June 17, 2013
Question: We are designing our wellness programs for this year and want to offer a wellness benefit to our non-smokers. Are there special compliance rules surrounding wellness programs? Answer: A group health plan is allowed to offer a discount to non-smokers if it is part of formal wellness program that is non-discriminatory under HIPAA. The Department of Labor has specific guidelines as follows: For a group health plan to maintain a premium differential between smokers and nonsmokers and not be considered discriminatory, the plan’s nonsmoking program would need to meet the five requirements for wellness programs that require satisfaction of a standard related to a health factor. Accordingly, under the final rules, this wellness program would be permitted if: The premium differential is not more than 20 percent of the total cost of employee-only coverage (or 20% of the cost of coverage if dependents can participate in the program)*; The program is reasonably designed to promote health and prevent disease; […]
