Underwriting and Brokers

[Chaz]

Small employer is considering changing health insurer. The new insurer needs medical information for underwriting purposes. The employer's broker is collecting medical history forms from the employees and forwarding them to the new insurer.

The employer itself will not be receiving any PHI contained on the forms. The employer does not have a BAA with the broker not has it generally taken any steps to comply HIPAA's privacy rules

Any HIPAA privacy concerns?

[leevena]

Chaz, we do this all the time. The way you have described the process I would say there is no issue, but I do have a concern.

Ours is web-based, with each employee receiving a an email with a link from which they can complete the form. Once completed the forms are placed in a pdf file and submitted to the carrier. Other than the employer sending a cover letter with the link, there is no employer/broker involvment, so there is no need for an agreement.

Your situation is a manual approach, so while the employer may not be receiving any PHI information, is it possible that someone at the group is able to view these forms? If there is a possiblity, then an agreement might be worthwhile. I could envision a situation where the employee completed the form, placed in a sealed envelope and returned to the broker, which would not be an issue for the employer.

Rambled a little, hope it helped.

Lee