• Health Care Reform

    Health care reform and incentives: How the ACA will impact workplace wellness

     

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    November 14, 2013

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    New ChairStarting January 1, 2014, companies will be able to increase incentives for employees who participate in workplace wellness programs – a result of the Affordable Care Act (ACA). And, with a reported 63 percent of businesses currently offering these programs, the terms of the ACA’s workplace wellness provision is a hot topic with employers across the country.

    Starting January 1, 2014, companies will be able to increase incentives for employees who participate in workplace wellness programs – a result of the Affordable Care Act (ACA). And, with a reported 63 percent of businesses currently offering these programs, the terms of the ACA’s workplace wellness provision is a hot topic with employers across the country.

    With all of the buzz around health care reform, it can be difficult to fully understand the changes and how they may impact your business. We’re breaking down the wall of confusion to give you a clear view of how the ACA will affect incentivized wellness plans.

    Employee rewards

    By law, incentivized wellness programs must be designed to improve health or prevent disease among employees, and companies are able to provide workers with rewards, such as premium discounts, cash, gym memberships and more, for their participation.

    Under the ACA, businesses will be able to provide employees a higher percentage of total rewards. For example, workers who participate in wellness program activities, such as health screenings or weight loss initiatives, can be offered as much as 30 percent premium differential. And, if the program is focused on preventing or reducing tobacco use, employers can offer up to 50 percent reward. This is a notable increase from the current standard that employers are able to offer – 20 percent.

    Wellness for all

    Employers need to create wellness programs that allow everyone to participate, regardless of medical conditions. For people who are unable to meet program standards, employers must offer an alternative means of qualifying to all similarly situated individuals.  For health-contingent programs, a reasonable alternative (or waiver of the standard) must be available to all individuals for whom it is unreasonably difficult due to a condition or medically inadviseable to satisfy the standard.

    For example, a business sets up a nutrition-focused wellness initiative aimed at encouraging better eating habits, with the long-term goal of gradually reducing employees’ Body Mass Index (BMI). Participants who have a low BMI, or lower their BMI, are eligible to receive 30 percent reduction in premiums.

    If a worker at the company is pregnant, it’s unreasonable to expect her to reduce BMI. Therefore, the employer needs to offer a program alternative so she can participate. The employee could qualify for the program incentive if she regularly meets with a nutritionist to learn proper eating habits for expectant mothers, for example.

    Finally, employees must be given the chance to qualify for the program’s reward at least once a year.

    About Cindy Bjorkquist, M.S.

    Cindy Bjorkquist is the Director of Wellness, Care Management and Health Promotion Program Development for Blue Cross Blue Shield of Michigan (BCBSM). She is responsible for the development and lifecycle process for clinical member-facing programs as well as contracting and management for any vendor programs for all market segments including commercial, individual and Medicare programs. Cindy has more than 24 years of experience in the design, delivery and evaluation of integrated wellness and care management programs for hospitals, corporate entities and health plans. Cindy lectures regularly on a national level and holds a master of science in exercise physiology, corporate health management, from Michigan State University and a bachelor of arts in exercise in sports science and biology from Spring Arbor University. To connect with Cindy and discuss Michigan workplace wellness, join the Leading Michigan to a Healthier Future LinkedIn group.

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