Employer Wellness Programs are Validated

On Monday, May 16, 2016, the Equal Employment Opportunity Commission (EEOC) finalized rules regarding permissible elements of employer wellness programs. The EEOC published two rules, one of which amended agency regulations implementing Title II of the Genetic Information Nondiscrimination Act (GINA) and the second of which amended the agency’s regulations for implementing Title I of the Americans with Disabilities Act (ADA).
 
Both rules allow employers to continue to offer wellness programs and to offer limited incentives for wellness programs that are part of a group health plan, and ask questions about employees’ health or include medical examinations.
 
The final rules will go into effect in 2017 and apply to all workplace wellness programs, including those in which employees or their family members may participate without also enrolling in a particular health plan. Under the final ADA rule, wellness programs that are part of a group health plan can offer incentives of up to 30 percent of the total cost of coverage for an employee who answers questions about the employee’s health or participates in medical examinations. The final GINA rule says that the value of the maximum incentive that is attributable to a spouse’s participation in a wellness program cannot exceed 30 percent of the total cost of employee only coverage.
 
The GINA rule prohibits incentives in exchange for the current or past health information of employees’ children or in exchange for certain genetic information such as family medical history or the results of genetic tests.
 
GINA’s prohibition on the use of genetic information by employers to make employment decisions continues to be in effect as are the existing provisions of the ADA that prohibit discrimination on the basis of disability.
 
Both rules include confidentiality provisions to ensure that the wellness programs support the objective of good health and are not just used to collect or use sensitive medical information about employees and family members or to shift health insurance costs to them. Both the ADA and the GINA rules require wellness programs to be reasonably designed to promote health and prevent disease, according to the EEOC.
 
The effective date of the new rule is the first day of the first health insurance plan year that begins on or after January 1, 2017.
 
Wellness programs are becoming more popular as employers have to address rising health care costs. These rules will allow employers who wish to continue or implement employer wellness programs to do so.


This alert is provided as a service to our clients and firm associates. While the information provided in this publication is believed to be accurate, it is general in nature and should not be construed as legal advice.