How Does ACA Impact Employee Wellness Programs?

历年文章· 2014-02-11· 0 浏览

Did you know that the Affordable Care Act (ACA) contains provisions related to the implementation of employee wellness programs? The latest information the final rule that appeared in the Federal Register defined new parameters for employee wellness programs. It directs how they must be designed and administered to make sure they are equally available and fair to employees. It also explains that programs cannot discriminate based on health factors. Employee Wellness Programs and the Final Rule Under the ACA The purpose of the final rule is to clarify the different types of allowable wellness programs and the requirements of participation and rewards under each type of program. Emily York Richards told us in a recent BLR webinar. This rule was based on the general framework of the HIPAA wellness rules that preceded the ACA. The final rule becomes effective on January 1, 2014. Each program must not discriminate either due to health conditions and/or the ability to participate. Richards advised. This is applicable to both grandfathered and non-grandfathered health plans. Why is this rule important? It s because the ACA is promoting the prevention of chronic illness as a way to lower healthcare costs for everyone. The new rule supports the workplace wellness and prevention, which has been outlined in the Affordable Care Act. It helps alleviate the costs and burden of chronic illness and growing healthcare claims costs. Richards explained. Employee Wellness: Two Broad Types of Programs There are two types of wellness programs identified under the Final Rule within the Affordable Care Act. They include participatory programs and health-contingent programs. Participatory programs are, as the name implies, participation-only. They do not provide rewards based on any current or achieved health factors. An example of a participatory program would be monthly lunch and learns in which employees attend a lunch training session. If all employees can participate regardless of a health factor, it is probably deemed a participatory program. Health-contingent programs , unlike participatory programs, do provide rewards based on achieving specific health factors. An example reward might be a lower co-pay for employees who do not smoke. Health contingent programs have more restrictions than participatory programs. For example, health-contingent programs are restricted to a cap of 30 percent of the total cost of employee-only coverage. This rule does not apply to participatory programs. Health-Contingent Programs: Two Sub-Types Within health contingent programs, there are two types: activity-only programs, and outcome-based programs. Activity-only programs require individuals to complete an activity related to a health factor to receive a reward. The activity is the key not the outcome. These types of programs do NOT require a specific goal or target to be met to receive a reward they only require participation in an activity. An example of an activity-only program would be a walking club in which employees get rewarded for their participation, regardless of whether their weight or any other health factor changes as a result. When administering activity-only programs, employers must offer alternatives for individuals with certain medical conditions that preclude their participation. Outcome-based programs , as the name implies, are programs that focus on achieving a specific outcome, such as losing

10 lbs or reaching a specific body mass index (BMI). The final rule in the ACA does allow for those with adverse health factors to receive a greater reward/incentive for improvement of their existing condition. Like activity-based programs, outcome-based programs must also offer a reasonable alternative to those who cannot meet the initial standard. 管理新知您可能感兴趣的文章罗振宇骗局！生活没有提升，工资没有加，知识付费其实都是忽悠 2018-01-03 Instead of Monitoring Employees, Try Motivating Them 2013-09-04 招聘十年，我是如何评估人才潜力的？

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