Health Care Reform and Wellness Rewards

There is some guidance for wellness programs and their administration under group plans – both for insured and self-insured companies. The Department of Treasury, Labor and Health and Human Services released regulations that go in to effect January 1, 2014.

Rewards – maximum reward is 30% of the cost of medical (and recent guidance from the Obama administration shows up to 50%) – both employer and employee contributions

Reward Types – premium discounts, reduction in cost-sharing, deposits in to HSA and HRA, enhanced benefits; frequency – employees must be eligible to earn a reward once a year; a reward can be based on coverage for an entire family

Participatory Wellness – Reward based on participation; individual does not need to meet health standards, and no limits on rewards

Health-Contingent Wellness – programs that require an employee to maintain health outcomes; i.e. smoking cessation, certain BMI (body mass indexes)

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