If You Use Your Company’s Abortion Travel Perks, Will Your Boss Find Out?

By Tami Luhby, CNN

The company’s rush to cover employee travel expenses related to abortions after the Supreme Court’s decision to allow states to ban or severely restrict abortion raised a big question: will the boss know if you take advantage?

The answer is usually no, especially if reimbursement is covered by your company’s health insurance plan, benefit experts say.

“Just as your employer doesn’t know if you’re going to the doctor for treatment of another medical condition, they can’t find out that you’ve been reimbursed for travel expenses for an abortion in a state where it’s legal,” said Harvey Cotton, who advises employers on the administration of benefits as principal of the law firm Ropes & Gray. “That’s why it’s so important that this benefit works through the sick plan.”

The Health Insurance Portability and Accountability Act of 1996, known as HIPAA, protects the privacy of patients’ medical activities, whether it’s nursing or travel, Cotton said.

dating app company For example, Match offers a travel allowance for reproductive care that may not be available in an employee’s home state. The program will be administered through its health insurance plans, it said is confidential.

“Match Group’s reproductive services are structured by a third party to ensure employee privacy and confidentiality,” it said in a fact sheet advising that care and support services received by an employee are never shared with the company.

Likewise Yelp, The crowdsourced verification platform said it will not have access to employees’ abortion-related travel expense records.

“The privacy of our employees was critical to how we would roll out this benefit, which as mentioned above is managed by our health insurance company to further ensure confidentiality,” a spokeswoman told CNN in an email. “Yelp will never receive information about who made a claim and/or received a refund.”

But there are other ways to set up the travel benefit. One in particular — a taxable refund program — could raise questions about how employers Check expenses while maintaining worker privacy.

Provision of travel reimbursement

A number of large employers have done this recently announced they would pay to have their workers travel to providers where abortions remain legal.

A procedural abortion typically costs $575 in the first trimester in 2020, according to a recent study by researchers at the University of California, San Francisco. But pregnant women in states that ban or will soon ban abortion may have to spend hundreds or even thousands of dollars to travel in states where abortion is legal.

In addition to Match and Yelp, the list of companies that cover abortion travel expenses includes Microsoft, Kroger, Starbucks, JPMorgan Chase, Netflix and Levi Strauss, among others.

According to a Mercer survey, about 11% of companies are now implementing travel and lodging benefits for abortions, and 23% are considering doing so in light of ongoing changes in state laws this has been going on since the beginning of June.

Larger companies are more likely to offer such services because they are self-insured, which means they pay their workers’ claims and hire an outside administrator, usually an insurer, to administer the health plan. Self-insured plans are subject to federal regulation, which does not restrict abortion treatment. However, many small and medium-sized businesses have fully insured plans that are subject to government oversight and would have a harder time providing abortion benefits or travel reimbursements in states where the procedure is banned.

How the reimbursement plan might work

There are several ways companies can set up these programs, although the most common is expected to be through existing health insurance plans. Some employers already cover workers’ travel expenses when they need certain medical care, such as B. heart surgery, orthopedic surgery or cancer treatments.

Insurers generally have or will create forms and processes that allow workers to claim reimbursement for travel, lodging, and other covered expenses related to an abortion and to submit receipts. It could be similar to how workers file claims from off-network doctors and then receive reimbursement, said Julie Campbell, head of Mercer’s health and benefits practice.

Some companies plan to set up these reimbursement programs in the coming weeks or months, experts say.

Other ways employers might recover travel expenses are through medical reimbursement arrangements, known as HRAs, through employee assistance programs or EAPs, or as taxable reimbursements.

For example, employers might turn to HRAs if the insurer they work with is unable to add a reimbursement program mid-year, or they could opt for EAPs if they want to cover a broader range of employees, not just those covered by the company’s healthcare plan, said Jonathan Zimmerman, a partner at Morgan Lewis and co-lead of the law firm’s reproductive rights task force .

Both options are subject to HIPAA privacy rules, but they can be more complicated to set up and come with more restrictions. For example, the maximum reimbursement for an HRA this year is $1,800. Also, not all providers who administer HRAs and EAPs can or will agree to the rapid establishment of an abortion travel expense reimbursement program.

However, granting the benefit as a taxable refund could be more difficult for businesses to manage, depending on how it is set up. It may not be subject to HIPAA. And companies may have to balance the need to substantiate travel claims and employees’ desire for privacy.

What to look out for

Employees wishing to access their corporate travel benefit should read the fine print before assuming all of their expenses will be paid.

Workers may need to meet their deductibles before they can be reimbursed for travel expenses related to an abortion, particularly if they belong to high-deductible health plans.

Some companies may also say that the travel benefit is only available to those who cannot access abortion services within 50 or 100 miles of where they live. Some may require workers to go to the closest state to get treatment, while others give workers the flexibility to go to where they can get an appointment fastest.

Companies can also reimburse appropriately Airfare without tax consequences, the IRS limits hotel charges to $50 per night for one patient and an additional $50 per night for a companion if required, for a total of $100 per night. Therefore, some employers may limit housing coverage to avoid additional tax problems.

For those driving to other states, employers may require them to submit receipts for gas or reimburse them at a flat rate of 22 cents per mile, which is the rate set by the IRS for 2022.

And workers need to consider whether the out-of-state providers they see are considered on-network or off-network. The latter could prove to be much more expensive.

However, some employees may still struggle to cover out-of-state costs for the procedure as they may not receive a refund for weeks. This is especially true for low earners.

“A reimbursement mechanism will only work for people who can afford that money,” said Alina Salganicoff, director of women’s health policy at the Kaiser Family Foundation. “If you don’t have a credit card, if you don’t have that much money saved, you have to borrow money from somewhere to get that money, so your employer will say, ‘We’ll pay you back,’ for doing that.”

Can states get involved?

It remains to be seen whether state law enforcement officials could make claims related to abortion services and travel if that state passes Laws that seek to limit the reproductive care its residents can receive outside its borders.

There are certain exceptions under HIPAA related to law enforcement that could allow state agencies to obtain medical records, said Tzvia Urlaub, a partner in the employee benefits practice group at law firm Epstein Becker & Green.

But some other states where abortion remains legal are enacting laws to limit access to medical information and prohibit courts and law enforcement agencies from cooperating on abortion-related cases within their borders.

Also, the US Department of Health and Human Services and the US Department of Health and Human Services Office of Civil Rights issued guidance last week that said protected health information can only be shared with law enforcement and without a patient’s authorization “only in limited circumstances designed to protect an individual’s privacy.” and to support their access to health care, including abortion care.”

“So much of this is unknown at this point, and it varies from state to state,” said Katharine Marshall, group leader for legal and policy at Mercer, a welfare consulting firm.

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