Multiple Agencies Release Guidance on Wellness Programs
by American Fidelity Assurance Company
Workplace wellness programs must comply with a complex set of rules including the Patient Protection and Affordable Care Act (ACA), the Americans with Disabilities Act (ADA), the Genetic Information Nondiscrimination Act (GINA), and the Health Insurance Portability and Accountability Act of 1996 (HIPPA). On April 16, 2015, the Equal Employment Opportunity Commission (EEOC) released proposed regulations addressing application of the ADA to workplace wellness programs. Additionally, the Departments of Labor (DOL), Health and Human Services (HHS), and the Treasury (the Departments) released three set of FAQs regarding wellness programs, HIPAA privacy/security, and the ACA’s market reforms, as well as a research report on workplace wellness programs.
The proposed EEOC guidance makes it clear that the ADA is applicable to employer-sponsored wellness programs if the program includes disability-related inquiries or medical examinations. One example would be requiring employees to complete a health risk assessment or biometric test in order to earn a wellness incentive. Under the proposed EEOC rules, wellness programs must be voluntary. It is not permissible to require employees to participate or to take any adverse action for failure to participate. Wellness programs must also be reasonably designed to promote health or prevent disease, and incentives for participation in the wellness program may not exceed 30 percent of the total cost of employee-only coverage. The proposed regulations clarify that the 30 percent maximum applies to both health contingent wellness programs and participatory wellness programs that include disability-related inquiries or medical examinations.
The Departments of HHS, Labor, and Treasury FAQs reinforce previously released wellness program guidance. Additionally, the HHS Office for Civil Rights (OCR) issued guidance on HIPAA privacy and security rules applicable to workplace wellness programs.
All of these regulations suggest that wellness programs should be designed carefully and with these new regulations in mind. Please visit our website at HCReducation.com for additional information on wellness programs, and links to the new federal guidance or call our Health Care Reform hotline at 877-302-5073 if you have specific questions you would like answered.
American Fidelity Assurance Company's Patient Protection and Affordable Care Act VIP Notification. For details on this and other ACA related topics, visit our site