Considering Wellness Initiatives? DOL Cracks Down

Click here to read a summary at Human Resource Executive Online. (HRE Online also has a nice piece on medical tourism and barriers to widespread adoption here).

Last month, DOL's Employee Benefits Security Administration issued a letter outlining regulatory guidelines for wellness programs.

Here is the DOL News Release with the relevant Bulletin (Field Assistance Bulletin 2007-04) and contact Gloria Della, Phone Number: 202.693.8664.

Click here for the actual Field Assistance Bulletin.

From the article:

"The guidance letter effectively plugs a loophole that could have allowed programs to discriminate against people with health problems that are beyond their control," says Tom Bixby, a partner in the Health Law practice group at Neal Gerber Eisenberg, a Chicago law firm.

The loophole comes into play because while the Health Insurance Portability and Accountability Act does not allow employers to charge different premiums for different employees (thin vs. overweight, for example) in employer-paid health plans, supplemental coverages could circumvent HIPAA.

Some employers have used supplemental coverages to offer "discounts" or "credits" to employees following specific "healthier" paths -- for example quitting smoking or losing weight.

Currently, there are exceptions from strict HIPAA regulations for wellness programs -- permitting financial incentives of up to 20 percent of the cost of coverage per employee. But the supplemental coverages, which are not part of HIPAA restrictions, could be used to as a way around that number while, at the same time, penalizing those who can't meet certain criteria."


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Arige Prakash said...

How Necessary Are Medical Tourism Companies?Does it make more sense to plan my health vacation on my own or to use a medical tourism company to help out with the details. The latter is more expensive but seems a great deal easier.