Workplace Wellness Programs: A Summary of the New Regulations

by | Aug 1, 2016 | Blog

  • Amy Letke

    Amy Newbanks Letke, SPHR, GPHR, is the Founder of Integrity HR, Inc. Amy provides workplace solutions to improve performance, reduce liability and increase profits. She is passionate about helping other entrepreneurs and business owners achieve success. Contact us for more insights - 502-753-0970 or info@integrityhr.com

Workplace Wellness Programs can be complicated. To keep you compliant, here’s a summary of the new regulations that may impact your company’s wellness program.

Recently, laws were passed that have changed various facets of wellness programs. The Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) apply to wellness programs offered by employers that request health information from employees and their spouses. These two laws set out guidelines on how workplace wellness programs can comply with the ADA and GINA regulations, consistent with current wellness program laws – the Health Insurance Portability and Accountability Act (HIPAA) and the Affordable Care Act (ACA).

Boiled down, here’s the deal – All of these different laws have intertwined and are changing how companies and employees approach their wellness programs. Rather than wading through all the technical jargon, we’ll give you some insights and tips on how to be compliant with the workplace wellness program changes.

What Are Workplace Wellness Programs?

Many companies offer wellness programs to encourage their employees to maintain healthier lifestyles and prevent disease. These wellness programs often use medical questionnaireshealth risk assessments, or biometric screenings to determine an employee’s health risk factors.

Such factors could include:

  • Body weight
  • Cholesterol
  • Blood glucose
  • Blood pressure levels

Some of these programs offer financial and other incentives for employees to participate or to achieve certain health outcomes.

A Summary Of The New Regulations That Impact Your Workplace Wellness Programs

If an employer is providing a voluntary wellness program, both laws enable employers to ask health-related questions and conduct medical examinations, such as biometric screenings, to determine risk factors.

  1. Spousal Coverage. If both an employee and spouse are asked to complete a biometric screening and/or health risk assessment, then the premium discount is capped at 60% of the cost of single-employee coverage under the employer’s least expensive medical plan.
  2. Incentives. The ADA cap includes both financial and in-kind incentives. An example of this could be gift cards, as well as financial savings.
  3. Tobacco-Related Incentives. Under the ADA, the higher cap of 50% only applies to tobacco-related incentives. This is where the employee is only asked to state whether he or she is a tobacco user. If the wellness program tests for tobacco use based on a biometric screen or medical exam, then the lower 30% cap must apply for purposes of the ADA.
  4. Benefits For Transgender Employees. The new regulations also make it difficult for a group to exclude benefits for transgender employees, if they so desired. This is as of the first plan year, beginning on or after January 1, 2017.

In addition, no incentives are allowed in exchange for the current or past health status information of employees’ children or for specified genetic information (such as family medical history or the results of genetic tests) of an employee, an employee’s spouse, and an employee’s children.

Please be aware of the adoption deadline. Employers must adopt the new regulations as of their first renewal on January 2017 or after. These changes will go into effect in 2017, applying to all workplace wellness programs.

Not sure how to notify people about the changes resulting from ADA and GINA? Here’s a sample notice letter that you can fill out and get guidance from.

Wellness programs can be complicated, so don’t try to deal with all of these new rulings alone. Integrity HR has a variety of HR services right at your fingertips. Contact us today for more information.

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