(CA) My startup uses a PEO. Can the PEO legally raise premiums based on our startup’s healthcare “usage”?

I don’t even understand how a PEO would come to know how much healthcare our startup’s employees are consuming.

I’m just an employee, but our HR cites our healthcare usage as one reason for the increase in cost we are facing. (She may be incorrect.) Premiums went up 36% for us but apparently not for all member companies for the PEO.

The PEO is a garbage company, and from the way they share information, I have reason to believe they’re not in the know about the law. Of course, neither am I.

However, it seems strange that they’d have access to info on how much we billed the insurance providers, given HIPAA, and it feels weird that factors other than our demographic info (and the statistical reasons outlined on common websites) would influence pricing under the protections of the ACA.

Is our HR mistaken in what she understood about our usage contributing to higher premiums? If she wasn’t, is the PEO breaking the law? And why is the PEO privy to such information about how our startup employees use healthcare, except in the aggregate of the broader pool that includes all their customers?

We are a startup of maybe 10 employees around the country, based in CA, members slightly older in age than some other companies (30s/40s).

submitted by /u/para_blox
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