Wellness Program Requirements
Wellness
programs offered as part of a group
health plan must generally comply with the following nondiscrimination,
notice, and privacy protection requirements under HIPAA, as amended by the
Affordable Care Act (ACA).
Nondiscrimination
Requirements
If
a wellness program is part of a group health plan, it must comply with rules
created by HIPAA that prevent the employee from being impermissibly
discriminated against based on a health factor.
"Health factors" include:
- Health status;
- Medical condition, including both
physical and mental illnesses;
- Claims experience;
- Receipt of health care;
- Medical history;
- Genetic information;
- Evidence of insurability; or
- Disability.
Participatory wellness programs are
deemed nondiscriminatory under HIPAA as long as they are made available to all "similarly
situated individuals." HIPAA states that plans may
distinguish among employees only on "bona fide employment-based
classifications" consistent with the employer's usual business practice. For
example, the following employees can be treated as different groups of
similarly situated individuals: