The employer cannot withdraw an offer of employment to you based on information from a medical examination unless the reasons for the exclusion are job-related and consistent with business necessity, or you are being excluded because you are a direct threat to yourself or others. The employer also must show that no reasonable accommodation was available that would enable you to perform the essential functions of the job without a significant risk to health or safety, or that such an accommodation would cause an undue hardship. After you are hired, your employer may require that you and other employees take medical examinations to reaffirm fitness for jobs, when there is a need to determine whether you are still able to perform the essential functions of your job. When you are an employee, unless medical examination information indicates you can no longer do the essential functions of your job with reasonable accommodation, or it indicates you are a direct threat to yourself or others despite reasonable accommodation, the information cannot be used as the reason to remove you from your job. How the ADA affects health insurance plans is a complex and evolving matter.
Some employers are self-insured.
Some employers contract for health insurance coverage for their employees. Some policies are regulated by state law. Therefore, it is not appropriate to use this brief guide as a definitive document on the topic. Moreover, given the complicated nature of insurance, the complexity of the science of underwriting, and the national health care reform movement, clarifications on how the ADA affects insurance decisions made by a particular employer, will be shaped and reshaped by the Equal Employment Opportunity Commission, Congress, and the courts over the next decade. Given this caveat, here is what is understood now.