July 26th marked the 22nd anniversary of the signing of the ADA. All across the United States, communities, including employers, schedule events to celebrate the great progress that has been made. But there is still much to be done to eliminate the barriers that remain in our society before people with disabilities are fully included in the American mainstream.
One such issue is the continued discrimination in providing health insurance to employees with HIV/AIDS. The ADA prohibits employers from discriminating on the basis of disability in the provision of health insurance to their employees and/or from entering into contracts with health insurance companies that discriminate on the basis of disability. Insurance distinctions that are not based on disability, however, and that are applied equally to all insured employees, do not discriminate on the basis of disability and do not violate the ADA.
For example, blanket pre-existing condition clauses that exclude from the coverage of a health insurance plan the treatment of all physical conditions that predate an individual’s eligibility for benefits are not distinctions based on disability and do not violate the ADA. A pre-existing condition clause, that excluded only the treatment of HIV-related conditions; however, is a disability-based distinction and would likely violate the ADA.
Similarly, a health insurance plan that capped benefits for the treatment of all physical conditions at $50,000 per year does not make disability-based distinctions and does not violate the ADA.
A plan that capped benefits for the treatment of all physical conditions, except HIV or AIDS, at $50,000 per year, and capped the treatment for AIDS-related conditions at $10,000 per year, does distinguish on the basis of disability and likely violates the ADA.
As the ADA anniversary approaches, minimize your risk by scheduling a review of your company’s insurance policy to ensure that it doesn’t include any provision that inadvertently discriminates against employees with disabilities.
This information should not be construed as “legal advice” for a particular set of facts or circumstances. It is intended only to be a practical guide for participants familiar with this subject. Users should seek appropriate legal advice tailored to address their specific situation.