Should I voluntarily provide information from my doctor to my employer?

August 20, 2012 4:31 AM

My employer wants all employees to provide lab results in order to receive a deduction in insurance premiums. OK, or a little too Big Brother-ish?

I've worked for a large international company for the past ten years. As an incentive, we have always been offered a (small--about $150 per year) reduction to our health insurance premiums in exchange for self-reporting basic health information via an online questionaire. This year, in order to receive the deduction, we are required to submit information from a doctor. This information includes the results of a full, basic blood workup.

Is this common? Is this requested in your workplace? This feels a bit too Big Brother for me. I know it's voluntary--I know the information goes to a third-party rather than directly to my employer--I'm not hiding anything about my health from my employer--but this just does not feel comfortable to me. I'm debating whether I should just do it, or decline and pay the full cost of my insurance premium. Thoughts?

posted by bookmammal to work & money (22 answers total)

We also can get deductions with our health insurance by completing certain health goals and eating well (honor system). We are not required to submit any lab work for this purpose. We do have to have full in-house exams when hired and every 3 years (because of the nature of the jobs and facilities) but none of that affects our insurance.
I find it strange and uncomfortable. Who would you give your lab work to? HR? Do you have medical staff there that can read test results?
posted by KogeLiz at 4:41 AM on August 20, 2012

Yeah, I think there is a huge potential for abuse and privacy violation. I would be worried about a few things:
-Your lab results being misinterpreted by someone not qualified to analyse them
-Your lab results being accidentally or intentionally exposed to interested parties with or without your consent
- Slippery slope: If enough people buy in, it could become mandatory (especially if this is how you went from self-reporting to needing to provide blood test results).

Personally, I would forgo the deduction and protect my privacy.
posted by sundaydriver at 4:54 AM on August 20, 2012 [11 favorites]

I do some sort-of-HR work at my (very small with no formal HR) company. If we were to ask for something like this, it would get sent straight to a guy outside our company who brokers our insurance and makes sure were getting the best prices for the plans we want. That guy, in turn, would submit and file everything.

It may very well work differently in larger companies, but if I were you,
I would ask your HR person if there's someone (outside your company) you can submit this to directly.
posted by phunniemee at 5:01 AM on August 20, 2012

I bet the cost of the workup and copies of the results would pretty much negate the discount.

That plus the creepiness factor would make this a no-go for me.
posted by windykites at 5:09 AM on August 20, 2012

It is apparently becoming increasingly common.
posted by drlith at 5:09 AM on August 20, 2012

I've only had to do it when buying extra life insurance through the company; everything was handled externally.
posted by tilde at 5:20 AM on August 20, 2012

At my work non-smokers pay less in premiums than smokers. Employees don't have to submit to a test (yet) but they do have to make a selection annually when doing the health insurance enrollment whether they are smokers or not. I know some people who claim to be non-smokers when they do in fact smoke, but I suppose the only way to find out is when they start putting claims for smoking related diseases.

The only thing we need to do annually is to submit to a TB test since the employer is a healthcare provider.

In any case, the information from a medical should not be going to the employer but at the very least to the insurance company because really, if you think about it, you're buying insurance from the company and not from your employer. Also, it's protected medical information.

I wouldn't give them anything, not for only $150. And what determines the amount of the discount you may receive? What exactly are they looking for? It seems not well thought out. It would be one thing if they were looking for drug abuse or something specific but I wouldn't submit to a general inquiry.
posted by eatcake at 5:22 AM on August 20, 2012 [1 favorite]

Our employer conducts on site biometric screening once a year. We're tested/measured on :
Height measurement
Weight measurement
*Body Mass Index (BMI)
*Blood pressure
Waist circumference (abdominal girth)
Fasting glucose/Blood sugar (the amount of sugar in the blood)
*Total cholesterol
HDL and LDL cholesterol level
*Triglycerides level (the amount of fatty acids in the blood)

If you pass at least 3 of the 4 (those with *) you get a 10% discount on your health insurance premium.

It's kinda degrading... if you ask me. But everyone else I work with is okay with it, so not much I can do.
posted by xicana63 at 5:40 AM on August 20, 2012

I work in employee benefits. This is common - and increasingly so, as employers try to keep health care costs down.

The wellness program specifics aside (this may or may not be a HIPAA wellness program, depending on the actual details), when you work for a very large employer, your health plan is often self-funded, which means that the employer doesn't shift the risk of medical expenses for employees to a health insurance company, but pays claims itself (often through a third party administrator). So what eatcake is saying may or may not be true.

