EEOC Removes 30% Incentive Safe Harbor from Wellness Program Regulations

The Equal Employment Opportunity Commission (the “EEOC”) issued final rules, published in the Federal Register on December 20, 2018, that remove the 30% incentive provisions from the EEOC’s wellness program regulations governing the Americans with Disabilities Act (“ADA”) and the Genetic Information Nondiscrimination Act (“GINA”).  The final rules are effective January 1, 2019.  As a reminder, the ADA rules previously provided that a wellness program that asks questions about employees’ health or includes medical examinations is not voluntary if the incentive to encourage employee participation in the program exceeds 30% of the total cost of self-only coverage.  The GINA rules previously provided that an employer may not offer an incentive that exceeds 30% of the total cost of self-only coverage to an employee to encourage a spouse’s participation in a health risk assessment under a wellness program. Read More ›

Posted in Employee Benefits | Tagged , , , , ,

Share this Article:

New Plan Year, New Wellness Program – Some Things to Keep in Mind

As a follow-up to our recent blog Count Down to Open Enrollment – Some Quick Thoughts, below is a little more detail on how seemingly simple wellness program design changes can have significant legal consequences.

  • HIPAA – Employers feeling extra generous this plan year may want to increase their wellness program’s financial incentive.  It is important that such employers remain mindful of the limitations under HIPAA, i.e., 30% of the total cost of health plan coverage, or 50% for programs designed to prevent or reduce tobacco use.  As noted in our previous blog “Wellness Rules Under the ADA – Will There Ever Be Certainty?
Read More ›
Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , , , , , ,

Share this Article:

Count Down to Open Enrollment – Some Quick Thoughts

As open enrollment approaches for the 2019 calendar year, below are some items employers may want to consider:

  • Wellness program changes – Many employers change their wellness programs during open enrollment.  This is a reminder that even small changes to a wellness program may have significant consequences.  For example, if an employer increases wellness rewards, it may impact not only whether a program complies with the 30% test under HIPAA but it may also impact affordability under Code Section 4980H.  Making changes to a wellness program structure may also create problems.  For example, employers with tobacco surcharges might allow people to avoid surcharges by attesting that they do not use tobacco. 
Read More ›
Posted in Health & Welfare Plans, Health Care Reform | Tagged , , , , , ,

Share this Article:

Wellness Rules Under the ADA – Will There Ever Be Certainty?

We previously blogged about the EEOC’s final rules, published in the Federal Register on May 17, 2016, that explain how the Americans with Disabilities Act (“ADA”) applies to employer sponsored wellness programs. These rules clarified when an employee health program, which includes a disability-related inquiry or medical examination, is considered “voluntary” under the ADA.  The EEOC’s rules stated, amongst other things, that an employer may offer incentives for employees who participate in a wellness program as long as the incentive does not exceed 30% of the total cost of self-only coverage.

We also previously blogged that this incentive provision was under scrutiny by the U.S. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , ,

Share this Article:

Wellness Incentives Under Scrutiny After District Court Decision

In the most recent updates to the AARP v. EEOC wellness case (AARP v. EEOC, D.D.C., No. 1:16-cv-02113), the District Court for the District of Columbia has ordered the Equal Employment Opportunity Commission (“EEOC”) to review the wellness regulations related to the Genetic Information Nondiscrimination Act (“GINA”) and the Americans with Disabilities Act (“ADA”) with respect to the amount of incentives that an employer may provide under a wellness program.

The ADA and GINA both permit the collection of certain health information by an employer so long as the disclosure is “voluntary.” However, neither the ADA nor GINA provides a definition of what is considered “voluntary.”  In May of 2016, the ADA and GINA wellness regulations were finalized and provide, in relevant part, that a wellness program can offer incentives or penalties of up to 30% of the cost of self-only coverage. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , ,

Share this Article:

Open Enrollment Looms and ACA Changes are Uncertain – What are Employers to Do?

