Final Rule Provides Wellness Incentive Guidance

 

 

On May 29, 2013, the U.S. departments of Health and Human Services, Labor and the Treasury issued afinal rule on employment-based wellness programs in compliance with the Patient Protection and Affordable Care Act (PPACA), to bepublished in the Federal Register on June 3. The final rule will be effective for plan years beginning on or after Jan. 1, 2014, and applies to both grandfathered and nongrandfathered health plans.

The new rule supports workplace health promotion and prevention as a means to reduce the burden of chronic illness, improve health and limit growth of health care costs, while ensuring that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status.

Specifically, it outlines standards for nondiscriminatory health-contingent wellness programs, which generally reward individuals who meet a specific standard related to their health. Examples of health-contingent wellness programs include programs that provide a reward to those who do not use, or decrease their use of, tobacco, or programs that reward those who achieve a health-related goal, such as a specified cholesterol level, weight, or body mass index, as well as those who fail to meet such goals but take certain other healthy actions

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