In my life I have attended a lot of breakfast meetings. The ones that used to tickle me the most were the ones sponsored by a local hospital or doctor’s group. Even though they preached healthy living, they almost always served the standard breakfast fare (at least for my area of the country), which was scrambled eggs, bacon, sausage, biscuits, and gravy. Delicious, but not exactly healthy. I chuckled but also had some sadness, the same sadness I feel when I drive by a doctor’s office and there are people in uniforms standing outside smoking.
I have come to the conclusion that wellness, just like safety, is as much about an “attitude” as it is about anything else. You can have all of the programs you want, but if there is no support for them from the top on down they will not be effective.
That’s where leadership comes in. Executives need to provide the example of wellness. They need to embrace wellness, not only for the cost savings aspects of it, but for the benefits employees will receive from it outside of their work lives. Executives need to exhibit a positive attitude by being conscious of their own wellness. They need to make fitness a priority, be aware of their health, and check up on it on a regular basis. They have to model the behavior they want their employees to exhibit. If they don’t, why should an employee be concerned about his or her own wellness, at least as it applies to being a better and more productive employee?
According to the Kaiser Family Foundation, 94 percent of employers with more than 200 workers and 63 percent of smaller employers offer some sort of wellness program. And more companies will be offering wellness programs as the Affordable Care Act becomes fully implemented. If you are not offering a program already, what can you do to promote wellness?
Believe it or not, despite the fact that you are trying to promote a good thing, there are some legal issues you need to be concerned with. There are prohibitions to aspects of wellness programs under the Genetic Information Nondiscrimination Act of 2008 (GINA); HIPAA, and the Affordable Care Act.
According to the New York Law Journal article “Legal Implications of Employee Wellness Programs,” there are two types of wellness programs: participatory programs and incentive-based programs. They differ in that participatory programs are open to everyone and don’t provide any rewards based on specific achievements. Incentive programs, on the other hand, provide awards based on specific outcomes related to health standards or goals, for example a reduced premium for stopping smoking.
According to the article, under HIPAA:
… such outcome-based programs are permissible so long as (1) the reward does not exceed 20 percent of the cost of coverage for the employee; (2) the program is reasonably designed to promote health and prevent disease; (3) the program gives individuals eligible for the program the opportunity to qualify for the reward under the program at least once per year; (4) the rewards under the program are available to all similarly situated individuals, and the program allows a reasonable alternative standard or waiver for any individual for whom it is unreasonably difficult due to a medical condition, or medically inadvisable to satisfy the condition; and (5) all plan materials describing the program disclose the availability of a reasonable alternative standard or the possibility of waiver of the otherwise applicable standard. See 29 CFR §2950.702(f)(2).
The ACA codifies these regulations and actually increases the potential reward amount to 30%.
Under GINA, standards were also put into place to prevent group health plans and insurers from changing their premiums based on genetic information, requesting that individuals undergo genetic testing, or purchasing any individual genetic test information.
Further, the following regulations were also put in place:
“…health plans are prohibited from requiring individuals to complete a Health Risk Assessment (HRA) that requests family medical history in order to receive a reward under a wellness program on grounds that such request is deemed a request for underwriting purposes. The EEOC followed with its own regulations interpreting Title II of GINA in 2010, stating that in order to comply with GINA, a wellness program may not condition receipt of an incentive on an employee providing genetic information.”
All wellness programs should be voluntary and should not discriminate against women, minorities, or older workers. Understanding these restrictions will allow you to develop a wellness program that will help your organization accomplish the goals of employee wellness, reduced costs, and increased productivity. The costs of implementing a program will be quickly offset by reduced sick time and an increase in productivity, not to mention morale. Your employees will be healthier, and the world will be a better place.