EEOC Harmonizing ADA Rules
and
PPACA Wellness Incentives
Who: Any employer-based health plan that includes a wellness program and its participants.
When: On April 20, 2015 the Equal Employment Opportunity Commission (EEOC) issued a “Notice of Proposed Rule Making” (NPRM). Comments on the proposed rule must be submitted by June 19, 2015.
What: The EEOC is responsible for assuring employers comply with the American’s with Disability Act (ADA) and do not discriminate against disabled employees. The proposed rule coordinates the EEOC concerns related to potential discrimination with employer requested health information and related wellness incentives allowed under PPACA and HIPAA.
Executive Summary: It is increasingly common for health plans to integrate information from Health Risk Appraisals and/or the use Bio-metric testing to qualify for wellness incentives. The problem is the ADA limits an employer’s ability to ask questions about an employees’ health or requiring them to undergo medical exams. In 2014 the EEOC caused market uncertainty when it filed a lawsuit against Honeywell over its wellness program potentially violating the ADA. Even though allowed under PPACA, prior to the NPRM the EEOC had not agreed that employers could offer incentives to encourage employees to participate in wellness programs without violating the ADA.
The EEOC proposed ruling would harmonize its position with HHS, The DOL, and Treasury. The EEOC proposed ruling makes it clear that wellness programs with incentives are allowed under the ADA if they:
1. Are not used to discriminate based on disability,
2. Are voluntary and do not subject employees to threats, intimidation, or coercion for refusing to participate,
3. Do not deny access or limit health coverage for non-participation,
4. Provide reasonable accommodations that allow employees with disabilities to participate in wellness programs and receive any incentives offered,
5. Have wellness incentives (or penalties) of not more than 30 percent of employee-only coverage,
6. Medical information provided to an employer must be aggregated so that it is not likely to disclose the identity of specific employees,
7. Provide notice a notice that describes what medical information will be collected, with whom it will be shared, how it will be used, and how it will be kept confidential.
Actions: Affected employers and industry groups should review the proposed rule and submit any comments by June 19, 2015. Employers with existing wellness and incentive programs can follow the proposed rule until a final rule is issued. However, check with your broker, consultant, and/or legal counsel to get updated information as a final rule is being developed.
The information presented and contained within this article was submitted by Ronald E. Bachman, President & CEO of Healthcare Visions and Chairman of the IHC Editorial Advisory Board. This information is general information only, and does not, and is not intended to constitute legal advice. You should consult legal advisors to determine the laws and regulations applicable to your company. Any opinions expressed within this document are solely the opinion of the individual author.