Employers often advocate on behalf of their employees in benefit disputes and appeals, answer Question:s with regard to the health plan, and generally help them navigate their health benefits. Is…

Question

Options

• ANo
• BSometimes
• CYes
• DThe answer is indeterminate

• A
  4% (1)
• B
  8% (2)
• C
  85% (22)
• D
  4% (1)

Explanation

Option C is correct because HIPAA's privacy rules require individual authorization before protected health information (PHI) can be disclosed or used, even when an employer is acting in a supportive capacity on the employee's behalf. Although employers sponsor health plans, this does not grant them automatic access to employee health data - the individual retains privacy rights over their own PHI, and their explicit consent is necessary for any advocacy role involving that information.

Why the distractors are wrong:

• A (No) incorrectly assumes employer sponsorship of a plan overrides employee privacy rights - it does not.
• B (Sometimes) is tempting but wrong; the consent requirement is not situational - it applies consistently under HIPAA whenever PHI is involved.
• D (Indeterminate) is wrong because there is a clear, established legal standard (HIPAA) that settles the question.

Memory tip: Think "Your health, your say." No matter how helpful the employer's intent is, HIPAA's rule is that the individual must authorize access to their own health information - the beneficiary controls the gate, not the employer.

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