I was told that USAA is using health insurance utilization (cost they spend on each employee as self-funded plan) as the filter for layoff/terminations where performance was not a concern. Looking for anyone in HR or higher up who can confirm this is whats happening. For ancedotal does anyone recall if the people laid off were overly sick or known to be using their healthcare alot? Could be a major ERISA 510 violation if we can crowdsource some proof.
May the Odds be in your favor!
HIPAA law is real. Once a healthcare provider violates it, they are doomed. And so is the employer who colludes with the healthcare provider.
Employees who smoke or have high BMI pay higher premiums. Lose 5% or 10% weight, get a bonus. Quote HIPPA all you want, it's undeniable they keep track of the individual.
@gg if on a zoom call, always save the transcript or ask to have it recorded. True, it will probably not save your job, just like with the bank, members started going to the CFPB, then the OCC got involved, enough complaints go to EEOC, they’ll have a field day with USAA.
Employees won’t succeed if they do nothing after being discriminated against. Document everything and keep everything in writing even if your manager asks for a zoom call. Write an email and specify what’s discussed. If you choose to mediate through employee relations just keep in mind ER is NOT on your side. Treat your manager like the police who arrested you and ER like the prosecutor. You are your only defense. File a claim with EEOC when you get the layoff notice. I’ll be very straightforward with anyone in this situation. All those WILL NOT save your job, but more complaints are more likely to get attention.
Fact check from ChatGPT: high cost utilization not identifiable to specific employee:
“They often have access to data that shows which employees are generating high costs…”
⚠️ This is the main issue.
Employers in self-insured plans do NOT typically receive identifiable data about specific employees’ claims.
Under HIPAA, they are generally limited to:
De-identified data
Aggregated reports
Sometimes “large claimant” reports without names
👉 What they can see:
“One member has $150k in annual claims”
Total specialty dr-g spend
Trends by category (e.g., autoimmune dr-gs)
👉 What they cannot see (in normal setups):
Employee name tied to claims
Specific dr-g tied to a person
Diagnosis tied to a person
✔️ Correction:
Self-insured employers bear the financial risk and receive detailed cost/utilization reports, but these are typically de-identified and do not reveal which specific employee incurred the costs.
AI generated response:
Yes, employers can often know the healthcare billing costs of employees, particularly in self-insured plans. While HIPAA protects personal medical records from being disclosed by providers, insurance carriers often provide employers with detailed claims data and reports on high-cost claims to monitor utilization, especially for companies with over 1,000 employees.
Here are the key details regarding employer access to employee health data:
Self-Insured vs. Fully-Insured:
Self-Insured: The employer bears the risk and pays claims directly (using a third party for administration). They often have access to data that shows which employees are generating high costs, though typically not the specific diagnosis, to manage costs.
Fully-Insured: The employer pays premiums to an insurance company. They generally only receive high-level, aggregate reports (e.g., total plan spend) and less employee-specific data.
What Employers Can See: Employers can track large, high-dollar claims, especially those exceeding stop-loss insurance thresholds (e.g., $100k+), to understand insurance rate increases. They often see the "what" (e.g., specific high-cost treatment) but not always the "who" unless it is a small company.
What HIPAA Protects: HIPAA prohibits employers from receiving identifiable medical data directly from doctors or hospitals. It does not, however, stop insurers from sharing aggregated or de-identified claims data for administrative and plan management purposes.
Legal Protections: While employers can know the costs, using this information to discriminate, terminate, or harass an employee due to their health conditions is illegal under laws like the Americans with Disabilities Act (ADA).
Common Scenarios:
Small Companies: If a company has fewer than 50 employees, they are usually fully insured and rarely see individual claims data.
Large Companies: HR or benefits managers in large, self-insured firms often receive reports on pharmacy trends and large, individual high-cost claims (e.g., chronic illness, cancer treatment, or maternity care) to manage company benefits.
Under Health Insurance Portability and Accountability Act (HIPAA), healthcare providers generally cannot disclose an individual’s medical conditions or billing information to an employer without the employee’s authorization. However, there are limited exceptions—such as workers’ compensation cases, employer-sponsored health plan administration, or legally required disclosures—where certain information may be shared under strict rules.
Fmla may be correlated but they will state just that, and that the cause of your layoff is due to changing business needs/ reorganization.
That sounds almost perfect, actually. I came back from sick leave and was immediately targeted. I was fired a month and a half later.
This would be absolutely crazy if true. What a dystopian scenario. I can't believe that they would do that without some sort of evidence. Maybe I'm just naive, but some of my old coworkers who I've become friends with are now Managers and Directors. One in particular was the manager of a team that had layoffs, and they told me that their EMG basically said that two people needed to be let go. It was up to them to decide who got cut.
Setting aside the fact that tying reasonably-priced health insurance to employment is already crazy in the US, a company laying its people off for utilizing their health insurance benefits is even crazier.
What's next, laying people off for getting their full 401(k) match? Laying people off who get the max charity match? Using their dental benefits to get braces?
Even though it's illegal, I have zero doubt that people who take frequent FMLA and/or have JARs that the company deems "inconvenient" are targeted and retaliated against. If you are a person who "inconveniences" your manager, EMG, or the company as a whole, all it takes if finding some instance where you showed up late, took too long on your break, sped in the parking garage, parked in a compact car spot, etc. for you to face disciplinary action for "legitimate" actions.
They'll never lay you off for taking FMLA or having a JAR on paper; but they can (and do) put you under a microscope for everything else. And now that we all signed arbitration agreements, the company has even more leeway to do what they want.
If you get impacted, take the severance and run far away from this place. Do not think this ship is unsinkable, no matter how much they brag about the “fortress of a balance sheet” USAA has.
I wouldn’t believe its costs. But there’s a strong connection between layoffs and FMLA and JARs and age.
I also hear they monitor breakfast taco consumption.
SAT is consistently ranked as one of the worst cities in America from a health standpoint (specifically obesity). So, if they are using medical benefit usage as a filter, most of that office would be canned.
This is one of the d-mbest things I’ve seen on this site (and that’s a low bar)
I have experienced two very rough years with my husband and myself medically - billed costs for the two years were $1,500,000+. Even with all the medical issues I missed very few days of work. No performance issues.
I was part of the January 28th layoffs, I did use my medical benefits when it came to fertility treatments, IVF. But not once did my work suffer or deadlines missed.
I am not HR but I was recently laid off. I had been on a JAR, for a serious medical condition that required multiple visits to specialists each week. For months. It was expensive for me. My issue is now resolved. My performance was not a concern. It was also a personality conflict with a hostile environment and boss. I resolved the JAR but they still were not happy due to the fact that I continued my Dr appointments probably. Yes, it felt like they were pushing me out due to medical reasons and did not want to pay the benefits.