I plan to open up a small business consisting of less than 20 employees. I will be offering my employees with group health insurance. Will the health insurance group be requiring the medical records of my employees?

It depends on the State where you are at. In some States, insurance companies usually require the personal information and medical history of their insurance group policy holders. These include drug prescriptions, major or minor surgeries, illnesses of family members, and other medical information. The medical information are often requested from the doctors or hospitals. This information is necessary especially if the health plans have clauses for pre-existing conditions. The cost of the plan depend on the general health conditions of your employees.

In some States, like New York or New Jersey, the insurance groups do not require extensive information on the employees’ medical history.

Since your business is small, insurance companies might accept the information in your application, or conduct a telephone interview with you. They can also get the records from the Medical Information Bureau or MIB. The MIB stores all the records of your medical insurance claims. The insurance companies usually verify the medical records, but they usually don’t do this for group insurance of small companies.

Insurance companies usually require at least 25 employees for the company to be exempt from providing the medical history and other information of its employees.

If you’re health insurance is good, you might not be required to provide any medical records during the initial enrollment to the plan.

It might be best if you consult with an independent insurance broker in your State whether the insurance group will be requiring the medical records of employees.

Answer by general public - June 16, 2009 @ 4:41 pm

1 Comment

  1. If you are in CA, you will not need to show any medical records for your employees. It is Automatic Guarantee as long as 75% of your full time employees are joining the group plan, don’t worry if not there are many exceptions to this rule. Any questions please feel free to call me, 877-707-9898

    Comment by Lesley — June 18, 2009 @ 10:32 am

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