Wellness Program Info-Graphics

Here's a few info-graphics from a quick search on Bing. They bring up some positive and negative points about the programs but also good stats (going back to 2002 even).

Defining Different Types of Wellness Programs

1. General educational or participatory & not health-plan related

These programs are optional and educational that provide helpful information to employees. They don't provide any sort of medical care, only information/programs (yoga classes) to help promote healthy lifestyle choices. These types of plans are less likely to be involved with federal employment and benefit laws.

2. Participatory & health plan-related

These programs are once again very optional for employees and rewards are not tied to any sort of results from actually participating. When programs are health plan related, it means they are only available to employees enrolled in the employer's health plan. Now, federal employment and benefits laws apply more to these types of programs with more specific requirements that relate to programs that involve provision of health care.

3. Activity-only & health plan-related

The biggest difference between activity only and participatory are that these programs require individuals to a complete a specific activity in order for them to receive a reward.

4. Outcome-based & health plan-related

The rewards in this case are tied to participation in a health plan. Further, the reward can be based on existing health conditions or results of  a biometric screening. These programs are outcome based and require participants to satisfy a health-related standard in order to receive the reward. Rules for these programs are a lore more severe (especially under HIPPA and PPACA).


Examples:
(+) Employees can receive a reduction in their healthcare plan contribution requirement for completing a health risk assessment.
(-) Smokers can face penalties for participating in wellness programs which will hopefully encourage the user to quit.

The penalty aspect of some of these wellness plans has been criticized heavily, especially by the Equal Employment Opportunity Commission. To avoid this, companies shouldn't require their employees to participate in any sort of program, or penalize employees being a smoker or being "overweight"(Fun Fact Cigna doesn't hire smokers whatsoever).

Source: https://www.ajg.com/media/1274703/designing-a-compliant-wellness-program.pdf

HIPAA and the Affordable Care Act Wellness Program Requirements

Before I dive into the specifics of different types of wellness programs, I wanted to look into the current regulation of wellness programs to ensure they comply with HIPAA and the ACA. This document from the Department of Labor explains the different types of wellness programs that comply with HIPAA and fall under the ACA.  The first two types of wellness programs are participatory and health-contingent.

Participatory programs are exactly what they sound like-they are programs where "Either no reward is offered, or none of the conditions for obtaining a reward are based on an individual satisfying a standard related to a health factor". Employees aren't required to participate in the programs and won't penalize employees for not participating. This complies with non-discrimination requirements of HIPAA. Health-contingent programs on the other hand " require participants to satisfy a standard related to a health factor in order to obtain a reward". Health-contingent programs can be divided further into activity-only and outcome-based. The article goes into more details about the individual requirements for health-contingent programs so that they comply with the  nondiscrimination rules.

Other factors wellness programs need to consider are whether or not they are "reasonably designed to promote health and prevent disease". A lot goes into healthcare regulations, and wellness programs are just another part of the overall system that has to make sure it meets ACA regulations and HIPAA guidelines. Read the document for more information!