The Employee Benefits Security Administration recently issued a checklist to help advisers and employers determine whether their wellness and disease management programs comply with the Health Insurance Portability and Accountability Act (HIPAA).
HIPAA’s nondiscrimination rules bar group health plans from denying subscribers benefits based on a health factor and charging them a higher premium for certain conditions.
The checklist — Field Assistance Bulletin 2008-02 — asks employers 12 yes-or-no questions about their programs to promote healthier behavior among their workers. See
http://www.dol.gov/ebsa/regs/fab2008-2.html to read the bulletin which provides guidance on the types of wellness and disease management programs that must comply with the Department of Labor’s HIPAA rules.
The bulletin includes examples and tips on how to apply wellness program rules and the five compliance criteria.
For example, a program by a group health plan that rewards workers with cholesterol levels under 200 with 20 percent lower premiums would violate the rules since the measure requires an individual to meet a health standard to obtain a reward.
However, a plan can require employees to complete a health risk assessment in order to enroll in the plan because the measure is not based on a health factor.
Source: Employee Benefit Advisor
Clarification
on Wellness Programs
