The U.S. Departments of Health and Human Services, Labor, and the Treasury have set rules for employment-based wellness programs. The rules:
- Support participatory wellness programs, which generally are available without regard to an individual’s health status and 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, without requiring them to take further action.
- Leverage workplace health promotion and prevention as strategy for reducing the burden of chronic illness, improve health, and limit growth of health care costs.
- Safeguard individuals against unfair underwriting practices that could otherwise reduce benefits based on health status.
- Outline standards for nondiscriminatory “health-contingent wellness programs,” which generally reward individuals who meet a specific standard related to their health. Examples include programs that:
- Provide a reward to those who do not use, or decrease their use of, tobacco, or
- Reward those 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 are designed to:
- Ensure flexibility for employers by increasing the maximum reward that may be offered under appropriately designed wellness programs, including outcome-based programs; and
- Protect consumers by requiring that health-contingent wellness programs be reasonably designed, be uniformly available to all similarly situated individuals, and accommodate recommendations made at any time by an individual’s physician based on medical appropriateness.
The rules take effect for plan years beginning on or after January 1, 2014.
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