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Final rules cap wellness plan incentives at 30%


Employers can offer incentives worth up to 30% of premium costs to encourage employees and their spouses to provide health information as part of an employer-sponsored wellness program.

The incentive cap was formally set May 16, when the EEOC issued final rules interpreting how the ADA and the Genetic Information Nondiscrimination Act (GINA) are affected by the wellness program provisions of the Affordable Care Act.

The two rules also spell out how employees who provide health information through a wellness plan are protected against discrimination.

 Online resources  The EEOC has published extensive guidance on how the final rules interact with both the ADA and GINA:

Advice: If you offer a wellness program that solicits health-related information from employees and their spouses, discuss these final rules with your attorney and your wellness plan provider.

That’s especially important if your wellness program uses medical questionnaires, health risk assessments or biometric screenings to determine health risk factors such as body weight and cholesterol, blood glucose and blood pressure levels.

The ADA and GINA generally prohibit employers from obtaining and using information about employees’ own health conditions or about the health conditions of their family members, including spouses. However, the Affordable Care Act carves out limited exceptions, addressed by the two new final rules.

To prevent discrimination against participating employees, the ADA and GINA rules state that wellness programs may only disclose aggregated data to employers, not information on specific employees. The rules require employers to give employees a notice that tells them what information will be collected as part of the wellness program, with whom it will be shared and for what purpose.

Note: The EEOC’s question-and-answer documents identify best practices for ensuring confidentiality, such as communicating clear policies, training employees who handle confidential information and encrypting health data.

The final rules, which go into effect Jan. 1, 2017, apply to all wellness programs, including those in which employees or their family members may participate without also enrolling in a particular health plan.