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Proposed wellness rules balance ADA, HIPAA

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The EEOC has issued proposed rules explaining how employers can legally administer wellness programs under the ADA and the Health Insurance Portability and Accountability Act (HIPAA).

This is an important issue because the Affordable Care Act health care reform law encourages employers to sponsor wellness programs.

Wellness programs typically focus on smoking cessation, exercise and weight loss. They often provide health screenings for high blood pressure, high cholesterol, heart disease, diabetes and other chronic conditions. Many wellness programs offer incentives to employees who participate or achieve health goals.

The objective: Better health for employees, lower health care costs for employers and insurance carriers.

However, that worthy goal can clash with the ADA and HIPAA requirements. The EEOC guidance is designed to resolve those conflicts.

The ADA limits the conditions under which employers may make disability-related inquiries or require employees to undergo medical examinations. HIPAA limits the incentives employers may offer employees to participate in wellness programs.

The EEOC’s proposed rules emphasize five key points:

1. Wellness programs must be reasonably designed to promote health or prevent disease.

2. They must be voluntary. The proposed rules forbid employees from being required to participate in wellness programs.

3. Employers may offer only limited monetary incentives for employees to participate or to achieve health outcomes—generally, not more than 30% of employees’ share of health insurance premiums.

4. Medical information obtained must be kept confidential.

5. Employers must provide reasonable accommodations that enable disabled employees to participate and to earn whatever incentives the employer offers.

The EEOC will accept public comments on the proposed rules until June 19.

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