Wellness is a big issue for everyone. Both individual Americans and the businesses they work for benefit when wellness issues are being addressed on a regular basis. As a result, many workplaces are offering wellness incentive programs to promote good health among their workers. Federal regulations help insure that these programs don’t discriminate against those who have a specific health status or disability.
Understanding Wellness Programs
Workplace wellness programs promote employee health and productivity, while also reducing the amount of money spent on health-related issues through the insurance plan. These programs are different depending on the employer, but studies show that about 20 percent of them offer a financial incentive for wellness activities.
Wellness programs must be voluntary, and can offer participants discounts on health insurance premiums, deductibles, and copayments. Regulations that protect the privacy of health information also apply to wellness programs.
Wellness can be measured in a number of ways. Some programs offer incentives for getting a physical and signing a document that you won’t smoke. Others are more comprehensive, giving insurance discounts to those who meet certain health conditions, such as a normal healthy weight or normal blood pressure measurements. Still others offer rewards for those who attend health and wellness classes offered by the company.
However, it’s important to make sure that those with existing chronic health issues, as well as those with disabilities, are not unfairly discriminated against in these programs. Those with existing health issues and disabilities should be able to earn the incentive in different ways.
First, the financial reward is limited. The maximum reward that can be offered is 30 percent of the total cost – both employer and employee portion combined – of the self-only insurance plan. This can be extended to 30 percent of the total cost of the family plan if spouses and dependents are eligible to participate in the wellness program. For wellness programs designed to prevent or reduce tobacco use, the maximum reward may be up to 50 percent of the total cost of coverage.
Second, programs must be reasonably designed to promote health and prevent disease. This means the program must have a separate, reasonable way to qualify for the reward for those who don’t meet the standard based on health measurements. This could mean that those who don’t meet a height/weight standard could still get the reward by attending a wellness class. The program must have a reasonable chance of improving health and not be overly burdensome for participants.
Third, the program must be designed to be available similarly situated individuals who need alternate arrangements. This means that employees who are disabled or otherwise medically cannot participate should have some way of also earning the reward.
Fourth, employees must receive notice that there are alternate ways to qualify for the reward. This needs to be presented in clear language in increase the likelihood of participation.
Finally, the reward from the program must be available at least annually.
The American with Disabilities Act (ADA) has more simplified guidelines of preventing discrimination, stating only that the employer “may not require participation nor penalize those that don’t participate.” This has led to some confusion for employers who offer financial incentives according to the ACA rules. The Equal Employment Opportunity Commission (EEOC) has recently proposed new rules to bring the rules in line with each other.
Wellness is very important to both employees and employers. Understandably, employers want to be able to offer voluntary wellness programs to staff, and to have significant enough rewards to encourage participation. However, it’s important that these programs also recognize those who cannot participate in the usual way, and offer alternatives.
For information on the ACA’s role in changing insurance options in the workplace and the Employer Mandate, read an article that discusses how Employers May Require Staff to Enroll in Insurance.