As you may recall, the U.S. Equal Employment Opportunity Commission (EEOC) had not clarified its position on employer-sponsored wellness programs. In fact, several lawsuits were filed by the EEOC against employer-sponsored wellness programs (e.g., the Honeywell suit). The pushback was based on the Title II of the Genetic Information Nondiscrimination Act of 2008 (GINA). On October 29, 2015 the EEOC issued proposed rules which would amend Title II of GINA as they relate to wellness programs that are part of health plans. Comments on the proposed rules were accepted through the end of 2015. In short, the proposed amendments to GINA are favorable and show that the EEOC does not want to be an impediment to wellness programs. The following changes, in part, are proposed to GINA: A key proposed change in GINA involves incentivized wellness programs. The changes would [...]
The Equal Employment Opportunity Commission (EEOC) recently issued final rules that clarify the application of Title I of the Americans with Disabilities Act (ADA) and Title II of the Genetic Information Nondiscrimination Act (GINA) to employer sponsored wellness programs. These rules were put in place to define what constitutes a “voluntary” health program, and determine the extent to which employers may offer incentives to employees and spouses participating in these programs. These rules do not countermand the Department of Labor (DOL) and/or Health and Human Services (HHS) regulations regarding Health-Contingent Wellness Incentives (i.e. “reasonable alternative standards” and required annual screening opportunities). General Considerations: Title I of the ADA prohibits employers from discriminating against individuals on the basis of disability, and restricts employers from routinely obtaining medical information from applicants and employees. However, Title I does allow employers to make inquiries [...]
David T. Andrews, Attorney for Day Ketterer The threshold issue to determine whether ERISA applies to a wellness program is whether the wellness program rises to the level of a “Group Health Plan.” ERISA defines a Group Health Plan as “an employer-sponsored welfare benefit plan to the extent that the plan provides medical care (…including items and services paid for as medical care) to employees or their dependents directly or through insurance or otherwise.” Many common wellness program initiatives will cause a wellness plan to become a Group Health Plan subject to ERISA, including health risk assessments that provide advice and counseling, employer-paid immunizations and employer-paid biometric screenings (i.e., blood pressure screening, BMI, cholesterol, etc.). In addition, a wellness program can become a Group Health Plan by becoming linked to a Group Health Plan, such as by rewarding employees for [...]
Frank C. Morris, JR for The National Law Review ________________________________________ Improved Employee Health and Reduced Health Care Costs The U.S. Department of Labor has proclaimed that “the Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces.” Employers have embraced wellness programs as a way to improve employee health, enhance productivity, and control health care costs over time. The extent of that embrace is shown in a 2014 Kaiser Family Foundation & Health Research and Educational Trust annual survey of employer-sponsored health benefits. The survey found that 94 percent of employers with over 200 employees, and 63 percent of smaller employers now sponsor some form of wellness program. The positive benefits of wellness programs were also discussed at a January 29, 2015, hearing of the [...]
Frank C. Morris, JR for the National Law Review On April 16, 2015, the Equal Employment Opportunity Commission (“EEOC”) released its highly anticipated proposed regulations (to be published in the Federal Register on April 20, 2015, for notice and comment) setting forth the EEOC’s interpretation of the term “voluntary” as to the disability-related inquiries and medical examination provisions of the American with Disabilities Act (“ADA”). Under the ADA, employers are generally barred from making disability-related inquiries to employees or requiring employees to undergo medical examinations. There is an exception to this prohibition, however, for disability-related inquiries and medical examinations that are “voluntary.” All comments regarding the proposed regulations must be submitted within 60 days from April 20, 2015, which is June 19, 2015. Employers should have considerable interest in submitting comments, especially as those hostile to wellness programs will surely [...]
Who To Watch in Health Care: What Are Some Of The Most Significant Challenges in Health Care Going Forward?
Crain’s Cleveland Danny Williams, executive director, The Free Medical Clinic of Greater Cleveland I believe three of the most significant challenges in health care today are: Finding a message that helps build a consensus around the idea that access to health care should be viewed as a basic human right, in much the same way as we view access to clean air and clean water. Adjusting the system for paying for health care from one tied to procedures performed to one focused on outcomes achieved for patient populations. Increasing the incentives to encourage more health care providers to pursue careers in primary health care to better serve the growing population of individuals suffering from a growing range of chronic diseases and conditions. Steffany Larkins, executive vice president, chief of staff, diversity officer, Medical Mutual of Ohio I believe that lack [...]
United States Department of Labor Wellness Programs On June 3, 2013, the Departments issued final regulations regarding nondiscriminatory wellness programs in group health coverage under PHS Act section 2705 and the related provisions of the Employee Retirement Income Security Act (ERISA) and the Code. The final regulations increase the maximum permissible reward under a health-contingent wellness program offered in connection with a group health plan (and any related health insurance coverage) from 20 percent to 30 percent of the cost of coverage, and further increase the maximum permissible reward to 50 percent for wellness programs designed to prevent or reduce tobacco use. The final regulations also address the reasonable design of health-contingent wellness programs and the reasonable alternatives that must be offered in order to avoid prohibited discrimination. In the preamble to the final regulations, the Departments stated that they anticipated [...]
The Affordable Care Act (ACA) has brought many changes to the health benefits system, with more to come. Please join us for an informational seminar so we can help guide you through the new healthcare laws. The importance of wellness as it relates to health care reform will also be reviewed. WHEN: Wednesday, May 29 at 9:00am WHERE: Solon Community Center 35000 Portz Parkway Solon, OH 44139 ***Please R.S.V.P at 216-378-9969 (with number that will be attending) by Thursday, May 23rd. Refreshments will be served, we hope you can attend!! We are happy to be part of the Solon business community. EGP is celebrating it’s 24th year in Solon. S&S Benefits and BeWell Solutions are both celebrating their 1st year in Solon!
U.S. Department of Health & Human Services Because of the Affordable Care Act, the 86% of Ohioans who have insurance have more choices and stronger coverage than ever before. And for the 14% of Ohioans who don’t have insurance, or Ohio families and small businesses who buy their coverage but aren’t happy with it, a new day is just around the corner. Soon, the new online Health Insurance Marketplace will provide families and small businesses who currently don’t have insurance, or are looking for a better deal, a new way to find health coverage that fits their needs and their budgets. Open enrollment in the Marketplace starts Oct 1, with coverage starting as soon as Jan 1, 2014. But Ohio families and small business can visit HealthCare.gov right now to find the information they need prepare for open enrollment. The health care [...]
Sue Reid for Solon Times City council’s finance committee approved preparing legislation last week to accept the proposal of Be Well Solutions, a Solon company, as third-party administrator of an employee wellness program. The cost to Be Well Solutions for the one-year contract is $25,850. The city interviewed five companies of 10 proposals it received, with Be Well Solutions believed to be the “best fit” for the city and its culture, Human Resources Coordinator Jessica Vest told the committee. The fee proposal, which is an estimate, is based on the number of expected participants and includes biometric screenings, health risk assessment, coaching, incentive tracking and on-site presentations, among other services. The hope is to expand the program to cover all the city’s 283 employees and their spouses, Ms. Vest said. “Wellness programs have been gaining popularity over the last [...]