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Lawmakers Seek Clarification for Wellness Programs

By Wellsource, Inc.

Compare the fine print in the Affordable Care Act (ACA) about wellness provisions against the Americans with Disabilities Act (ADA), and you'll probably be left scratching your head about a few things.

  • Is it legal to make wellness programs mandatory?
  • Can you penalize employees who don't participate or meet certain benchmarks for good health?
  • Are there questions about personal health information that are off limits in a work setting?

Conflicting answers to these questions have plagued wellness programs since President Barack Obama signed the ACA into law in 2013. However, critics believe a coordinated effort to address the conflicting language of the ACA and the ADA is long overdue.

Preserving Employee Wellness Programs Act

However, the ACA does provide guidelines regarding employer-sponsored wellness programs. A string of lawsuits between consumer-advocate groups and employer-sponsored wellness programs prompted lawmakers to propose legislation to clarify the ACA's wellness program guidelines. Senator Lamar Alexander, R-Tennessee, recently introduced H.R. Bill 1189, S. 620, also known as the Preserving Employee Wellness Programs Act.

"This is a bill to clarify the rules relating to nondiscriminatory employer wellness programs," writes Alexander, "as such programs relate to premium discounts, rebates, or modifications to otherwise applicable cost sharing under group health plans."

The bill recognizes employer-sponsored wellness programs as an effective tool to promote health, prevent disease, and control healthcare costs. It also provides proposed guidelines regarding wellness program incentives, collection and privacy of personal health information, and compliance with existing laws like the Genetic Information Nondiscrimination Act and Americans with Disabilities Act.

If approved, the Preserving Employee Wellness Programs Act would provide:

  • More specific parameters permitting employers to offer financial incentives for wellness program participation.
  • Grant wellness program participation to spouses.
  • Allow employees up to 180 days to request an alternative wellness program, without penalties, if health or medical reasons prevent them from participating in the existing program.

Complaints Prompted Proposed Changes

Last year, consumer-advocate groups filed complaints with the Equal Employment Opportunity Commission regarding unfair practices regarding employer-sponsored wellness programs. In one case, the EEOC responded by filing a lawsuit against Honeywell International Inc. (EEOC v. Honeywell) for penalties imposed on employees who chose not to participate in the company's biometric screenings as part of its wellness program. Employees reported penalties as high as $2,000 for not participating, and said similar penalties applied to non-participation in a tobacco-testing program.

However, U.S. District Judge Ann Montgomery rejected the EEOC's claim and pointed to "uncertainty surrounding the legal questions at issue" based on conflicting wellness program guidelines found in the ACA and the ADA.

Future of Wellness Programs Looks Bright

From a political perspective, there are many unanswered questions about the function, scope, and legal limitations of employer-sponsored wellness programs based on current guidelines in the ACA. The Preserving Employee Wellness Programs Act is an attempt to try and clarify the ACA, and at the same time, maintain compliance with the ADA and other federal laws already in place.

However, there's no doubt that wellness programs will continue to serve as valuable interventions to combat rising healthcare costs, and increases in chronic diseases like obesity, diabetes, and heart disease. At the same time, these goals for employer-sponsored wellness programs need to be supported by legislation that is clear and not conflicting with existing disability laws. This is the goal behind HR. Bill 1189, which hopefully will prevent future lawsuits and remove uncertainties for employer-sponsored wellness programs.

Tags: Wellness Programs

"Good health is your greatest asset. You will never regret a decision to take better care of your health."

Don Hall, DrPH, CHES, Founder Wellsource

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