So, the health plan, which is a separate entity from the employer has access to certain protected health information and must comply with HIPAA privacy and security rules (an employer that works with an insurance company may be subject to a certain extent, depending on how "hands off" they are with respect to the plan). However, in practice, that "separate entity" is often the same (HR/executive) people, just wearing their "health plan" hats.

This is just to say that, theoretically, your privacy concerns should be addressed by HIPAA, but it may be nerve wracking, because for practical purposes, your employer might be the one seeing the information.
posted by Pax at 5:42 AM on August 20, 2012 [7 favorites]

I work for a county government system and we've done this every year since I've been here. In fact, sometimes they host health fairs and do the blood work for us so we can skip a copay at the doctor's office. It's kind of Big Brother-ish, yes, but legal, as far as I know.
posted by carolinecrane at 6:03 AM on August 20, 2012

I'd rather pay extra than submit my medical records to my employer - and in fact, next year I will be paying extra. It's demoralizing, but this is how I think of it:

1. I don't trust the average employer to keep private data secure
2. All it takes is a couple of unscrupulous people to misuse medical information in the employment process - it's far, far harder for an employee to prove wrongdoing and to get restitution than it is for someone to fire you or discriminate
3. I don't want to be pressured to accept medical treatments that my own doctor, who has seen me for fourteen years, does not think needed - and as far as weight and general health go, my doctor has a much better idea of my actual health than some rent-a-doc who has nothing but a cookie-cutter set of medical 'standards' and who presumably isn't skilled enough to be in a real practice.
3.5. My employer does not accept any "health" measures except those that you pay for - you can't say "I bike commute every day, so I am getting exercise and should get 'points' in your system" - they only count gym visits, for example. Virtually none of the healthy things I do are 'visible' in their system (I'm vegan, I bike every day, I walk a lot, etc). Which strongly suggests to me that their system is stupid, inaccurate and designed to coerce employees rather than generate healthy outcomes.
4. And above all - these things are the thin end of the wedge. There are far worse and more coercive plans out there, as describe above - the annual physical with a company doctor, for example. And there are plans (the TN university system, for example) where the premium jumps are much, much higher than 10% if you don't comply. (I expect, frankly, that if we had enough information we'd see a pattern of firings of employees with chronic illnesses.) Since this country is in a disastrous state, I expect that things will get worse in the near future - but employee resistance will at least slow the process down and get us a little more good time before the deluge.
posted by Frowner at 6:22 AM on August 20, 2012 [14 favorites]

Welcome to the 21st Century! This has been in place at my workplace (public) for the last couple of years and at my wife's (private) also for a few years (Wisconsin). They initially pretended that it was going to lower insurance premiums but rates have since gone up. I passively fight the system by scheduling my bloodwork several hours after a particularly satisfying and huge lunch.

The thing that bugs me about it is that it penalizes employees for bad behavior without rewarding them for good behavior. A better program would give discounts for gym membership to encourage healthy lifestyles.
posted by JJ86 at 6:23 AM on August 20, 2012

This strikes me as creepy and intrusive and yes, big-brother-ish, and I would NOT participate, even if it was a larger price cut than that $150. I don't care if the information goes directly to your boss or to the insurance company: personal medical details shouldn't go any farther than your primary care physician.
posted by easily confused at 6:25 AM on August 20, 2012 [1 favorite]

Yeah, this is disgusting, and the fact that it is increasingly common only makes it more so. Don't do it.
posted by Violet Hour at 7:03 AM on August 20, 2012 [2 favorites]

Pax, my employer is self-insured.

We are offered screenings once a year also, BP/cholesterol etc..., but the results of that screening are done by a third party and the employer/insurer do not receive do not have access to them.
posted by eatcake at 8:37 AM on August 20, 2012

Creepy, intrusive, violation of privacy. Legal. I don't think they can do genetic testing, though. I had to provide medical info to my employer (or be charged a lot more for health insurance), and I don't trust the company that holds the records one little bit. I wish I was in a union that could fight back for me.
posted by theora55 at 10:14 AM on August 20, 2012

My company does this, and I participate. But to be clear, the employer doesn't get the results of the testing. Just a Y/N that you completed it. The third-party company reports the results to my physician.

The way it's run here is it's a points thing where you have to earn a certain # of "wellness points". You can also get the points by logging weekly exercise, participating in quit smoking or weight loss programs, going through some online self-paced health related courses, etc. It is possible, though difficult, to get enough points without the screening. If you meet the points threshold you get 10% off premiums the following year.
posted by misskaz at 11:30 AM on August 20, 2012

I know of companies that do this, and my former employer apparently was considering a discount program like it, but have never done it myself. That said, I've had bloodwork done for life insurance eligibility, which is pretty much standard, and didn't think much of it.

