A Quick Guide to the ACA and Wellness Programs


The ACA and Wellness Programs

In 2013, the Affordable Care Act mandated regulations that impacted how employers could run their wellness programs. Many of these stipulations affected areas relating to qualification, rewards, and discrimination. Now, with the impending adoption of Trumpcare, companies are curious as to how wellness programs may be altered. It’s a valid question, but one that may not be clear for some time.

Here is what we know so far about the current relationship of ACA and Wellness Programs, and how it could potentially change moving forward.

Crash Course in ACA and Wellness Programs

Traditionally, a corporate wellness program promotes better health and preventative maintenance in the workplace. You can use a variety of tools and events to encourage progress including:

  • Health assessments
  • Use of metrics and analytics
  • Incentives and penalties
  • Other wellness assets

Employees who participate are rewarded for engaging in healthier behaviors, fighting bad habits like smoking, or achieving health goals. There are usually a set of standards or parameters for each wellness program. But not all employees meet those standards. So, how do you include or treat employees who want to improve their health but don’t exactly fit the parameters of your corporate wellness program? This issue is what the ACA and wellness programs have in common. The ACA set forth rules to help employers avoid discriminating against employees based on medical factors.

Current State of ACA and Wellness Programs

aca and wellness programs

The ACA has now provided definitions for different types of wellness programs including ones that are considered participatory and health-contingent. Participatory wellness programs are only based on participation factors such as:

  • Enrollment in nutrition or fitness classes
  • Participation in individual and team challenges
  • Involvement in weight loss programs

Health-contingent wellness programs are based on actual health conditions or assessments. This type of wellness program includes goal-oriented programs. Reach a goal as an employee and you receive an award.

Possible Changes Moving Forward

One of more heavily discussed possibilities in changes to employer-implemented wellness programs, is the possibility of employees being fined if they choose not to participate. These penalties are as a high as 30 to 60 percent of the total cost of an individual/spousal plan.

We may see alterations in the way incentives work in wellness programs as well. Cash incentives that might be offered for acquiring healthy weight or participating in fitness programs, may be less prevalent than discounts being offered on health premiums. This is due to how insurance companies will be affected should the ACA be repealed.

Again, with many changes still taking place in U.S. healthcare, there are no certainties when it comes to how corporate wellness programs will be affected. What is clear, however, is the benefits that employees and workplace morale gain by coming together in the spirit of improved health and wellness through the implementation of a comprehensive corporate health and wellness program.

Please contact us today to learn more about how the ACA could affect implementation of your corporate wellness program.

Updated on: June, 17 2017 at 10: 15 am