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The U.S. Equal Employment Opportunity Commission on Monday issued final rules that allow employers to offer limited incentives for employees and spouses who provide their personal health information as part of a voluntary workplace wellness program.
The rules, which are mainly consistent with the EEOC's proposals last year, clarify how Title I of the Americans with Disabilities Act and Title II of the Genetic Information Nondiscrimination Act of 2008 apply to wellness programs that ask employees and spouses for health information. They go into effect on Jan. 1, 2017.
The final ADA rule allows voluntary wellness programs that include medical examinations or ask questions about employees' health to offer incentives of up to 30% of the total cost of self-only coverage. The final GINA rule says the maximum incentive that can be provided to an employee's spouse also is limited to 30% of employee self-only coverage.
However, the ADA prohibits an employer from denying access to a particular health plan because an employee does not answer disability-related questions or undergo medical examinations, the EEOC said in a statement.
The rules also prohibit the use of incentives to gain the health information of employees' children, or the genetic information of an employee, an employee's spouse and an employee's children.
“The commission worked to harmonize (the Health Insurance Portability and Accountability Act's) goal of allowing incentives to encourage participation in wellness programs with ADA and GINA provisions that require that participation in certain types of wellness programs is voluntary,” EEOC Chair Jenny R. Yang said in the statement. “These rules make clear that the ADA and GINA provide important safeguards to employees to protect against discrimination.”
Reacting to the final rules, Steve Wojcik, vice president of public policy at the National Business Group on Health in Washington, said they are “largely consistent with what the EEOC proposed last year. We had hoped for a little more flexibility with respect to the calculation of the spousal incentive.”
The final rules do not refer to family coverage. Instead, they limit spousal incentives to 30% of employee-only coverage, Mr. Wojcik said. Family coverage is more expensive than employee-only coverage, so employers who had tied incentives to family coverage previously “might have to scale it back,” he said.
Mr. Wojcik also said it had been hoped that the use of “gated” benefit plans, which allow employees to enroll in the richest plan if they comply with a biometric screening or health risk assessment, would have been allowed, but the final rules rejected that approach.
“As long as the default plan is acceptable … why not say that if you are willing to do a biometric screening or health assessment, you can have a more generous plan option?” he said.
The final rules do provide “a clear roadmap to employers on how to structure incentives” for voluntary workplace wellness programs, Mr. Wojcik said.
In an employer victory, a federal District Court in Wisconsin has ruled against the Equal Employment Opportunity Commission, and held that a plastic manufacturer's policy of requiring employees to participate in its wellness program to be eligible for coverage in its group health insurance plan does not violate the Americans with Disabilities Act.