On the morning of July 28, 2017, another effort to repeal or replace the Affordable Care Act (“ACA”) failed in a 49-51 Senate vote when three Republican senators voted against the bill. Attempts to pass even a trimmed down “skinny” version of the bill were unsuccessful.  Following this dramatic vote, the path forward for health care reform is as uncertain as ever.

With fall open enrollment fast approaching, employers may be wondering what actions to take with respect to their health plans. Given the uncertainty of whether changes will be made to the ACA before open enrollment, employers may wish to proceed as though the ACA will remain in effect for 2018. Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , , , , , , , , ,

Share this Article:

EEOC Final Rules on Wellness Programs and the ADA – Worth the Wait?

On May 16, 2016, the EEOC issued final rules that explain how the Americans with Disabilities Act (“ADA”) applies to employer sponsored wellness programs.   Although some may welcome the guidance, others may be frustrated because the rules are somewhat inconsistent with the rules under HIPAA, inconsistent with the court decisions under Seff v. Broward County, 691 F.3d 1221 (11th Cir. 2012) and EEOC v. Flambeau, Inc., 131 F. Supp. 3d 849 (W.D. Wis. 2015), and do not ensure compliance with other federal nondiscrimination laws (e.g., Title II of GINA or other Sections of Title I of the ADA). Read More ›

Posted in Employee Benefits, Health & Welfare Plans, Health Care Reform | Tagged , , , , , , , , , , , ,

Share this Article:

A Wellness Win for Employers, But Will it Last?

As explained in our April 21, 2015 and May 9, 2015 blog posts, wellness programs that are part of a group health plan are subject to the HIPAA nondiscrimination rules, and other state and federal laws including, but not limited to the ADA, Title VII of the Civil Rights Act, and GINA.   Navigating the regulatory maze has been a challenge for employers, and the most recent struggles involve compliance with the ADA’s “voluntary” requirement. On December 30, 2015, the Federal District Court for the Western District of Wisconsin in Equal Employment Opportunity Comm’n v. Flambeau, Inc., bypassed the ADA’s voluntary rule and held that Flambeau’s wellness program complied with the ADA under an alternative exception –  the ADA’s safe harbor. Read More ›

Posted in Employee Benefits, Health & Welfare Plans | Tagged , , , , , , , , , ,

Share this Article:

EEOC Proposed Regulations May Require Revisions to Your Tobacco Prevention Wellness Program

In our April 21 blog, Wellness Programs: Agencies Issue Helpful Guidance but Look Before You Leap, Nancy Campbell wrote about the release of the much-anticipated EEOC proposed regulations concerning wellness programs.  In her blog, Nancy briefly touched upon some of the differences between the EEOC proposed regulations and the final HIPAA wellness regulations issued by the Departments of Treasury, Labor, and Health and Human Services on June 3, 2013.

One of the most noteworthy differences between the two regulations is the treatment of the maximum permissible reward that employers can offer to employees under wellness programs designed to prevent or reduce tobacco use.  Read More ›

Posted in Employee Benefits, Health & Welfare Plans | Tagged , , ,

Share this Article:

Wellness Programs: Agencies Issue Helpful Guidance but Look Before You Leap

Recent studies indicate that wellness programs significantly improve the health of workers.  If only it were so easy to implement a wellness program . . .

As explained in our July 17, 2013 Benefits Update – Final Wellness Rules May Require Review of Existing Wellness Programs, final HIPAA wellness regulations were issued by the Departments of Treasury, Labor, and Health and Human Services (the “Departments”) on June 3, 2013 and apply to employer-sponsored group health plans for plan years beginning on or after January 1, 2014.  Wellness programs that are part of a group health plan must comply with the HIPAA wellness regulations, but additionally must comply with other provisions of state or federal law including, but not limited to the ADA, Title VII of the Civil Rights Act, and GINA. Read More ›

Posted in Employee Benefits, Health & Welfare Plans | Tagged , , , , ,

Share this Article: