Workplace Wellness Plan Design – Legal Issues

Below is an article overview. Click here to read the full version.

Employers that offer health benefits to their employees may decide to implement wellness plans as a way to help control health plan costs and encourage healthy lifestyles. However, there are a number of legal compliance issues that are involved with designing workplace wellness plans. Wellness plans must be carefully structured to comply with both state and federal laws. The three main federal laws that impact the design of wellness plans are:

  • • The Health Insurance Portability and Accountability Act (HIPAA);
  • • The Americans with Disabilities Act (ADA); and
  • • The Genetic Information Nondiscrimination Act (GINA).

These laws each have their own set of legal rules for acceptable wellness program design, which are not always consistent with one another. This Compliance Overview provides an overview of the requirements for wellness plans under HIPAA, the ADA and GINA. See Page 9 for a chart that compares key wellness plan requirements under these three laws.

Links And Resources

  • • HIPAA’s nondiscrimination rules for wellness plans
  • • EEOC’s final ADA rule for wellness programs that include disability-related inquiries or medical exams
  • • EEOC’s final GINA rule regarding requesting a spouse’s health information as part of a wellness program

Article Highlights

HIPAA:

• HIPAA’s nondiscrimination rules apply to wellness plans that are offered in connection with group health plans.
• There are different rules for participatory and health-contingent wellness programs.

ADA:

• Wellness programs cannot discriminate against individuals with disabilities.
• If a wellness program involves medical exams or disability-related inquiries, it must satisfy certain requirements

GINA

• GINA’s restrictions apply to a wellness program when it requests genetic information—for example, family health history.