Long story short... I was pregnant, had a miscarriage, and was "laid off" the day I returned. I didn't tell them I was pregnant but the timing is too much of a coincidence to ignore. This company has never done lay offs and, even for blatant performance issues, they have a progressive disciplinary process they always follow before they fire anyone. I had a crystal clear record and this came out of nowhere. My gut is telling me that something is off about this. I was the only person let go.
Anyways, they have a self-funded plan. I'm thinking that the company knew I was pregnant and, for one reason or another, cut me loose because of it. Maybe my costs were too high? Maybe they were worried about a future pregnancy causing a disruption? Maybe they saw my miscarriage labeled as an "abortion" (medical term) and didn't like that?
Per the TPA's website, employers have a portal where they can...
- "Look up enrolled members to confirm coverage status, track deductible/out-of-pocket progress, view specific claim details, request new ID cards, and more."
- "Search by claim to view information such as services received, provider charges, and what the health plan covered. You can also download the member’s Explanation of Benefits (EOB) for additional detail."
So I know that at least one person at the company has the ability to view claims in detail through this portal. Of course, they're not supposed to use that information to make employment decisions but I'm sure it happens anyways. It's a VERY small company.
I'm assuming that the TPA has to document PHI access for HIPAA reasons. From what I was able to gather, I'm not entitled to these logs but I really want to get my hands on them to see if anyone at the company was peeking into my claims and when. It's highly likely that the person/people who have access to the TPA are the same people who decided to lay me off.
I realize that this is a niche question but does anyone have any advice? Should I try reaching out to the TPA to see if they'd be willing to give me this info? Or is this information generally very guarded and I would need a court order?