Wellness Programs
While there is no statutory or uniform definition of a wellness program, the term refers to employer-sponsored programs that focus upon improving the physical and/or mental health of employees. They may range from initiatives as informal as bringing a nutritional consultant to talk with employees to programs as comprehensive as periodically having employees undergo biometric testing and paying incentives based upon maintaining or achieving healthy levels on the respective test.
Employers have a great deal of latitude in structuring wellness programs, and common types of wellness programs include:
- Health risk assessments
- Immunization programs
- Smoking cessation programs
- Health educational classes or lectures
- Nutrition counseling
- Disease/condition control and management programs (e.g. , diabetes, heart disease, blood pressure/hypertension, asthma, depression)
- Biometric testing in conjunction with maintenance/improvement programs (e.g. , blood pressure, cholesterol, BMI/weight loss, nicotine)
- Gym memberships or subsidies (including on-site gyms)
- Stress management programs
- Health coaching
One of the key considerations in structuring a wellness program is whether employees will be offered a monetary incentive to participate. If a monetary incentive is offered, the key distinction is whether the incentive is participation-based or results-based. If the incentive is participation-based, such that employees must simply participate and are not required to meet any objective standard to receive the incentive, then there is no limit upon the amount of the incentive that the employer may offer. If the incentive is results-based, such that an employee must achieve a particular health outcome, then the permissible financial incentive is capped. The maximum financial incentive that a results-based wellness program can award is 20% of the total premium cost for employee-only coverage under the employer’s group health plan (i.e. , the COBRA rate less the 2% administrative surcharge). It should be noted that the Patient Protection and Affordable Care Act (“PPACA”) will increase this cap to 30%.
Wellness programs are subject to a number of requirements under the Americans with Disabilities Act of 1990 (“ADA”), the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), the Genetic Information Nondiscrimination Act of 2008 (“GINA”) and the Age Discrimination in Employment Act of 1967 (“ADEA”). Wellness programs also potentially are subject to the Employee Retirement Income Security Act of 1974 (“ERISA”) if they are provided as part of the employer’s group health plan or are administered directly by the employer.
For a detailed discussion regarding corporate wellness programs and their potential economic benefits for employers, see "Corporate Wellness Programs: Are They a Wise Investment for Employers?," TLNT.com.
