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State Health Plan to employees: We can discriminate

Posted By Adam Linker On September 30, 2009 @ 2:13 pm In Uncategorized | Comments Disabled

Packets from the State Health Plan are hitting mailboxes this week explaining [1] legislative changes that increase cost sharing for state employees and impose new sanctions for smokers and overweight workers.

Included is also an amazing “Notice to Plan Members” that I’m sure will get everyone excited about working for the state.

First the notice explains the federal law known as the Health Insurance Portability and Accountability Act of 1996 (or HIPAA), which prohibits group health plans from engaging in discrimination. But, no worries, the State Health Plan says:

In order to implement its comprehensive wellness initiative, the State of North Carolina has elected to exempt the State Health Plan from the HIPAA rules prohibiting discrimination against individual participants and beneficiaries based on health status related factors, including health status, medical condition(physical and mental illnesses), claims experience, receipt of health care, insurability, and disability.

There is also a state law, the disclosure explains, that prohibits “discrimination against individuals based on lawful use of lawful products during nonworking hours.” I’m certain that cigarettes are still legal. So shifting employees into costlier plans because of smoking seems to violate this provision.

But the State Health Plan is exempted from that as well. Also, because these draconian measures will likely cause some people to lose their insurance, the State Health Plan will be kind enough to provide you with a certification of creditable coverage.

The notice helpfully explains:

The certificate provides evidence that you were covered under this Plan, because if you can establish your prior coverage, you may be entitled to certain rights to reduce or eliminate a preexisting condition exclusion if you join another employer’s health plan, or if you wish to purchase an individual insurance policy.

Translation: you won’t be able to afford our coverage anymore, but we’ll give you a certificate that will make being uninsured a bit easier.

I know there are people still out there saying that this entire scheme is a good idea because smokers are hurting the entire health plan. But I think those people are not considering all of the collateral damage — the random mouth swabs for all state employees, the administrative shifting between plans for all state employees, exempting the State Health Plan from HIPAA and state statutes.

There is simply no good argument for these policies. And no good excuse for treating state employees like recalcitrant children.


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URL to article: http://pulse.ncpolicywatch.org/2009/09/30/state-health-plan-to-employees-we-can-discriminate/

URLs in this post:

[1] explaining: http://www.shpnc.org/comp-wellness.html

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