The Equal Employment Opportunity Commission (EEOC) recently released final rules regarding the use of incentives to promote participation in corporate wellness programs — and if you offer MedBen WellLiving, you may need to make critical changes to your program to meet the new regulations, says Vice President of Compliance Caroline Fraker.

"The new EEOC rules go into effect in 2017, and place a limit on how much financial incentive employers can offer to their employees to encourage healthier habits," Fraker noted.

The rules, which provide guidance to ensure that wellness programs comply with the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA), are as follows:

The ADA Rule

• Corporate wellness programs that ask questions about employee health or include medical examinations can only offer incentives up to 30% of the total cost of self-only coverage.
• Employers may not deny any employee who does not participate in a wellness program access to health care or prohibit any employee from choosing a particular plan.
• It also specifies that employers must give participating employees a notice that explains what information will be gathered in a wellness programs, who will see it and for what purpose.

The GINA Rule

• Maximum incentives for having a spouse participate may not pass 30% of the total cost of self-only coverage, either.
• Incentives for spouses are allowed for health assessments, biometric screenings, and questions about current health status, but are not allowed if tied to questions about family history or genetic tests.
• The rule bars exchanges of "current or past health status information" of employees' children for incentives altogether.

Prior to the release of the EEOC rules, the 30% maximum on cost incentives pertained only to “health-contingent” wellness programs, or those that require plan members to meet a specific health-status factor standard (i.e., achieving a specified cholesterol level) to get the cost reward or avoid a penalty. “Participatory” wellness programs, which are generally available without regard to an individual’s health status (i.e., getting an annual wellness exam), were exempt from this limitation, but no longer are.

Because MedBen WellLiving is considered a participatory wellness program, clients who are currently offering cost incentives exceeding 30% will have to modify their program design to comply with the new EEOC rules. In addition, employers who require plan participants to get a WellLiving medical examination in order to be eligible for a certain health benefit plan (a “compliant” plan) will need to modify this strategy.

MedBen will notify clients that need to make changes and work with them to ensure that their programs are compliant with the new rules and offer appropriate incentives. Both of these rules apply to employers beginning on the first day of the first plan year on or after January 1, 2017.

MedBen WellLiving clients with questions regarding the final EEOC rules are welcome to contact Fraker at 800-851-0907 or cfraker@medben.com. You can also read more about the rules at Healthcare Dive.