Effective for plan years beginning on or after Jan. 1, 2014
As part of federal healthcare reform, the U.S. departments of Health and Human Services, Labor, and the Treasury have issued final rules on employment-based wellness programs. The rules support workplace health promotion and prevention as a means to reduce the burden of chronic illness, improve health, and limit growth of healthcare costs while ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status.
The final rules continue to support participatory wellness programs, which generally are available without regard to an individual's health status. These include programs that reimburse for the cost of membership in a fitness center; provide a reward to employees for attending a monthly, no-cost health education seminar; or reward employees who complete a health risk assessment.
The rules also outline standards for nondiscriminatory health-contingent wellness programs, which generally reward individuals who meet a specific standard related to their health. Examples of health-contingent wellness programs include those that provide a reward to employees who achieve a specified health-related goal, such as a specified cholesterol level, weight, or body mass index, as well as those who fail to meet such goals but take certain other healthy actions.
The rules also ensure flexibility for employers by increasing the maximum reward that may be offered under appropriately designed wellness programs, including outcome-based programs. The final rules also protect consumers by, among other things, requiring that health-contingent wellness programs be reasonably designed, are uniformly available to all similarly situated individuals.