Protecting Confidentiality for Individuals Insured as Dependents

August 31, 2023

Billing and claims processing procedures widely used in private health insurance routinely, albeit inadvertently, prevent anyone insured as a dependent on someone else’s policy from obtaining sensitive services confidentially. One of the most frequent ways in which disclosure occurs is through explanation of benefits forms (EOBs) sent by insurers to policyholders after anyone covered under their policy obtains care. EOBs—which typically identify the individual who received care, the health care provider and the type of care obtained—essentially make it impossible for dependents, often minors and young adults, to obtain the confidential access to sexual and reproductive health care they need.

Several states have developed creative approaches to address these as well as broader confidentiality concerns—solutions that satisfy the needs of insurers, protect policyholders from unexpected financial exposure and, most importantly, facilitate access to confidential care for all covered individuals.

Highlights

14 states have provisions that serve to protect the confidentiality of individuals insured as dependents.
- 6 states allow individuals insured as dependents to request confidential communications from their insurance provider via a written request.
- 4 states have confidentiality protections specific to EOBs. These states allow insurers to mail an EOB directly to the patient instead of the policy holder. Insurance providers in New York and Wisconsin are not required to send an EOB to the policyholder if there is no balance due.
- 6 states explicitly protect the confidentiality of minors insured as dependents.
  - 4 states have specific protections for minors seeking STI treatment.
  - 3 states have protections for minors seeking any medical service.

Current Policy Status Table

Protecting Confidentiality for Insured Dependents
STATE	STATE EXPLICITLY REQUIRES INSURER TO PROVIDE CONFIDENTIAL COMMUNICATIONS UPON WRITTEN REQUEST OF INSURED DEPENDENT	PROTECTIONS SPECIFIC TO EOBs	PROTECTIONS FOR MINOR DEPENDENTS
		PROTECTIONS SPECIFIC TO EOBs	Confidentiality for STI Treatment	Broader Confidentiality Provisions
California	X
Colorado	X^†
Connecticut			X
Delaware			X
Florida			X
Hawaii				Health care provider must inform insurer when "minors without support" request confidentiality
Illinois	‡
Maine				Minor may refuse parents' request for EOB or claim denial
Maryland	X
Massachusetts	X	X
New York		X
Oregon	X
Washington	X^Ω	X	X	Insurer may not disclose private health information, including through an EOB, without minor's authorization
Wisconsin		X
TOTAL	6	4	4	3
* An insurer may grant requests for sensitive services or for services whose disclosure may endanger the dependent. † Applies only to adult dependents. Ω For adult dependents, applies to sensitive services or to all services if the patient has specified a particular person who may not receive information. For minors, applies to all services unless minor has authorized that information may be disclosed. ‡ Illinois protections only apply to sensitive services provided to Medicaid participants.