Miami Herald (MH); Sunday, December 1, 1991
Marilyn Adams, Herald Business Writer

It's illegal for Florida employers to AIDS-test workers or to fire or refuse to hire them because they're infected. But state law gives health and medical insurers lots of leeway in the workplace: It's legal -- and increasingly common -- for insurance companies to question or blood-test employees for group policies.

"Our customers, the employers, want to know," said Aetna Life and Casualty spokesman Bob Nolan. "They're paying the bill here, and employers are reluctant to assume the cost of high-priced treatments."

When basketball superstar Magic Johnson revealed he was infected with AIDS, fans were equally surprised by the way he found out: a blood test for a life insurance policy he wanted to buy for himself.

It's routine for life insurers to blood-test applicants for individual policies over $100,000.

But it's the AIDS screening for group health and life policies -- especially at small companies with small risk pools -- that has the potential to touch the most workshops, offices and factories.

Pointed questions about AIDS have become increasingly common on health insurance forms; blood tests are often required for life policies with large payouts.

Health-insurance screening is just one way the workplace's benefits are changing. A federal court recently gave some large employers the right to virtually eliminate insurance benefits for AIDS patients. And AIDS testing of an employee by a Broward dentist has sparked a test of the state's anti-discrimination law.

But it is the screening of employees for the virus that is believed to cause Acquired Immune Deficiency Syndrome that may have the widest implications for the workplace of the '90s.

At Miami-based Spec's Music, for example, screening takes the form of a detailed questionnaire. New employees who don't sign up at once for group health insurance must complete and sign a Blue Cross and Blue Shield form.

Sample questions: "Has anyone applying for coverage ever tested positive for exposure to HIV infection? Has any person applying for coverage ever been diagnosed as having AIDS-related complex or AIDS caused by the HIV infection or other sickness or condition derived from such infection?"

Signing the form gives Blue Cross access to medical and insurance records on the employee and allows Blue Cross to release data to Spec's or other insurers, the form says.

"It's rough. We stress that people should sign up right away" to avoid the forms, said Patty Walker, Spec's personnel manager. "When people apply late, the insurance company thinks something's wrong."

If the answer to either question is yes, then the employee can be denied coverage, says Walker. The detection of HIV or AIDS symptons is considered no different from any other pre-existing medical condition such as cancer, diabetes or heart disease.

Experts on AIDS fear such surveys could have a chilling effect on people who might be infected -- and ought to find out if they are.

"My concern is this may be a big disincentive to get tested," said Sherry Glied, an assistant professor of public health at Columbia University in New York.

"So long as you don't know, you can honestly say never tested HIV-positive."

Not only small companies are affected. Many big employers are self-insured and last month, a federal appeals court in New Orleans ruled that employers with self-insured health plans can slash medical benefits to workers with AIDS.

In that case, a Houston music store worker with the AIDS virus sued after the store cut his benefits to $5,000 from $1 million. The ruling in favor of the company is now law in Louisiana, Texas and Mississippi. A similar case is pending before the appeals court that covers Florida.

Once confined to clinics and high-risk jobs, AIDS screening is confronting workers in a variety of ways.

Blue Cross, the state's biggest health insurer, considered requiring blood tests in group policies but "we didn't think it would be cost-effective," said spokeswoman Marianne Elden. Instead, Blue Cross decided to use surveys at companies with fewer than 100 employees. Travelers requires workers at companies with fewer than 50 employees to complete a health-history questionnaire that asks about AIDS, cancer and other illnesses. Aetna surveys late enrollees at companies with up to 200 employees.

"It's my sense that screening is on the increase," said Gary Pullen, director of insurer services for the state Insurance Department. Considering Florida's anti-discrimination law, "there is a gray area. The complaints I've heard center around the privacy of this information."

The identity of someone who's HIV-positive is supposed to be kept secret. But if a small company is declined coverage because an employee is infected, "the employer immediately wants to know who it is," Pullen said. "It doesn't take a rocket scientist to figure it out."

Along with health insurers, the life insurance industry has reacted to fears of huge AIDS losses -- losses that haven't fully materialized. In 1987, the industry estimated AIDS death claims would mount to $50 billion by the year 2000. But current estimates range from $10 billion to $14 billion.

Life companies offering group policies use blood tests and physicals to screen employees wanting higher-than-usual coverage. Tests check for the AIDS virus, cancer, drugs, alcohol and heart disease.

At firms with up to 200 employees, Aetna requires blood and urine tests for employees wanting more than $100,000 in coverage. Prudential requires tests only for late enrollees for policies that size.

AIDS tests aren't always done just for insurance, either. Since Kimberly Bergalis charged she contracted AIDS from her dentist, some dentists are blood-testing themselves and their employees.

The Legislature's Task Force on AIDS Oversight has received reports from around the state of dentists testing employees and posting signs to reassure patients.

AIDS testing of employees is legal in Florida only when it's crucial to be HIV negative on the job. In the Broward test case, a dental assistant was fired for refusing the test. The assistant filed a complaint with the state Human Relations Commission. Lawyers in the case are keeping secret the names of the dentist and the assistant.

The assistant's lawyer, Allan Terl of Fort Lauderdale, argues the dentist violated the employee's rights to employment and privacy.

"The AIDS test was designed to monitor the nation's blood supply, not for employers," Terl said.

But the dentist's lawyer, Michael Gora of Boca Raton, said the dentist believes he had a right to check his staff and inform his patients.

"I'm sorry if people think this is AIDS hysteria," he said.

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