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I mean key word “generally”?

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.