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Wellness Programs

The U.S. Departments of Health and Human Services, Labor and the Treasury have set rules for employment-based wellness programs. The rules: 

  • Support participatory wellness programs, which generally are available without regard to an individual’s health status and include programs that:
    • Reimburse for the cost of membership in a fitness center;
    • Provide a reward to employees for attending a monthly, no-cost health education seminar; or
    • Reward employees who complete a health risk assessment, without requiring them to take further action.
  • Leverage workplace health promotion and prevention as strategy for reducing the burden of chronic illness, improve health and limit growth of health care costs.
  • Safeguard individuals against unfair underwriting practices that could otherwise reduce benefits based on health status.
  • Outline standards for nondiscriminatory “health-contingent wellness programs,” which generally reward individuals who meet a specific standard related to their health. Examples include programs that:
    • Provide a reward to those who do not use, or decrease their use of, tobacco, or
    • Reward those who achieve a specified health-related goal such as a specified cholesterol level, weight or body mass index, as well as those who fail to meet such goals but take certain other healthy actions.

The rules are designed to:

  • Ensure flexibility for employers by increasing the maximum reward that may be offered under appropriately designed wellness programs, including outcome-based programs; and
  • Protect consumers by requiring that health-contingent wellness programs be reasonably designed, be uniformly available to all similarly situated individuals, and accommodate recommendations made at any time by an individual’s physician based on medical appropriateness.