School districts and other governmental organizations that implement wellness programs for teachers and other employees know they are an excellent way to decrease Health Insurance costs. When employees are well, they have less insurance claims, which help keep rates down.
Additional benefits of wellness programs are known to increase employee morale and productivity, as well as reduce absenteeism.
If your organization has a wellness program in place now, or if you are planning to implement one in the future, make sure your program is ACA compliant and nondiscriminatory.
ACA Releases Modified Wellness Rules
The ACA has modified the wellness program rules. The new rules apply to all group Health Insurance plans, whether or not you have grandfathered or nongrandfathered status. Nondiscriminatory rules have been clarified to ensure that all employees, regardless of health status, have the opportunity to participate and be rewarded.
The ACA has classified wellness programs into two categories: Participatory and Health-Contingent.
Participatory Wellness Programs
Participatory wellness programs are based on employee’s participation. Events such as attending a health seminar, a fitness center reimbursement program or completing a health questionnaire would be considered participatory. Nondiscrimination requirements are satisfied as long as the program is available to all employees, regardless of their health status. Also there is no limit on the financial incentives for a participatory wellness program.
Health-Contingent Wellness Programs
A Health-Contingent wellness program can either be activity-based or outcome-based. An activity-based program offers the employee an incentive for participating in an activity such as exercising, dieting or walking. Activity-only wellness programs do not require an employee to attain or maintain a specific health outcome. An outcome-based program requires that an employee meet a specific goal, i.e., to stop smoking or maintain certain health standards (such as achieving a specified cholesterol level or weight).
A Health-Contingent wellness program must meet the following ACA standards by January 1, 2014:
Your health plan is committed to helping you achieve your best health. Rewards for participating in a wellness program are available to all employees. If you think you might be unable to meet a standard for a reward under this wellness program, you might qualify for an opportunity to earn the same reward by different means. Contact us at [insert contact information] and we will work with you (and, if you wish, with your doctor) to find a wellness program with the same reward that is right for you in light of your health status.
It is important to review your own wellness plan to see if changes need to be made. If your organization doesn’t currently have a wellness plan, now may be the time to consider one to help mitigate the increasing costs of Health Insurance.