Employer right to information

[Guest rspitts]

During the enrollment of my husbands medical/dental benefit plan, his company asked him to provide certain documentation. This documentation included: children's birth certificates, marriage license, wife birth certificate, and social security cards for children and wife. I have never been asked for information to this extent before, so I did not feel that we should comply. Do this company have the right to ask for this documentation in order to provide us with medical/dental coverage and if so, why.

[E as in ERISA]

There are a lot less "privacy" rules in regard to employment than people would generally think. And the rules vary widely state to state.

The one area where there are more rules is in relation to "medical information." I think that relates more to actual health information, but you might try posting your question on the HIPAA board to see if those experts can help you.

[Steve72]

Companies (including insurers) are currently permitted to ask for information such as a Social Security Number to ensure that they have a unique identifier for each customer.

HIPAA governs "protected health information", which is basically information related to your health status or treatment.

States have different privacy laws. Although it is unlikely, your state may have a law preventing the employer from requesting or using this information. In what state are you located?

[edited for terrible typos]

[KIP KRAUS]

Normally an employer and the insurer need to know that dependents are legal dependents eligible for coverage as defined in the group insurance contract or the plan document. Unless there is some reason to suspect that an employee is trying to cover someone not eligible as a dependent I see no need to ask for birth certificates or a marriage license.

Providing, names, social security numbers and addresses of the dependents should be sufficient and reasonable. Usually employers and insurers are protected from insurance fraud by state insurance laws, which can be very stringent. On the other hand, if the employer is self-insured the employer may be unprotected.

I have been involved with a medical plan where an employee had eligible dependents with different last names and addresses. In this case we investigate and ask for documentation that the dependents are legitimate.

Seems odd to me that an employer would routinely ask for birth certificates and marriage licenses except in the case of a newborn or new marriage related to an employee wanting to add a new dependent.

[Sandra Pearce]

Regarding the request for proof of marriage and birth certificates, health plans have specific eligibility requirements. Some plans allow for domestic partners and/or for common-law partners. If the plan defines an eligible spouse as a legally married spouse, it may request supporting proof. Because we have employees in states which recognize common-law marriages we have had an on-going problem in our health plan since we, as of yet, have not required proof of the legal marriage (and this is a requirement of eligibility in the plan). Same thing with birth certificates. Eligibility in the plan may have requirements that make it prudent for the plan to see that the children listed do in fact meet those requirement (such as a requirement that the child be a natural child of the employee.) There is nothing wrong in requiring proof of eligibility; however, if required it should be required of all.

[Guest rspitts]

I completely understand why a company may ask to see the birth certificates of any dependant children. I also understand why they may ask to see a marriage license for the spouse. What I don't understand is why they would ask to see the spouses birth certificate. What information can they possibly get from the spouses birth certificate that is not currently on the marriage license. Can the spouses refusal to give them a copy of his/her birth certificate warrant the company not honoring the employees right to add his/her spouse the their benefit plan.

[Sandra Pearce]

I can't see any reason for asking for a spouse's birth certificate.

[jeanine]

I'll admit that this is pretty out there--but you did say you could not see ANY reason they would need to see the birth certificate--some states have laws that say that your gender cannot be changed on your birth certificate. So if you had a sex-change operation, in Ohio and some other states, you are still a man or woman according to what your b.c. says. The issue becomes whether you can legally marry in that state. There was a newspaper story locally a few months back where the procecutor was considering fraud charges against someone in this particular situation, relative to a marriage license application but not sure what became of it.

[papogi]

If the plan offers early detection benefits which are age-banded (e.g., cholesterol check every three years if you are under 50, and every year if you are over 50), then the plan might want to verify ages before handing free benefits out. Still seems excessive to me, but if it's done on a uniform basis, appears legal. I think they can legally deny coverage if the documentation is not provided.