Insurance, Wellness, and the Potential for Discrimination
One of the topics that I've always felt our class explores too little is employer-provided insurance benefits, especially the issues surrounding health insurance. So, I'm going to try to include periodic posts to make up for the lack of time we spend in class.
In that regard, a recent article from the Wall Street Journal Online's Career Journal caught my attention. In "Wellness Plans May Face Hurdle for Penalizing Unhealthy Workers," Victoria E. Knight describes employer-sponsored wellness plans that reward employees for hitting particular wellness benchmarks (e.g., nonsmoking, healthy body mass index, proper cholesterol count, etc.). The rewards often come in the form of reductions in the employee's deductible amount under the main health insurance plan the employer offers. Knight describes the following example:
On the surface, these plans seem like a creative way to encourage employees to get or stay healthy, thereby allowing employers to save money on health insurance premiums. And they may (or may not ) do just that. Regardless, the Department of Labor's Employee Benefits Security Administration has issued guidelines that will affect their administration.
These wellness plans may be subject to regulation under the Health Insurance Portability and Accountability Act ("HIPAA"), a federal law that regulates a number of aspects of the health insurance industry. If the wellness plan is group health insurance coverage, it cannot discriminate among groups members on the basis of an individual's "health factor" in determining eligibility, benefits, or premiums. The Department of Labor considers current health status, medical condition, and genetic information or predisposition just such health factors.
Read the article to find out how an employer can avoid violating HIPAA requirements and still maintain a supplemental wellness program. Then leave your thoughts in the comments about these wellness programs, the pervasiveness of regulation in this area, or anyting else about the topic or article that gets you thinking . . . .
In that regard, a recent article from the Wall Street Journal Online's Career Journal caught my attention. In "Wellness Plans May Face Hurdle for Penalizing Unhealthy Workers," Victoria E. Knight describes employer-sponsored wellness plans that reward employees for hitting particular wellness benchmarks (e.g., nonsmoking, healthy body mass index, proper cholesterol count, etc.). The rewards often come in the form of reductions in the employee's deductible amount under the main health insurance plan the employer offers. Knight describes the following example:
Vital Measures is one wellness program where credits are issued under a supplemental policy. Launched in July by UnitedHealthcare, a unit of UnitedHealth Group Inc., and BeniComp Group of Fort Wayne, Ind., the program is available to companies with 100 to 1,000 employees in Rhode Island, Pennsylvania, Colorado and Ohio. Typically, employees sign up for a health plan with a $2,500 deductible and can then participate in a free, confidential health screening for body-mass index, cholesterol, blood pressure and non-nicotine use. For each test workers pass, they earn a $500 credit toward their deductible, issued under a supplemental plan, BeniComp Advantage.
On the surface, these plans seem like a creative way to encourage employees to get or stay healthy, thereby allowing employers to save money on health insurance premiums. And they may (or may not ) do just that. Regardless, the Department of Labor's Employee Benefits Security Administration has issued guidelines that will affect their administration.
These wellness plans may be subject to regulation under the Health Insurance Portability and Accountability Act ("HIPAA"), a federal law that regulates a number of aspects of the health insurance industry. If the wellness plan is group health insurance coverage, it cannot discriminate among groups members on the basis of an individual's "health factor" in determining eligibility, benefits, or premiums. The Department of Labor considers current health status, medical condition, and genetic information or predisposition just such health factors.
Read the article to find out how an employer can avoid violating HIPAA requirements and still maintain a supplemental wellness program. Then leave your thoughts in the comments about these wellness programs, the pervasiveness of regulation in this area, or anyting else about the topic or article that gets you thinking . . . .
posted by Professor Prenkert at
9:30 AM
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