health insurance group – Do I have to give medical records?

7 Responses to health insurance group – Do I have to give medical records?

1. stars

   August 30, 2010 at 5:56 am

   Some insurance company’s require each enrollee to fill out health questionnaire. It asks for age, medications, surgeries etc. Not a good idea to lie since in some cases they will request medical records from the doctor. They do this due to having to cover a pre-existing condition. And your rates my depend on the health of your employees. Its not a bad idea to have someone price out all of the policies in your area to get you the best rate. Also COSE may be able to help you as well.
2. Rose

   August 30, 2010 at 5:56 am

   Not if it’s through your business….
3. golden oldy

   August 30, 2010 at 5:56 am

   You should be able to have an open enrollment thought that might not be the cheapest way to go.
4. mbrcatz17

   August 30, 2010 at 5:56 am

   Depending on how small the group is, the health insurance would likely be individually underwritten – which means, yes. Usually you have to have a minimum of 25 covered employees to avoid that. "Small" is a very subjective word – it could mean four employees, it could mean a hundred.
5. LOLI

   August 30, 2010 at 5:56 am

   It depends on the company you go with but a good policy doesn’t require any medical questions or records nor previous condition disqualification during your employees initial enrollment period.
6. Dan H

   August 30, 2010 at 5:56 am

   I looked at some of these answers. Mbrcatz and Loli are agents but give vastly different answers. I can only chalk that up to state differences (insurance is state-mandated) so be sure to check with a licensed broker in YOUR state.

   All companies will be medically underwritten, it simply depends on whether it is a short (abbreviated) or long application. If it is a small group, it will be the long form. Small group reform was passed back in ’96 or so and said that any company with between 2 and 50 employees could not be turned away for health insurance. If you have 51+ employees you can probably do a short form…and with larger companies, sometimes they simply ask the employer if they know of any major claims and/or illnesses with their employees. Since you can’t ask the employees this, it is to the best of your knowledge. Some companies will not write a ‘virgin’ group if you have more than 50 employees (not having previous coverage). There IS a pre-existing clause on all new business (in contradiction to what one of the answers said, with two exceptions: 1) if it is an HMO or HMO-based program like a Point-of-Service plan which has an HMO side, or 2) if your state mandate disallows it).

   As far as records, typically insurance companies don’t ask for it…doesn’t mean they CAN’T. Generally, if it is a small group, they will go by the application, telephone interview and MIB (medical information bureau) which has a record of medical insurance claims on you. If records are requested, it is typically to clarify something that came up. In my experience it has NEVER been asked for as part of the application. And with the small group, the company will just typically rate up the plan to the state-allowed maximum rate and call it a day rather than tracking down records and paying someone to review it. There are many options available to business owners for health insurance and/or employee benefits. I’m more than happy to answer your questions, so feel free to email me. However, if you are not a Nevada or Ohio company, I may only be able to give you general information which I’m more than happy to do at no cost.
7. Size 2

   August 30, 2010 at 5:56 am

   NY or NJ small group plans do not require any individual medical records. There is a small section on some group applications that inquires about major illnesses. That’s all you would have to answer around here.

   (There is a 4% chance that you’re business is located in this area so it couldn’t hurt to try.)