Personally, $150/yr doesn't seem like enough of a discount to to me, to make it worth the pain in the ass of going to a dr's appointment and getting blood drawn, and possibly release the samples in a way that doesn't cover them under normal PHI rules. (Information obtained via voluntary disclosure directly from a patient is covered differently under PHI rules, to my understanding, than information obtained as part of medical diagnostics; this seems like it could be considered a voluntary disclosure directly by you, the patient, and that is something you want to avoid if you are concerned about your privacy.) This strikes me as one of those areas where regulation is lagging practice by quite a lot, and you should tread carefully in giving anyone any access to information, and particularly samples and an authorization to run tests on them.

However, in all likelihood they are only running a very few, very basic tests on the sample, because tests are expensive and it just doesn't make sense to run that many of them. There are only a few of them that can provide you with any good (statistically significant) information about the health risks of an otherwise-healthy person, which they don't already know as your insurance company just from looking at your past claims, anyway. The chances that they are going to do some sort of Gattaca-style DNA sequencing and profiling of you, behind your back, are pretty slim. But there might not be much stopping them from doing it if they wanted to, which would give me 150 bucks worth of pause just in the abstract.

I'd basically try to figure out how much someone would have to pay you to study all their disclosure documents and privacy policies in order to confidently understand them, and if that's less than $150, great -- go for it. But if it's not -- as I suspect it would be for most people -- then you should walk away. If enough people pass on their discount, they'll either make it more lucrative or ditch the idea entirely.
posted by Kadin2048 at 12:47 PM on August 20, 2012

My company does it for buying down our health insurance premium benefit (-$250). I don't really mind, but I could see how it's an invasion of privacy. They're typically checking for cholesterol and smoking (there's a marker in blood).

The blood work is done 3rd party, Qwest or Lab Corp, etc., and the company only gets the basic results for the things they're checking that I also get. It's pretty common, but completely voluntary.
posted by neveroddoreven at 4:38 PM on August 20, 2012

My last employer did this, and my new one will probably do so eventually. The way it's worked for me is the lab results are given directly to the insurer, and shared with the employer in aggregated data form. As far as I can tell, the insurance company strategy is to offer this discount in exchange for a better idea of what the insured base is, so they can fine tune their offer in the next competitive bidding. To Kadin's point, the data was collected on site, during an on campus phlembotomist visit. It was kind of amusing theater; they're just phlebotomists but they wore white labcoats and a few wore stethescopes. Anyways, the numbers are just cholesterol, diabetes, and height / weight.

This system is big brother. All insurance is, or they suffer from adverse selection. That might not be a bad thing. The baby boomer population is becoming quite expensive to insure, and knowing more about the future and how much to collectively set aside to cover said expenses is important in not bankrupting the insurers we expect to cover us. These systems also roll out information campaigns based on indicated risk factors. While the ones I ran through reeked of federally required minimum efforts, perhaps they'll help some.

The concerns about genetic testing are simultaneously misplaced and critical to the future of healthcare. Insurers are prohibited from considering genetic information, but the public is not. The amount of genetic information we can gather every year is increasing rapidly, to the point where in less than a decade I figure I can buy a personal genome sequencing for around a thousand dollars. Collecting lots of the right people's genomes should isolate specific defective genes in some genetic diseases, and knowing which genes are defective is useful in pharmacology. Some kind of "big brother" will be required to make this happen.
posted by pwnguin at 8:27 PM on August 20, 2012

No. Nooooooooooo. I am a reasonable person drawing a reasonable line, and I'm turning down the discount at my work.
posted by desuetude at 10:12 PM on August 20, 2012

I'm turning down a discount where I work. I find it creepy and intrusive and redundant to the relationship I've already established with my doctor. It took me around 15 years to feel like I could safely go to my doctor and be taken seriously. And I'm one of those people whose veins pop and roll, even in the best of hydrated times. My doctor put herself through med school by being a phlebotomist and she's the only person that has gotten me on first stick without digging, popping or rolling. Random person drawing my blood? No, just... No. On so many levels.

And then there's the bullshit where they're going to give us all high deductible insurance and HSAs instead of PPO. It's almost enough to make me consider looking for another job. I'm happy paying a higher premium to get the health care I want, just let me do it and leave me the fuck alone.
posted by susanbeeswax at 12:22 AM on August 21, 2012