New rules on wellness programs will let employers cut insurance costs
Employers can give workers a big break on their health insurance after they and their spouses answer questions about their health and lifestyle, rules announced Monday by the Equal Employment Opportunity Commission (EEOC) say.
Until now, federal laws appeared to conflict on this issue for workplace wellness programs.
The Americans with Disabilities Act says employees have to voluntarily provide health information, while the Affordable Care Act encourages companies to offer workers incentives for participating in wellness programs.
EEOC proposed last year that offering an incentive for workers or their family members to provide health information under a wellness program wouldn’t make the programs mandatory.
Monday’s final rules maintained that position. AARP, which represents people 50 and older, says they do and quickly released a statement saying it is “deeply disappointed” by the rules.
AARP executive vice president Nancy Leamond said the practice is “financially coercing ” workers to surrender personal health information, weakens medical privacy and civil rights protections and makes it involuntary.
“These rules put workers between a rock and hard place,” Leamond said. “Older workers, in particular, are more likely to have the very types of less visible medical conditions and disabilities — such as diabetes, heart disease and cancer — that are at risk of disclosure by wellness questionnaires and exams.”
EEOC Chair Jenny Yang said the commission tried to balance medical privacy laws with the goal of encouraging wellness programs. The rules also show current anti-discrimination laws provide the necessary safeguards against misuse of the data.
Senate Health and Labor Committee Chairman Lamar Alexander, R-Tenn., thinks the rules don’t go far enough, however, and the Chamber of Commerce charged the rules will discourage employers from setting up wellness programs because EEOC made the issue more complex.
Alexander lashed out at the commission’s decision to cap the incentives employers can offer at 30% of the cost of an employee’s self-only coverage — rather than the 50% the ACA allows.
“Wellness programs are the only part of Obamacare that everyone agreed on — everyone except the EEOC,” Alexander said in a statement. “Congress will need to act to help employees seeking to improve their health, while bringing down their insurance costs.”
Bryce Williams, CEO of HealthMine, a data analytics company for wellness plans, doesn’t think the new rules will discourage wellness programs and instead thinks they could now become more common among smaller companies.
The rule requires enough disclosures to address concerns and is “measured and appropriate” given the large investment employers are making in workers’ health, he says.
Companies should meet the rules if they help workers understand health risks, says Seth Perretta, co-chair of the health practice at the Groom Law Group. Problems could arise if an employer makes a financial incentive payable if an employee achieves a certain health goal, such as a lower body mass index, without providing more ways to help the employee meet those goals, he says.
James Gelfand, senior vice president for health policy at the ERISA Industry Committee, says wellness plan incentives drive strong participation so “everyone wins.”
While groups representing employees often oppose these kinds of wellness plans, some employees are happy to have both the push to improve health and the savings on their health insurance.
Megan Garcia, who works at JFK Hospital in Edison, N.J., says she wouldn’t have known husband Michael had severe hypothyroidism if he hadn’t been pushed to get a blood screening test under the program. After treatment, he feels much better, lost 20 pounds and avoided what his doctor said could have turned into cancer within four years.
Last year, the Garcias saved $164 a month on Megan’s insurance, thanks also in part to Megan’s 130-pound weight loss after bariatric surgery.