To "Come Out" or Not to?

brij2006 · August 2013

I currently have my health insurance through my employer. Well with the ACA and HCR coming out after the 1st of the year, our employer wants to do some changes to our health insurance plans then. So we were sent this survey that we need to fill out and submit to the insurance company online. This will help determine which plan our company should go with for its employees, and what changes to be made at the first of the year.

Well, I know that the guy who handles our health insurance will be seeing the surveys. Along with the owner and co-owner of the company (my bosses). In the survey it asks you to list any diagnoses, pre-existing conditions, and future procedures. Then it has you grade your current coverage, and one of them is "infertility" (since it currently isn't covered). If you put the lowest grade, then you have to explain why before you can go to the next screen.

Should I come out and be 100% truthful in the survey, or try to go around the questions as much as I can to not "out" myself? It would be great if they re-did the coverage at the 1st of the year to cover it, but there are only 2 of us in the office at childbearing age. So I highly doubt they will change the coverage just because of 1 person (the other girl already has 1 and isn't sure if she wants another). I don't mind my bosses knowing what is going on, but we work in an office of 14 people so word gets out and travels fast. Especially with the guy who deals with our health insurance.

LuckyAngel07 · August 2013

That's a tough decision. The survey has to be anonymous (HIPPA law, with answering those kinds of questions), but I guess with such a small office, you'd easily be tagged as the one answering any sort of reproductive questions that way. I'm really not sure what I would do.

Panderp · August 2013

I think it's in your best interest to "come out" here, because it has the potential to influence the coverage. I definitely have a "no shame" approach when it comes to infertility related things though. The company may not offer coverage, but they may provide you with assistance in payment for treatments.

Does your husband have insurance through his company that could help you all if/when it comes to treatments?

brij2006 · August 2013

Ugh, I really don't know what to do either. If I don't put in anything about the IF, then my employer is going to continue not having it covered. If I put in something about it, then at least maybe I can get him to consider adding the coverage.

It is pretty much a survey of what coverage we want, but in that you fill in your diagnosis and any meds or treatments. Then our employer will determine from there what policy to pick for our office.

brij2006 · August 2013

@Panderp: H's coverage is actually worse than mine. Mine will at least currently cover any diagnosis, and the blood draws and ultrasounds. His will not cover any of that, and his deductible is triple mine.

I think I'm just going to put it all out there. I'm not too shy on discussing it, but this isn't necessarily the way that I wanted to tell my bosses.

nfp147 · August 2013

I don't know a lot about health insurance, but if coming out might help you in the long run, I would strongly consider it.

In my experience (and we're totally "out"), I have experienced nothing but support from work/family/friends.

ILoveRedVino · August 2013

That sucks, I don't know what I'd do.

I'd probably come clean, just because that is a decision that has the potential to save you a lot of money. Plus, if you end up needing time off for fertility treatments, it's hard to hide it.

PinkinProvence · August 2013

Wow - I feel like this is a serious intrusion of privacy even though it is "anonymous" because of the small environment you work in. HIPAA only applies to healthcare professionals (like doctors) and agents thereof (like insurance companies) but this seems like it is not an instrument of the insurance company but rather a tool your company is using. It might violate some federal regulations, but practically that doesn't matter for you.

I doubt you are the only one uncomfortable with this. Infertility is just one of many stigmatized health issues. I am sure there are people in your office with pyscholological diagnoses who do not want to reveal their issues, among many other things. I know for me, I also have psoriasis and while not a big deal, I do not love for everyone to know that!

I don't know what you should do, but it seems really unfair!

caseyandlizzie · August 2013

I would definitely come out with it. Your health information should be protected under HIPAA, and the person dealing with everyone's personal information has an obligation to keep that private. I'm sure there are people in your organization who have various health issues, or their family members do and that shouldn't come out under any circumstance. You sharing your information can only benefit you in the long run if your employer sees that there is a need for extended coverage. If you say nothing, then nothing will potentially change.

amccul20 · August 2013

I think I would feel very conflicted about this as you are.

but ultimately I think its in your best interest to disclose the issue.

musac15 · August 2013

I agree with PP - I'm not sure sure HIPPA fully applies here, and I also feel it is a huge invasion of privacy. I do not know that I would disclose everything, but it is hard to say as I don't fully know your hospital dynamics.

