled. Lets say me, the single guy, sinlge coverage, had a bill of $300. Now, lets say my co-worker, married, with 2 children......had a bill of $700.

In the scope of things............is this fair? The company policy was to pay for the employee and his family......well, I didn't have a family, so I didn't need as much coverage as others. So, when you think about it.....wasn't I kind of getting ripped off?

I mean, just because my fellow employee had a family he was entitled to $400 more a month than me? Shouldn't I have gotten a check cut to me at the end of the month for $400......Hek, he was getting it, and he didn't even show up for work half the time!

Honestly, I bet I could get a good lawyer invoved in this and start one hek of a mess.

That's why I feel group healthcare for employees and their families is really unfair. Your basically short change people for NOT having a family.

Would that be a fine also......asking people how large their family is? Could a deciding factor for hiring someone be based on their family size and the cost of their health insurance?????

With the way health insurance is increasing......I bet it could be.......and therefore.....that's why I really believe this whole entire healthcare system in general is turning into one big giant heap of dog doo.

steve

Lanelle · #5 (**permalink**) 11-01-2003, 11:50 PM

This difference between the solo employee vs. the family coverage has lead some companies to just cover all or part of the employees' health insurance premium and then the rest is deducted from the paychecks to cover the cost of family coverage if that is what the employee has elected to have. I notice that many in this industry make certain that their spouses hold jobs with full benefits.

Stonehenge · #6 (**permalink**) 11-02-2003, 12:29 AM

And I think that is how I'm going to approach this next year - I will pay a set amount per employee toward benefits. They have to kick in the remainder, whether that's $50 or $500.

But even that may not help - the insurance premium does not get divided according to the needs of the insured. For example, let's say I'm kicking in $200 per month toward premiums. And let's say I have two employees, one young and healthy single person, one old and sickly single person. Clearly the odds are that the old, sickly employee is going to cost the insurance company the most, but they can't assess premium charges by employee; they have to charge by the group. So they take this two person group, run the medical info through their actuary and underwriting tables, and create a total premium amount. That total is then divided among the members. So in this case, the healthy person is paying more than their share, the sickly person less than their share.

With this scenario it's possible to see how an employer could be persuaded to make employment decisions based on the medical conditions of the older, sickly employee (like give him the boot so the other employee could enjoy lower premiums, making him happy and the boss look good). So the employer would need to take steps to prevent himself from discovering medical info. And beyond that, I believe the employer is required to notify the employees that this law is in effect, so that they do not unknowingly disclose things themselves that could hurt them.

I guess I don't know how some of this could be avoided - if someone calls in sick, I want to know what they are sick with, so I know if I need to plan on them being gone for a day or a week or what. And if I think they are trying to pull a fast one, I want to be able to ask for a doctor's note spelling out what they have and their prognosis. Because I am willing to offer my employees a better compensation package than my competitors, I should not have to compromise my ability to run my business and me and my employees to earn a living. Suffice it to say, if I were put in jail for an infraction of HIPAA, production would stop and everyone would lose their jobs. I'm sure that's not the consequence the gov't was hoping for...

scl · #7 (**permalink**) 11-02-2003, 01:05 AM

Yeah, but you'd get free health care while you were in there!

Stonehenge · #8 (**permalink**) 11-02-2003, 01:56 AM

D'oh!! Yeah, and I would use my phonecall priveleges to call each of my employees to thank them for paying their taxes so that I could enjoy such benefits!

chc · #9 (**permalink**) 11-29-2003, 07:22 PM

As I recall from my days as an insurance salesman, the pool is large enough to compensate somewhat for the situation you decribe & make it a little less unfair. From an employer's point of view it is a tough nut to crack, not to mention expensive. My problem right now is trying to determine how to handle the winter months when the employees are laid off but the premiums are still coming due. Any thoughts on this?