Yes it does effect it. I have administered plans for two companies and it does effect it. It’s just that in a small company it’s more noticable.
One hotel I worked at we had about 170 full time workers on one health plan. During that year three workers got HIV and the cost for all plan divided by everyone was about $10/ per person, per paycheck. Normally the plan goes up less than $5 per person per year.
I worked at another place with only 10 full time employees and one guy had a heart attack and it was a bad one and it also pushed our group premiums up $10 per person, per paycheck.
Does the person (people) getting sick get tagged? No, they do not get tagged. You can get a summary of charges, used by the insurance company to justify the cost raise. Now normally no one ever does this, because there’s no point to it. If an insurer is going to raise your rates and does so, they do. There is no arguing them down. For instance, how did I know HIV 'caused the rate increase. I looked at the cost analysis from the previous year to this year. I can’t be 100% sure it was the HIV, but I now see it listed and it never was before.
Does the person get tagged. Absolutely not. There’s no way to know who is getting treatment for what. For that matter there was no way to know if the HIV treatment is for an employee or an associated family member on the plan.
In my case that was somewhat easy as I’m gay, and I knew who was missing from work and even though Chicago is a big city, the gay community isn’t so you can hear talk like, “Oh so and so is HIV+ now.” And you do the piecework and you can be 99% certain of who it is.
But working in H/R you can reasonably piece it back, through absences from work and such. No one can force you to disclose a condition but we did request people that had such things tell H/R in case of emergency. Of course if they didn’t disclose it, it was no big deal unless it directly effected the job. For instance an epilepsy and driving a car. Of course an epileptic may be able to drive safely but we’d need doctor’s certification for that
One person doesn’t get booted off a plan. This is the good thing about group insurance. Now this doesn’t mean that in a small company the owners won’t TRY to fire the person. Now that isn’t supposed to happen. But in real life it does all the time. And of course you wouldn’t be fired 'cause your heart attack 'caused a jack up in the rates. The owner would simply just watch that employee for other infractions and use those against him.
Companies don’t pay different rates for different employees for a group plan. But they may have different plans for employees. Sometimes you don’t realize this. One hotel I worked for, senior management (director level) had a choice of five plans. The union employees only got one choice, the one the union negotiated. Managers got three choices and line employees (non-union) got two choices.
But unless you were a line employee with two choices talking to a director, you’d never know, 'cause we never mentioned it. There are often many, many tiers of converage behind the scenes you don’t see.
So how did the companies I administered the plan work out the cost increase? Simple we went with another company. We would move from Human to Blue Cross, to Unicare. Every January 1st we went with a new company. Used to drive employees nuts, as they’d have to look for new doctors. I used to tell people, try to find doctors that take all three so you won’t have to switch.
In general the bigger the company the less likely you are to be singled out. As seen in my example once you get above 150 employees its extremely hard to tell or to make a reasonable guess as why insurance rates go up beyond the expected.
But if you work for a small company like 10 people, you’re going to be able to figure anything out with 99% certainty
