McAfee & Taft employee benefits attorney Brandon Long was interviewed by The Oklahoman about employer-sponsored wellness programs designed to improve the overall health and fitness of their workforces. While some employers use incentives to encourage employee participation in wellness programs, others use financial penalties. Earlier this month, the Equal Employment Opportunity Commission issued proposed regulations stating that employers, with some restrictions, can continue to assess financial penalties — up to 30 percent of the total contributions for employee-only health coverage — as a way to improve employee participation in various types of wellness programs.
“It’s important to remember that, under HIPAA (Health Insurance Portability and Accountability Act) and the ACA, the 30 percent (or 50 percent with tobacco use) limit doesn’t apply to participation-only programs, or ones that provide a reward to employees who complete a health-risk assessment regarding current health status without any further educational or other required action,” said Long. “The limit only applies to health-contingent activity or outcome-based wellness programs.”
He explained that while an activity-only program must allow a reasonable alternative standard or waiver for any individual who may have a medical condition that prevents them from participating in the activity, an outcome-based program must allow a reasonable alternative standard or waiver, regardless.