I wonder what's inside my jeans. Oh, correction, that would be genes. With the recent release of the final rule of the Genetic Information Non-Discrimination Act, it makes me wonder.

If I took a test, and it revealed that a family member or I had some sort of disorder, would there be a little insurance gremlin behind a computer database somewhere, stamping my name with a big fat red "G" and politely placing me in a high-risk category?

I thought that HIPAA was intended to protect my health information and keep it confidential for only those that needed to know. I guess I was wrong. The folks at The Coalition for Genetic Fairness must think otherwise, since their Web site states that over 500 organizations joined their voice to stop unfair discrimination in this arena. What about self-insured employer fairness? Pardon me, but we were kicked to the curb.

In the Library of Congress, I looked up and read the words of Louise M. Slaughter, in the House of Representatives, when she made an introductory speech on January 16, 2007 on GINA. She pointed out how individuals had been discriminated against in the 1970s, 1998, and in 2000 a railroad starting doing genetic testing without employee consent.

Okay, so there was a real problem. Does this still exist today, nine years later? I've surveyed several colleagues and searched the Internet to find the GINA Gnomes and have come up short.

You see, the final rules point out that if you have a mandatory health risk assessment process, even if it's after the individual is enrolled, you can't ask anything about family history because this is deemed genetic information.

And don't forget the delightful public comment from the EEOC in August of this year. In its opinion, if an employer is asking for health-related information in a health risk assessment or wellness program, the EEOC believes it violates the ADA if it's mandatory. Oh, I'm sure that chaps the hide of the underground employer group who meets in the dark basement of a restaurant on the shifty side of town and talks about ways they can discriminate, retaliate, and stick it to their employees.

If there were ever a group, I guarantee youd that I wouldn't be involved and certainly don't know a soul who would. But I guess the EEOC thinks they are out there.

Employers work hard

This stuff makes me grumpy. Employers have been working aggressively for years trying to make a difference in the way people view wellness.

Dr. Dee Edington from the University of Michigan forged the path when he told us that we needed to get involved in our employees' health. We were told to become aggressive with the data and to be clinically proactive to keep them from getting worse.

Disease management efforts have evolved from ineffective postcard reminders in the mail to actual integrated systems of nurses who politely nag diabetics to take their medication.

Huge sums have been invested in insurance provider systems attempting to streamline those that need help sooner rather than later. Everyone is coming up with solutions to our problems. All these efforts have shown to reduce costs for employer health plans, yet these recent decisions have stomped our efforts to the ground.

If you've been one the bright employers that has implemented a mandatory wellness program or health risk appraisal to improve health or increase disease management, hats off to you. Now you'll need to change that hat to a helmet as you've entered a minefield of legal danger zones.

Don't give up

There's always a way around anything, and the proponents of reducing health care costs for employers in this country won't give up. I'm sure they'll eventually figure out a way to modify their attempts at goodness. Perhaps they will figure out new questions to ask or provide new employer guidelines.

These complications, or hiccups, will more than likely result in creative solutions. I remember when I was faced with what seemed to be an impossible situation. I had 1,400 employees who needed open enrollment meetings in one 22-foot tin trailer.

The courteous invite to piggy-back on 50+ safety meetings with a generous allotment of 10 minutes didn't sit well with me. Just when I thought my open enrollment was going to be a disaster, the cream rose to the top. The big top that is. We rented a large heated tent in the parking lot and employees strolled in and out on their own terms. It was a huge success, but only after I was faced with adversity.

Employers won't give up. Proactive carriers and providers won't give up. Don't give up. These may be setbacks, but they are only temporary, and I'm hopeful the system will work itself out. I know it will. After all, I feel it in my jeans.