This is not true. I don’t like having my health care tied to my job - they are orthogonal concerns. But in the US, your employer does not have access to your healthcare records.
If it's a "self-insured" plan[1], your employer potentially has access to all insurance claims because they are the insurer. That's not the same as access to complete healthcare records but it's pretty telling information.
> If it's a "self-insured" plan[1], your employer potentially has access to all insurance claims because they are the insurer. That's not the same as access to complete healthcare records but it's pretty telling information.
No, companies almost never manage the claims themselves. They underwrite the plans, but managing claims is cost-prohibitive, as it's outside the core competency of most large companies.
They definitely do if they’re self insured. That doesn’t mean your boss can just pull it up willy-nilly, but I promise someone in HR can. I’ve sat in on conversations at my company where we’ve been pitched on claims analysis tools for our own HR department to use.
Self-insured doesn't mean they manage claims themselves. For most companies, managing claims would be cost-prohibitive and an absurdly wasteful use of resources.
Most companies use a Third Party Administrator (TPA) for the actual back office claims management. That doesn’t mean people in HR and Finance don’t have visibility into claims data.
> Most companies use a Third Party Administrator (TPA) for the actual back office claims management.
Yes
> That doesn’t mean people in HR and Finance don’t have visibility into claims data.
I mean, this is technically a true statement - "A does not necessarily imply not-B" - but kind of irrelevant, because as it turns out, HR and finance generally do not have visibility into individual-level claims data (as opposed to aggregate data, which is necessary for underwriting).
>, HR and finance generally do not have visibility into individual-level claims data
I'm not debating with you but somehow, Tim Armstrong (then CEO of AOL) found out about healthcare claims for one of his employees.[1] The story isn't clear on whether the granularity of the claims data would reveal to Tim who the particular employee was. (Even if Tim didn't know the exact employee, I'm sure he could ask a few questions and/or look at employees' sick day records to figure out which employee it was. If the company pays $1 million in a health claim, that's not necessarily going to stay a secret.)
I’m not suggesting that there’s a team of employees watching you every time you pick up a prescription, but of course they could access an individual claim if there was a legitimate reason to. Not sure why it’s so unbelievable to think that an insurer would be legally barred from doing so if they are literally taking on the risk themselves, even if it is to audit the TPA to make sure they aren’t stealing from them.
If you are an extremely ill employee and you’re using a lot of healthcare your employer will know without you needing to inform them.
Remember when Tim Armstrong, CEO of AOL, blamed an employee's new baby's health issues on benefit cuts [1]? He may not have had "full access", but he basically blamed an employee's family health issues, publicly, as the reason for employee benefit cuts.
It’s in the linked article. The CEO (after a great financial quarter) announced benefits cuts, blaming costs and using as examples two “distressed babies” that cost the company $1M each. Armstrong was making $12M, by the way, so in other words, 12 Distressed Babies per year in compensation.
They do if the plan is self funded. If it’s not, they still get anonymized usage reports from the carrier that list all the claims with basic demographic info like gender, age range and whether it was the employee, child or spouse who the claim was for. You probably wouldn’t know if your company’s plan is self funded or not.
[1] https://www.healthcare.gov/glossary/self-insured-plan/