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April 23, 2002 at 08:00 PM
NU Online News Service, April 23, 3:25 p.m. — Washington
The health privacy rule proposed by the U.S. Department of Health and Human Services threaten key functions performed by insurance agents and brokers in the placement of group health insurance, agent groups say.
In statements filed with the department, agent groups say that the proposed rule will not allow agents and brokers to obtain information necessary for such functions as amending, supplementing and replacing group health plans.
“The significance of these concerns cannot be overstated,” the groups say. “Tens of millions Americans are currently insured through employer-sponsored group benefit plans.”
“In order to evaluate alternative and replacement benefit plans, group health plans must be able to obtain, use and share personally identifiable health information of plan enrollees,” the groups add.
“Prospective insurers cannot and will not price a group plan without specific information on the claims history of members of that plan,” they say.
Agent groups filed two separate statements with HHS. One was a joint statement filed by the National Association of Insurance and Financial Advisors, Falls Church, Va., and two Alexandria, Va., groups, the Independent Insurance Agents and Brokers of America and the National Association of Professional Insurance Agents.
The Council of Insurance Agents and Brokers, Washington, filed the other statement. Although the statements were filed separately, they closely track each other.
Specifically, the agents are concerned about a provision in the proposed rule that says that any covered entity may disclose protected health information to another covered entity for “health care operations” only if two conditions are met.
The first condition is that both entities have a relationship with the affected individual.
The second condition is that the disclosure falls under one of the first two paragraphs of the definition of health care operations or is necessary to detect health care fraud.
