4 Principles to Understand Wellness Regulations

by | Jan 13, 2014 | Miscellaneous

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As various laws covering health care, wellness, employee rights, privacy and more, how can HR benefits administrators and employees make sense of the rules?

CommonHealth spoke with David Wilson, a partner at Hirsch Roberts Weinstein and an expert on wellness law, to parse all the legalese into a few principles that might be most useful to employees.” Employers also should take note:

  • “Incentives, not penalties: A wellness plan is legal if it creates incentives for participation instead of penalizing an employee for not participating. A wellness program is considered voluntary as long as an employer neither requires participation nor penalizes employees who do not participate.”
  • “Avoid specific standards: To comply with the ADA, both voluntary and mandatory wellness programs should refrain from requiring the employee to achieve any specific health standard. The law bans discrimination based on health factors like health status, genetic information, medical condition, medical history and disability.”
  • “But the plan can use standards if…The reward is (for now) less than 20% of the total cost of coverage. The wellness program is ‘reasonably designed' to promote health. It gives employees a chance to qualify for the reward at least once a year. It allows a ‘reasonable alternative standard' to anybody for whom it is unreasonably difficult due to a medical condition, or medically inadvisable, to satisfy the initial standard. The employer may also choose to waive the standard for an employee who shows good cause. And it discloses that alternative standard in all wellness materials.”
  • “When it’s mandatory: Employers may also have a mandatory wellness plan under certain circumstances… If a mandatory program requires an employee to achieve a certain health standard, that standard should account for and be adjusted for age.”

Written By Laura McKenzie

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