HHS issued final rules on employment-based wellness programs, supporting workplace health promotion and prevention as a means to reduce the burden of chronic illness, improve health, and limit growth of healthcare costs, according to the HHS.
The rules, to be finalized on or after January 2014, also ensure that individuals are protected from unfair underwriting practices that could otherwise reduce benefits based on health status.
The final rules support “participatory wellness programs,” which are available without regard to an individual’s health status. These include programs that reimburse for the cost of membership in a fitness center; that provide a reward to employees for attending a monthly, no-cost health education seminar; or that reward employees who complete a health risk assessment, without requiring them to take further action.
The rules also outline 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 specified 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.
The rules also ensure flexibility for employers by increasing the maximum reward that may be offered under appropriately designed wellness programs, including outcome-based programs. Consumers are also protected in that the wellness programs must be reasonably designed, uniformly available to all individuals, and accommodate recommendations made at any time by an individual’s physician based on medical appropriateness.
Source: HHS, May 29, 2013
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