Wellness programs can take on many shapes but some of the most typical features include: health-risk assessments and screenings for high blood pressure and cholesterol; behavior modification programs that encourage weight management and exercise and discourage tobacco use; health education programs or materials; and changes in the work environment or increase the availability of special benefits such as subsidized health club memberships.
Although most wellness programs are voluntary, employers often offer incentives for those who participate in the program. These incentives can be anything from t-shirts and gift cards to offering a reduction in insurance premiums or deductibles. Some companies are also penalizing those who do not participate or fail to meet a company’s health standards. According to Aon Hewitt’s annual health care trends survey “nearly 600 large U.S. employers say they either already use or plan to use financial penalties over the next three to five years for employees who do not participate in certain health improvement programs. Of those companies using or planning to use penalties, the majority (81 percent) say they will do so through higher benefit premiums; increasing deductibles (17 percent) and out-of-pocket expenses (17 percent).” But before you penalize those who do not partake in your wellness program, be sure your program does not violate any federal or state laws.
Almost all employee wellness programs will be measured against numerous federal and state laws so it is your job to be aware of these laws before implementing or boosting your wellness program.
Health Insurance Portability and Accountability Act (HIPPA)
HIPPA was established in order to protect the privacy of personal health information. It also restricts employers from sharing employee medical records and limits how that information may be used. HIPPA also requires equal opportunity for wellness program eligibility and incentives.
Genetic Information Non-Discrimination Act(GINA)
Under GINA, it is unlawful to discriminate against employees or job candidates based on genetic information, including family medical histories. Employers may not request or require employees from disclosing their genetic information. However, employers may use genetic information that was voluntarily provided by the employee only for the purpose of guiding that individual into an appropriate disease management program. If financial incentives for participation and/or for the achievement of certain health outcomes are offered, the program must be open to every employee even to those with current health conditions and/or those whose lifestyle choices puts them at increased risk of developing certain conditions.
American with Disabilities Act (ADA)
The ADA prohibits employers from asking employees and potential employees disability-related questions unless the questions are job related, meaning, can the individual perform the functions of the job with or without reasonable accommodations. Employees may voluntarily participate in health assessments but employers cannot punish or penalize employees who do not participate.
Age Discrimination in Employment Act (ADEA)
The ADEA makes it unlawful to discriminate against employees or potential employees based on age. It applies to workers 40 years old and over. To be in compliance with ADEA, your wellness program should not require older workers to hit a certain level or score and should accommodate the reasonable expectations of older workers.
This past July a coalition of six heath care organizations came together to provide guidance to those who are looking to offer incentives for participating in wellness programs. Below are ten of those tips.
- Consider the four biometric target categories of weight, cholesterol, blood pressure and tobacco when implementing your plan.
- Keep mind of the potential financial and time burdens for employees when determining standards.
- Be sure that your plan does not place a greater economic burden on one race, ethnic group or other group of employees.
- Design a plan with reasonable goals (preferably individualized to the employee) rather than ideal targets applied to all employees.
- Offer (as required by law) a reasonable alternative standard to employees for whom it would be unreasonably difficult to achieve a health standard due to a medical condition.
- For these employees, defer to the employee's health care provider for setting and achieving a reasonable alternative standard or providing a waiver.
- Provide all employees with options for attaining the incentive, rather than only offering options to those employees with a medical circumstance.
- Do not set a reward or penalty that is so large it discourages health plan enrollment, denies coverage, or creates too heavy a financial penalty on individuals who do not satisfy the standard.
- Reward employees for the progress they’ve made in attaining the goal, not just rewarding employees who meet the goal.
- Help sustain healthy behavior changes over time by introducing strategies that encourage employees to integrate healthy behaviors in their personal lifestyles.
With health care costs on the rise, it is crucial for employers to set programs that help employees attain and maintain a healthier lifestyle. According to a report by the International Foundation of Employee Benefit Plans, A Closer Look: Wellness ROI, “most North American employers that have analyzed the return on investment (ROI) of their wellness programs have found $1 to $3 decreases in their overall health care costs for every dollar spent.” Although there are still questions over the effectiveness of wellness programs over the long run, employers should continue to experiment with and perfect the best ways to incorporate wellness programs into their own organization. Concern yourself with the overall well-being of your employees and overtime, you may find that your program also benefits the company’s bottom line.