I feel like there are better ways to survey employees, without asking for a list of current diagnoses.

musac15 · August 2013

http://www.workplacefairness.org/medicalprivacy?agree=yes

This website has a lot of useful information about HIPPA as it pertains to insurance and your employer. From what I can gather, you do not appear to be covered by HIPPA as far as privacy is concerned.

brij2006 · August 2013

The survey is through a Health Insurance website, and is to determine what type of group policy our employer should go with at the 1st of the year. So it isn't specifically a survey through our employer itself, but they receive the results and conditions and decide from there which type of policy to provide. But with being 1 of the only 2 women of childbearing age (the other already has a child), in our office. Then putting my condition and diagnosis down, they will easily be able to identify who it is that is requesting IF coverage.

I don't think the guy will go around talking about it, but he will definitely sit down with the bosses and likely 1 other guy and discuss the coverage options. That means that 4 out of 14 employees will know what is going on with H and I. Along with the 1 employee I have already told and is a huge support. I just know how quickly word travels when 5 people in a small office know about something, and I'm not sure if I'm quite ready yet for it.

The only plus I see from putting this down, is that my boss is pretty awesome when it comes to this stuff and there would be a 50/50 chance that he adds IF coverage to our policy.

PinkinProvence · August 2013

Since your insurer is a HIPAA-covered entity, the information cannot be shared with your HR Department or boss. The threshold for anonymity with HIPAA is not just to redact a name, but to not disclose any identifying information that would allow someone to "figure out" who the medical information belongs to (it is a practical threshold rather than an objective one.) So as you say, since there are only 2 women in the office, your insurer sharing the survery information (even without your name) would be a HIPAA violation on the part of the insurance company because more likely or not your bosses would be able to "figure out" who the information belonged to. Thereafter, your bosses and/or HR have no legal duty to keep that information confidential.

So if the survey is truly being administered by the health insurance company, I might call them up and ask what they are doing to protect your information from being disclosed. Maybe only small portions of the survery will be shared with your bosses (i.e. just the ranking of coverage rather than the free-form answers.)

Xan921 · August 2013

I know it is a tough decision but if it means you could possibly get coverage then I'd do it. If I were in your shoes I would always wonder 'what if" if I hadn't put it in the survey.

brij2006 · August 2013

I've decided to just put it all out there. The worst that can happen is it be considered a pre-existing condition and not covered if we change insurance companies (it isn't currently covered anyways). I've already let my bosses know that I will be taking time off at short notice for medical issues, but did not disclose to them what for. Just let them know that it is not life threatening. My boss had asked then if it was covered under our insurance, and I told him no.

The best case scenario would be that they review the coverages and decide to add IF coverage to our policy. I guess if they find out what is going on, then oh well. It's something I'm just going to have to deal with. If it saves me money in the long run by them choosing a better suited policy for our agency, then great. If not, then I'm not any worse off than I was before.

LuckyAngel07 · August 2013

I hope it works out for you!! Best case scenario: your information isn't shared in any detail with HR and the insurance company just provides coverage recommendations to your company, which they decide to follow and offer IF coverage! FX.

Xan921 · August 2013

I think you're making the right choice @brij2006. Plus, think of it this way, how incredible will it be if you do end up getting coverage and then you'll also be the reason any future female employees get the coverage as well if they need it. You can make a big difference for the company just by being honest on a survey.

rccola1981 · August 2013

There could also be male employees concerned with getting IF coverage. DH has a separate policy from me because of policies at each of our employers and he would benefit greatly from getting IF coverage as our primary diagnosis is MFI.

DangerMuffin23 · August 2013

Xan921 said:

I know it is a tough decision but if it means you could possibly get coverage then I'd do it. If I were in your shoes I would always wonder 'what if" if I hadn't put it in the survey.

This. I really hope you get coverage. That would be amazing.

islandmonkey8 · August 2013

I hope that your boss decides to add the infertility coverage. I also hope this survey doesn't "out you." It should be up to you when or if you tell people.