If Hobby Lobby loses the case, will their employees be able to anonymously obtain contraception?

Unless their workforce is unionised, which I doubt, it is hard for me to imagine their employees feeling comfortable doing so if it is not anonymous. “Hi boss, I know you think this is a form of murder, and you fought tooth and nail to avoid having to provide it for your employees, but now that the courts say you have to, I am going to shove it down your throat. Oh, and while you are getting out that reimbursement form, can I also get the form to apply for a promotion?”

The lawsuit isn’t about them having to provide contraception directly to their employees. I mean, it’s not like, if they lose the case, the CEO’s office will have a big jar of birth control pills on it and people can come in and take some. The lawsuit is about whether or not the health insurance they provide for their employees will have to provide contraceptive coverage. So it would be like anything else. The employee would go to the doctor, the doctor would write up a prescription for birth control pills, the employee would go to the pharmacist to have it filled and provide their insurance info, and the insurance company would do the stuff they do to pay the pharmacy.

Hobby Lobby is out of the loop once they provide the insurance. Just like your boss doesn’t know what medications you take, Hobby Lobby won’t. The only people who’ll know that the person has a prescription for birth control is the person, their doctor, their pharmacist, and their insurance company.

The company blocks four of 20 types of contraception, those types which they see as causing “abortions” by preventing the fertilized egg from developing. Their employees can therefore get contraception, just not all types.

And their employees can certainly get those four types or anything they like by paying for it outside of company provided insurance. Nor do they have to tell Hobby Lobby anything at all about it. Why would they?

Were you asking a serious question or should this be moved where you can rant?

Believe me when I say I have absolutely no interest in the question of contraception provided, at all: just as with abortion, I find the claims of both sides self-serving and delusive

However, with regard to this point, anything can be paid for privately, whether a heart operation or a gun; but few salesmen would be interested in providing their own company car without compensation because their employer had religious objections to a certain car maker.

The company will have no access to an employees medical records or any information on what they purchase at a pharmacy with insurance.

HIPAA regulations being as strict and full of teeth as they are, Hobby Lobby won’t even know they’ve been to the doctor unless they volunteer the information.

You raise an important question.

Hobby Lobby is self-insured.

That means that someone at Hobby Lobby will receive copies of claims submitted under its employee health plan and will learn what sort of prescriptions are being filled.

Now, HIPAA does impose restrictions on how this information may be shared within the company. But it is not unreasonable for an employee to worry about this information being in the hands of the employer. For example, what if the clerk in HR who reviews promotion applications is the same person who used to review prescription claims and remembers that you once submitted a claim for an abortifacient drug? This person may not legally be allowed to share this information with the promotion review committee, but it may affect how they handle your application.

Now that’s an interesting line of thought. I really don’t see it being realistic for a company as large as HL. With the amount of insurance claims they’ll be processing I don’t doubt they’ve got a department set aside that does nothing but insurance with no crossover duties to any other group.

A smaller employer with only a few hundred employees might combine those administrative groups though.

Thank you, Alley Dweller, for an actual helpful answer.

This is what I was wondering. Contrary to what Captain Amazing claims, not everyone has some kind of privacy wall between their employer and their medical care. My wife is a public school teacher, and when she goes to the doctor or buys a prescription, she has to pay for it and then bring the receipts to someone in the main office (and not even in a private office but just a desk in an area where other people work) to be reimbursed. This is a small school district with only one of each type of school so this is not a great level of insulation.

Hobby Lobby is obviously a much larger institution, but I wondered whether they got to see what their employees are specifically charging to their medical care.

In my experience working for companies that self-insured, there was still a traditional health insurance company that provided our membership cards, sent us the list of participating doctors and was the one to whom we filed claims for coverage. I believe that the self-insured employer paid the insurance company to administer the insurance plan for them. So no one within the employer sees the claims.

Of course, there was the recent incident in which AOL’s CEO blamed the cost of covering two “distressed” babies meant that the company would be forced to change how it provides the employer match for the 401(k) plan. So he knew something about what was being covered.

Odd - most of the companies I’ve dealt with (most often, Blue Cross) you send the receipts to a processing department at the health insurer by mail; the employer never sees them. I wonder why your wife’s employer does this. After all, the insurer will then have to perform the same check (and probably is more qualified to weed out phony doctors, items not covered, limit reached, etc.) So essentially, this is just make-work for the employer. Hmmm, bureacracy at a school board because “that’s the way we’ve always done it…” Go figure.

I assume the insurer is allowed to share some information with the employer - items of a stistical nature that don’t give too much medical detail… although if a baby was born prematurely and needed open heart surgery or whatever, I’m sure everyone who worked with the parent(s) was well aware of one of the identity of that patient.

the other problem is that just because the law says “don’t share” does not mean someone won’t behind the scenes. There are numerous anecdotes of small-town doctors whose receptionist or nurse was not above gossiping, even with incomplete information, if the doctor kept his mouth shut. Unles the shit hits the fan legally, what’s the remedy? If a HL executive wants to browse the filing cabinets after hours (or the computer system) who’s going to notice and tell them to stop?

OTOH, just because the HL owners feel this way, does not mean the minions all the way down are obsequious toadies hopping to do their bidding and tattle about what they might see as unreasonable and possibly illegal queries. If your boss has multi-millions and you’re a $30,000 a year clerk, would you agree if he asked you to help him commit a felony breach of privacy?

If the computer system is set up properly, someone should notice the improper access of the patient records. Last year, for instance, six people were fired from Cedars-Sinai Medical Center for improperly accessing patient records (most often celebrities).

I’m a municipal employee in my town and the town is self-insured. The health coverage is administered by Blue Cross and Blue Shield and I carry a Blue Cross card. Basically Town Hall just makes sure all our premiums are paid up.

Even though a self-insured entity might contract with an insurance company to administer its program, it is unlikely that they will let the insurance company just write unlimited checks on their account on the honor system. The entity most likely retains the right to audit and spot-check the insurance company’s records. This is not prohibited by HIPAA. And in order to audit the expenditures, they must have access to the records.

American Health Lawyers Association – Tips For Employers To Identify HIPAA Issues