Workplace Wellness Programs and ACA Reforms

Whether you currently have a workplace wellness program or are considering implementing one, here are the Affordable Care Act (ACA) rules, tools and assistance that you should be aware of.

Incentive Increase and Nondiscrimination Rules

Starting in 2014, the maximum permissible reward for a Health-Contingent wellness program has been increased. A Health-Contingent wellness program is a program that requires an employee to either participate in an activity or meet a specific goal in order to qualify for a reward.

This increase allows employers to give their employees a discount or reward as an incentive for their participation in a Health‐Contingent wellness program. The new maximum reward will increase to 30% off of the employee contribution toward Health Insurance (up from 20%). Also, the reward can increase up to 50% off for programs designed to prevent or reduce tobacco use.

The other type of wellness plan is called a Participatory plan. Events such as attending a health seminar, a fitness center reimbursement program or completing a health questionnaire would be considered participatory. There is no ACA limit on the financial incentives for a Participatory wellness plan.

In addition, the ACA nondiscrimination requirements for workplace wellness programs have been finalized. These regulations clarify the rules about avoiding discrimination and providing reasonable alternative standards.

For more information about the non-discrimination rules of both Health-Contingent programs and Participatory plans, see ACA Updates Nondiscrimination Rules for Wellness Programs.

Workplace Wellness Employer Grant Program

If you recently started a workplace wellness program or are considering one, the ACA is providing financial assistance to employers. A $200 million dollar program has been created to help employers implement workplace wellness initiatives from 2011-2015. Grants will be available to eligible employers who provide a new workplace wellness program.

To be eligible for grants, employers:

• Must employ under 100 employees who work 25+ hours per week
• Did not have a workplace wellness program in force as of March 23, 2010 (the date that ACA began)

In addition, the wellness program must be open to all employees and must meet the following criteria:

• Include a supportive workplace environment
• Have initiatives to change unhealthy behaviors and lifestyle choices
• Encourage employee engagement
• Program should relate to health awareness including preventative screenings, health risk assessments and health education

The Department of Health and Human Services (HHS) will be responsible for providing direction about the grant program and application process. More information will be forthcoming once available.

Technical Assistance

ACA legislation has authorized the Center for Disease Control (CDC) to provide technical assistance to employers in regards to workplace wellness programs. Technical assistance includes consultation, resources and other tools to help employers evaluate, monitor and analyze their current wellness program. It’s also a useful tool for employers who have questions or need help with starting a new workplace wellness program. You can visit the CDC website for more workplace wellness information at www.cdc.gov.

For more information about workplace wellness plans and ACA reforms, please download our legislative brief.