Under the state's new health insurance law, known as Senate Bill 110, small businesses across the state are now required to gather extensive information about the health of their employees and their families. Some small businesses owners and human resources managers find the new family health statement forms burdensome and intrusive. But advocates for these insurance reforms say gathering more information is the only way to create more competition in the state's health insurance market. More competition they say will lower health insurance costs. New Hampshire Public Radio's Raquel Maria Dillon has more.
If you work for a small company, you might remember filling out a two-sided form earlier this year. It asked for the ages and occupations of your family members, any past illnesses, or chronic conditions.
This form is part of the state's new health insurance regulations. Senate Bill 110 passed last year – and changed the way insurance companies calculate premiums for small businesses. Before, under a system called "community rating", insurers based their quotes on the number of employees and their ages. Now under "demographic" rating, insurers can take other factors into account – like health status, location, and what kind of work the individuals do.
They want to know everything about your health and the health of the family members also covered by the plan. Does your wife have colitis? Does your child have asthma? Is your husband an alcoholic? Through these "family health statements," insurance companies gather data that determine what a company will pay for health insurance. But many employers and benefit managers feel uncomfortable handling all that personal information about their employees.
GREICO :08 all the information that's on there. they go right down to everything. They don't miss out on nothing. … Why should I have all this info from my employees? You know what I mean?
John Greico owns Quality Flame, a small manufacturing outfit in Fremont. He provides health insurance for his 11 employees and his policy will come up for renewal later this year. His first fear is that his insurance rates will go up again. But he's also dreading those forms.
GREICO :19 I was just devastated by all the As, Bs, Cs and the D, Es. It's like going in for an operation. They sit with you for an hour and fill the form out. … the agent made reference to me filling them out 4 months in advance because of all of the send-backs. If they had a cold and didn't put it down, they send it back.
Actually, the family health statements don't ask about colds or flus or ear infections, but they do ask about infertility, HIV infection, and mental illness. And insurance agents have to send many forms back because employees filled them out incorrectly.
Leslie Ludke, an attorney with the state Insurance Commission, says insurers can charge the entire company more if one employee does not provide complete information. She says all this personal medical information going back and forth between insurance brokers, employers, and employees is supposed to be private, under federal medical privacy laws.
LUDKE :13 Employer is legally barred from looking at them. …There's very extensive federal law and rules on this. Are there possibilities for violation of rules? Sure, no doubt about it.
To that end, Manchester employment attorney Pat McGrath advises employers to create policies and procedures that guarantee privacy.
MCGRATH :17 one terrific suggestion I've heard is employees are given family health statement to fill out, put in envelope, and sign across back, turned sealed signed envelope. Then the employers job is just to keep track of all the employees who've given it to them and then they send it off to the insurer.
MONBLEAU :07 it is impossible to insure that no one will ever see those forms.
Russ Monbleau is an independent insurance broker in Milford. When you sign the bottom of the family health statement, you're agreeing to release that information to an insurance agent like Monbleau. He compiles it with data from the rest of your coworkers and submits it to an insurance company for a quote.
No matter what pains employers and brokers take to keep the forms private, Monbleau says it won't work. Office chit-chat takes on new meaning when the health of your fellow workers determines your health insurance rates.
MONBLEAU :15 if you've got a company with 15-25 employees, if somebody comes down with cancer, everybody knows it. Heart attack. ... if they're out on disability. You can't keep that a secret.
Small business owner John Greico says that's exactly what happens at Quality Flame.
GREICO :19 everybody talks to everybody "gee you had that done?" If they got asthma, this and that, going to doctors. I'm on Lipitor. Somebody's on Paxil. Business owners are gonna go nuts with this. Worrying about what rates will be. They'll chase them to the drugstore. It's really a scary issue.
Insurance broker Monbleau worries that employers might accidentally or intentionally see the family health statements. And they might be tempted to hire and fire based on that information -- to keep the company's health insurance premiums low. Of course, that's not allowed under current anti-discrimination laws, but neither is age discrimination.
MONBLEAU :17 Happens all the time! Hehe. I could parade about 350 before your very eyes, who were downsized from major companies that said it was not age discrimination in order to get the severance package. All 50-year-olds, all had to hit the street at the same time.
And like in age discrimination lawsuits, the laid-off employee has to prove his case.
Monbleau sees it both ways though. He says this health information is necessary – it's how insurance underwriting works.
MONBLEAU :10 when it's now based upon health history, health condition, the insurance company has right and need to know what it is that they are insuring.
Proponents of the new insurance law argue that more information helps health insurers understand their market, and allows them to offer better prices.
But perhaps lawmakers have realized those better prices aren't coming any time soon.
Last week, the state Senate passed a bill that would cap health insurance premiums increases for small groups at 50% over the next two years.
It would also allow employees to mail their family health statements directly to the insurer.
For NHPR News, I'm RMD.
