The Genetic Information Nondiscrimination Act, or GINA was signed into law on May 21, 2008, and some of its provisions affect calendar year health coverage plans that begin after Dec. 7.
GINA has Title I and Title II segments. Title I forbids health plans and health insurers from utilizing genetic information for underwriting purposes. Genetic information may not be obtained before enrollment in health plans, and employees and their families cannot be compelled to undergo genetic tests. Title II prohibits discrimination in employment based upon genetic information, such as an individual's predisposition to cancer, diabetes or heart disease. Enterprises may not segregate, limit or classify team members based upon genetic information. For health plans, Title I of GINA is effective for plan years that began on or after May 21 and for calendar year health plans beginning on or after Dec. 7. Title II took effect Nov. 21.
Recent regulations under GINA are in force for group health plans that alter premiums, copays or deductibles based upon health risk assessments that include inquiries about family medical history. These changes are applicable as of the first plan year starting on or after Dec. 7.
Many employers must take action now since it is common to require staff members to provide health information during annual enrollments.
With very few exceptions, most companies must remove questions regarding family medical history in health risk assessments. In addition, businesses should not ask open-ended questions due to the possibility of associates providing family medical history information. When it comes to workplace wellness programs, vendors such as hospitals should be contacted to confirm that data is not attained from health or wellness materials.
The Internal Revenue Service, U.S. Department of Labor and Centers for Medicare & Medicaid Services have authority over Title I. Consequences for violations include civil penalties through the Employee Retirement Income Security Act and excise taxes under the Internal Revenue Code.
Title II of GINA permits organizations to secure family medical history data in health risk assessments if the information is not tied to a group health plan. Workers must be given a written disclosure and agree in writing to supply the data.
The Equal Employment Opportunity Commission maintains regulatory jurisdiction over Title II. A new EEOC poster has been issued to reflect GINA and other recent revisions to federal employment discrimination laws, such as the Americans with Disabilities Act Amendments Act of 2008.
Genetic information must be treated as protected health information under the Health Insurance Portability and Accountability Act. Corporations should review and update HIPAA privacy policies regarding genetic information. Wellness programs and group health plan enrollment practices should be modified immediately. Equal employment opportunity statements and nondiscrimination policies must now include "genetic information." Maintain genetic information in files separate from personnel files. Treat the data as confidential medical records. Prevent the illegal disclosure of these records. Operations managers and human resource professionals should be trained on the rights of laborers concerning their genetic information.
Lynne Haggerman, M.S., is president/owner of Lynne Haggerman & Associates LLC, a Springfield firm specializing in management training, retained search, outplacement and human resource consulting. She can be reached at lynne@lynnehaggerman.com.
