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July 01, 2002 at 08:00 PM
NU Online News Service, July 1, 5:25 p.m. — Dallas
The new federal health privacy rules could force brokers to change the way they help employers shop for coverage, according to a top federal health policy expert.
When the privacy rules take effect April 14, 2003, brokers will still be able to get and use enough personal health information to help group plan members resolve disputes with carriers, Janet Trautwein, vice president of government affairs at the National Association of Health Underwriters, Arlington, Va., said here at NAHU’s annual convention.
But, if the current interpretation of the rules stands, brokers and employers will no longer be able to get specific information about specific, named employees who have run up large claims, Trautwein warned.
Today, carriers often ask employers applying for coverage to describe which employees have had what conditions, and how much those conditions cost, to make forecasts of future claims as accurate as possible.
After April 2003, if the current interpretation of the health privacy rules prevails, “it’s not going to be that way,” Trautwein predicted.
Carriers would still be able to use personal health information in the underwriting process. But, because of the restrictions on brokers and employers, carriers might have to get personal, confidential medical statements directly from each employee, Trautwein said.
Trautwein suggested the rules could also cause huge headaches for employers that run their own self-funded health plans.
