Employer-sponsored wellness programs changes coming your way.

• Author: Curtice, Melanie K.
• Position: Legal Speak

If you provide incentives to encourage employees to participate in wellness programs, such as discounting the cost of the medical insurance coverage for being tobacco-free, changes may soon be necessary as a result of the US Equal Employment Opportunity Commission (EEOC) proposed rules that were issued on April 20, 2015. While it is true these rules are in proposed form, we recommend that employers review their current wellness program offerings to determine whether any changes would be necessary if the proposed rules are finalized. In particular, employers should review how employees are notified of the program, the health information privacy protections that are in place, and how much of an incentive is provided. The period to comment on the proposed ended on June 19,2015, and EEOC has indicated that it will finalize the rules following evaluation of the comments. This likely means the rules will be finalized before the end of this year.

What Is an Employer-Sponsored Wellness Program?

Wellness programs take a variety of forms, ranging from payment for health club dues or informational brochures about health or prevention to complex programs that give medical insurance cost reductions to employees if they participate in health risk assessments, coaching or consultation with case managers or nutritionists, or achieve some health-related outcome such as lowering their cholesterol. No matter the type of program, the goals are generally the same: to improve health, build workforce morale, and reduce health insurance costs. Regardless of the type of program, it is important to remember that various laws apply to them; one of those laws, the Americans with Disabilities Act (ADA), will be impacted by the EEOC proposed rules that change existing ADA regulations. It is also important to remember that compliance with one law does not necessarily mean compliance with other applicable laws: each wellness program feature must be analyzed under each law.

What Are the Main Laws that Apply to Wellness Programs? HIPAA: Under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), medical plans, referred to by all of the laws as "group health plans," are prohibited from discriminating against an individual (e.g., charging a different premium for health coverage) based on a health status-related factor, such as a physical or mental condition. However, group health plans that contain programs of "health promotion and disease prevention,"...