Wellness / HIPAA

4667607

I realize that most companies who offer wellness programs offer rewards for participation. I also realize that if the rewards are based on satisfying a specific standard, HIPAA rules apply. I am wondering if anyone out there DOES base their wellness program on satisfying a standard/s, and if so, how is it working for you? Also, do you find it difficult to keep the rewards within the 20% max allowed? And lastly, do you also have increased rates for tobacco users?

809022

We're doing some research and I'm very confused because I'm reading of entities that are doing upcharges for employees who are overweight etc. (Alabama) and I just don't see how that is HIPAA wellness compliant (article just references meeting a set point vs. participating in a program) yet in the article there was no mention of HIPAA.  My understanding is that as you said, you can give an employee discounts toward their share of the premium (aka rewards) up to 20% of the total cost of the premium (for whichever plan they're on) but that if you do so, there have to be alternative ways of getting those discounts such as participating in a weight loss program (even if the desired result isn't obtained). We would like to launch into a stronger wellness program but are unclear how to monitor outcomes. I read one article about a company who planned to give premium discounts for meeting  desirable levels for blood pressure, cholesterol, weight (or BMI), and tobacco use.  How does one police this without obtaining health records?  Does it require contracting with an agency who manages health assessments?  We too are confused.