Interaction of Bona Fide Wellness Program w/ Health Risk Assess. test - anyone?

[ERISAatty]

I am familiar with the "Bona Fide Wellness Program" proposed regulation Section 54.9802-1. Under this program, a "reward" (with a value of up to 20% of the cost of single employee health coverage) can be offered if a participant meets the standard of a bona fide wellness program.

So far, so good.

BUT - I have a client who wants to give all employees a Health Risk Assessment test (HRA). If an employee refuses to take the HRA, the employer wants to charge the employee the full cost of their health insurance premium, whereas those employees who take the HRA would pay only about 1/4 of that amount.

Assuming, for example, that the full cost of the premium is $1000, and that the discounted premium for employees taking the HRA is $250, the "reward" for taking the HRA exceeds the 20% differential allowed by the proposed reg.

Accordingly, I advised that the program doesn't meet the requirements of a bona fide wellness program, and therefore violates HIPAA.

My client assures me, however, that this is done as standard practice in the market.

The client's argument is that, since the discount is based NOT ON A HEALTH FACTOR, but merely on TAKING THE TEST, this program cannot violate HIPAA.

Any insights from you pros out there is welcome. Do you think that the client could be right - that HIPAA, and the Bona Fide Wellness Program Reg. are not applicable under these circumstances?

Thanks!

[Steve72]

GBurns and I had a fairly good discussion on this very issue just recently.

Recent Thread

I think your client is correct.

[ERISAatty]

Steve72,

Thanks for pointing me in the direction of the recent thread. Interesting....