Wellness is an employer hot topic, the fire fueled, no doubt, by the recent federal ruling from AARP v. EEOC where the court vacated portions of the EEOC’s rule regarding wellness program incentive limits. Before the decision, EEOC rules permitted an employer to impose a penalty of up to 30% of the cost of medical coverage if an employee or spouse refused to complete health-related medical tests or questionnaires. The AARP felt this penalty was inconsistent with the meaning of the term “voluntary” in the context of wellness program participation…and the court agreed.
There’s been little guidance issued regarding next steps, leaving many employers with incentive-based wellness programs thinking, “Now what?!”
So, what now? Well, let’s look at the basics. Employers offer wellness programs for various reasons, most often to address rising health care costs. Thought leaders now use “wellbeing” where once “wellness” was the buzzword. What is wellness? Is it different from wellbeing?
Well…the dictionary defines wellness as “(1) the state of being healthy in body and mind…especially because of effort; or (2) an approach to healthcare emphasizing illness prevention and prolonging life.” Wellbeing is defined as “a good condition of existence; a state of…happiness.” Based solely off these two definitions, it appears wellbeing may encompass wellness.
What can you do to shore-up your existing wellness programs?
- Inventory your current wellness programs to verify whether they qualify as group health plans (by providing “medical care”). If a wellness program provides medical care, then it’s likely it’s considered a group health plan and therefore most of the laws applicable to medical plans likely apply to your wellness program. Laws include: HIPAA, ERISA, COBRA, ACA, GINA and ADA!
- If you determine your wellness program is a group health plan, evaluate the amount of incentive, if applicable, and determine if a change is warranted. At present, the “jury’s out” with respect to whether employers should modify incentive-based program Such a decision should be made after careful review with business leaders, benefits advisers, and legal counsel.
- Last, ensure your wellness program administrative functions are tight and transparent. Take a fresh look at how you communicate wellbeing programs to your employees. Review HIPAA Privacy and Security guidelines, especially if your programs collect PHI. Leave no room for interpretation with respect to how an employee’s PHI is protected and may be used. This means shoring-up privacy and security manuals, provider agreements, and program marketing materials.