Since 2007, the HIPAA nondiscrimination rules have prohibited a group health plan from discriminating against an individual based on health factors. These rules include restrictions on the amounts of incentives or penalties (such as the lowering or increasing of premiums) an employer may apply based on employees’ participation in wellness programs. The ACA increased the percentage of premium incentives and penalties from 20 percent to 30 percent generally, and from 20 percent to 50 percent for smoking cessation programs. Click here for details. The ACA also changed the HIPAA wellness rules for operating a health-contingent program to include a requirement for the retroactive removal of a surcharge in certain circumstances. Click here for details on how this impacts our H&W Services.

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Wellness Program Rules

Nov 20, 2014

Since 2007, the HIPAA nondiscrimination rules have prohibited a group health plan from discriminating against an individual based on health factors. These rules include restrictions on the amounts of incentives or penalties (such as the lowering or increasing of premiums) an employer may apply based on employees’ participation in wellness programs. The ACA increased the percentage of premium incentives and penalties from 20 percent to 30 percent generally, and from 20 percent to 50 percent for smoking cessation programs. Click here for details. The ACA also changed the HIPAA wellness rules for operating a health-contingent program to include a requirement for the retroactive removal of a surcharge in certain circumstances. Click here for details on how this impacts our H&W Services.