From Issue 8 of Ceridian Health Care Compass July 1, 2010

Employers need to plan ahead to reap the benefits from new wellness incentives.

It's not a cure-all, but health care reform attempts to hold down rising costs in coming years through several provisions that make workplace wellness programs more affordable and attractive to both employers and employees.

The Patient Protection and Affordable Care Act (PPACA) provides various incentives, grants and information about initiating wellness programs.

Although some of the changes won't occur for several years, others take effect this year."This is going to force employers and employees to be more informed about wellness, which will ultimately be beneficial for both," said Shannon Rickert, Product Manager for Ceridian Health & Wellness.

Employers should start thinking now about how their existing wellness plans are working, or consider putting together a wellness program with the upcoming changes in mind, Rickert said.

New health plans, effective the first day of the first plan year beginning on or after September, 23, 2010, must provide coverage without employee cost-sharing for many preventive services that are considered key parts to a successful wellness plan, including diet and healthy lifestyle counseling, smoking cessation programs, and obesity and other health screenings.

Except for grandfathered plans, which are exempt, co-pays will not be allowed for items and services recommended by the U.S. Preventive Services Task Force and for preventive care and screenings recommended in guidelines supported by the federal Health Resources and Services Administration.

As detailed in previous issues of Health Care Compass, PPACA provides an incentive to create new wellness programs by making available $200 million in grants to employers with fewer than 100 employees who work 25 or more hours per week.

The grants, available from 2011-2015 through the Department of Health and Human Services, will help employers initiate comprehensive wellness programs that include health awareness initiatives, encourage employee participation, offer counseling and coaching services and create supportive and healthy workplace environments.

By 2012, group health plans and health insurance providers must begin reporting their wellness and health promotion offerings, both to the federal government and to enrollees. Wellness programs contained in federal employee insurance plans will be evaluated for results to help develop best practice guidelines for the rest of the market.

In 2013, the government will begin taking periodic, mandatory surveys of workplace wellness and health promotion programs to measure and improve their effectiveness.

One of the biggest changes takes effect in 2014. Employers can increase the wellness incentives they offer employees for participating in goal-oriented wellness programs from 20 percent to 30 percent of the total insurance premium, through rebates or discounts the employees wouldn't otherwise receive.

In addition, the new law leaves room for the federal government to raise those discounts to up to 50 percent.

Rickert advises employers to review the wellness plans they have in place, study the changes PPACA introduces, and start making adjustments now to find a comprehensive wellness plan that works for their companies.