First of all, it depends on the group coverage plan. The way it works (for now) is that an employer selects a group health insurance plan and then invite employees to enroll. Typically, employers cover at least 50% of each employee's monthly premium, and can also contribute to dependent premiums. The remainder is paid for by the employee. However, if an employee with ANY preexisting condition enrolls in the plan, there is no doubt the insurance carrier will know their condition because it's on a medical information database. Yes, "preexisting condition" is no longer an issue with getting health insurance, due to ACA, but the point is that the group plan is a pool. As the pool increases, if all employees are equal, the premiums are lower. But if someone has a health issue, the premiums rise for everyone.
Let's just say for the sake of argument, that all employees are paying $200/month for a premium. Then a person with a preexisting condition is hired and goes on the plan. Theoretically, the insurance carrier would increase the overall premiums and the additional burden is essentially equally distributed. So the premiums may jump to say, $300/month or more for everyone. So it doesn't take a genius to figure out the timeline and who caused the spike. They may not know you have CF. But if you're going to doctors periodically, or expressing physical issues at work, etc. People are nosey. They will find out. They can scrub your social media and if you've so much as hinted that you have CF, the jig is up. They know. And trust that human resources has ways of finding out. To be sure, they cannot fire you for having CF. That's against the law. But unless you have a clause in your contract, should you even have a contract, you can bet they can find other ways to leverage what they know against you until you quit or they can release you for any reason in a "right to work" state. Businesses don't exist to make us healthy and happy. They exist to make a profit and reduce overhead. However, there are a few conscientious employers. But that's a thin line with new ACA Obamacare rules.
Beginning on January 1, 2015, employers with 100 or more full-time workers will need to provide affordable health insurance to 70 percent of their employees or owe a $2,000 per worker penalty, under the long-delayed employer mandate provision of the Affordable Care Act (ACA). By imposing a penalty on medium-sized businesses – the smallest businesses are exempt from the health insurance requirement – that do not offer employee health insurance, policymakers hope to encourage more business owners to provide this benefit to workers.
So what is happening now is that many employers are cutting people to part time or releasing them from employment to meet the mandate. What will eventually happen is that group health insurance will eventually disappear for most employees, making the earlier argument mute. As premiums rises and employers have to pay upwards of 50% of the premium, it's simply more cost effective for employers to push employees into individual plans, cut hours or fired them. That takes a huge burden (overhead) off the employer. So eventually, the earlier argument may not even matter because employees will eventually be on their own.
Just be prepared for the day your employer tells you that they can no longer afford your coverage or cut you to part time or worse. If you work for an employer of less than 100 employees, you're on your own anyway. So it really depends on each individual situation.
There's been a lot of talk here lately about a spike in insurance premiums that an employer sees when a CF employee or a parent of a CFer gets hired. Can someone explain this to me? In my experience I've always signed up for a group health insurance plan. How would the costs of my prescriptions affect the company? And how would these costs compare with, say, an employee with 6 kids? An employee who is pregnant? An employee who is often in the hospital or has a sick spouse? Someone who is diabetic and requires many doctor's appointments?
I've never been hospitalized and only have Pulmozyme and Creon as expensive meds, but I am currently job hunting and this aspect of it makes me uncomfortable. I've never outwardly been discriminated against for my CF, but then again I don't broadcast it at work, either. Are the HR people looking at my paperwork and thinking that I am a liability and wondering why I have such high medical costs? Do my prescription costs make the rest of my coworkers have to pay higher premiums? Or does that not matter since it's a group insurance plan? Would it be better to aim for larger companies rather than small ones? Any enlightenment would help. I've been working full time and getting my own health insurance from my employer since I was 24 (11 years now) and I still don't quite get how this works.
Thanks!
Makes me feel better about job hunting and interviewing!