Gating Through Wellness Programs Under Proposed EEOC Regulation

This article talks about a new rule that limits some rewards given out in wellness programs. It’s called the EEOC Proposed 29 C.F.R. 1630.14(d), and it falls under the Americans with Disabilities Act (ADA). The rule seems to stop the practice of making different levels of health plans for employees.

It’s important to understand that employment law and employee benefits are connected, especially when it comes to health benefits. The ADA mainly focuses on discrimination at work, but this rule focuses on discrimination in an employer’s health plan. If the EEOC has concerns or an employee feels discriminated against, an employer should involve their lawyer. To properly defend a claim, the lawyer needs to understand the employee benefit concepts involved.

Some of the terms used in this part of the ADA might be new. Here’s a quick explanation of a few of them. • Gated Levels or Gating refers to using different levels of coverage in a health plan, like paying more or less for certain procedures.
• Health Plan is an employer-sponsored healthcare plan, like medical, dental, or vision plans.
• Health Risk Assessment collects data to assess potential medical risks and helps address them.
• Participant is an employee who enrolls in a health plan or wellness program.
• Wellness Program encourages employees to make healthy choices, like exercising or getting screenings and vaccinations. The EEOC has a regulation about when employers can ask their employees for medical information as part of a health program. The rule says that the program must be voluntary and have a reasonable chance of improving health. It also says that asking for medical history or health assessments makes the program subject to the rule. The EEOC is concerned about employers using money or rewards to make employees join the program. If you have to participate in a program, it’s not voluntary. This is not allowed if it means you can’t get any of your employer’s health plans, or if it limits your benefits by more than 30 percent of what it would cost for just you to be covered. It’s okay for the program to limit some parts of your health plan, like deductibles or copays, as long as it doesn’t cost you more than 30 percent of the total price for just you to be covered. For plans with set premium rates, it’s easy to figure out the total price. But for plans where the employer pays claims, it might be a bit more complicated. If it’s a self-insured plan that has set its COBRA premium rate, that rate (minus the extra cost) should be used to figure out the total cost. This regulation limits the amount of money or incentives that an employer can offer to encourage employees to participate in a health program. It’s straightforward when the incentive is a set amount of money or a premium reduction, but it gets tricky when the value of the reward depends on the medical treatments and services a person gets during the year. If the reward could potentially be more than 30 percent of the total cost of the employee’s health insurance, it might not be allowed under the law. This could make it difficult for employers to use these kinds of programs to encourage healthy behavior. The rules about wellness programs and incentives for genetic information for spouses and dependents are unclear. The proposed regulations suggest that employers can offer incentives for spousal genetic information, but there are limits on how much. The focus is on benefits received by employees, not their spouses or dependents. Employers may have to make their programs more complex to comply with the regulations. The new rules don’t have a set start date yet, so employers don’t have to follow them yet. But if they want to follow the rules, they might need to change their employee health programs to make sure no one has to pay more than 30% of the cost if they choose not to participate. If someone ends up paying more than that, it might not follow the rules. If they end up paying less, it’s probably okay. We have some concerns about a new rule from the EEOC that deals with wellness programs at work. We think the rule might make it harder for employees to participate in these programs. It also says that employers can’t punish or retaliate against employees for not taking part in a program. Employees also have to get detailed information about the program from their employer. Overall, we’re not sure if this rule is clear enough and might need some more guidance. The EEOC issued a regulation that may not be allowed under the Americans with Disabilities Act (ADA). The regulation applies to workplace wellness programs that offer rewards for completing health tests. However, it’s not clear how this could lead to discrimination against people with disabilities. Also, a federal court ruled that similar programs are allowed under the ADA, but the EEOC ignored this ruling when making their regulation. This raises questions about whether the EEOC had the authority to make this regulation. An employment lawyer helps companies understand and comply with new regulations that affect their programs and incentives. They advise companies on how to make changes to their programs to follow the rules and avoid legal trouble. They also help companies protect themselves from potential claims by employees. Overall, they make sure companies are aware of the rules and help them follow them. This article discusses how attorneys help businesses with their employee benefit plans to make sure they follow the law and get tax benefits. They work with government agencies to fix any mistakes and protect the plans during mergers and other changes. The article was written by the Labor and Employment Law Section.

Source: https://www.floridabar.org/the-florida-bar-journal/gating-through-wellness-programs-under-proposed-eeoc-regulation/