Corporate Wellness Program Success: 3 Goals, 2 Formats, 1 Solution

Transcription

1 Corporate Wellness Program Success: 3 Goals, 2 Formats, 1 Solution A Wellworks For You Ebook

2 Corporations everywhere are realizing the significant advantages of implementing corporate wellness programs within their workplaces. Whether employees are white collar, blue collar, full or part time, the value of promoting health and wellness among your staff should not be underestimated. While your company may have distinct objectives in place, most corporations that choose to start wellness programs share a few, common goals. 3 Common Goals of Corporate Wellness Programs: Save money on healthcare-related costs (this includes absenteeism, worker s comp, expenses related to addressing chronic disease) Boost employee efficiency (healthier employees work better, quicker and don t frequently miss work due to health complications) Improve the overall morale of the workplace (when employees feel cared for by their company, they take ownership of their jobs and are excited to excel) 2 Formats: Different Types of Programs An employer plan sponsor or insurer is allowed to characterize its wellness programs as either providing rewards (or incentives) or imposing penalties (or surcharges). The employer's or insurer's choice of terminology should not be detrimental from a HIPAA wellness program legal perspective. That said, other laws (such as the ADA) may influence employer plan sponsors and insurers toward utilizing positive descriptors and motivators (e.g., rewards/incentives), as opposed to negative descriptors and motivators (e.g., penalties/surcharges), in describing the terms of its wellness program. The final regulation continues to divide wellness programs into two categories, and newly divides health-contingent wellness programs into two subcategories: 1. Participatory Wellness Programs 2. Health-Contingent Wellness Programs Activity-only wellness programs Outcome-based wellness programs

3 Participatory Corporate Wellness Programs Participatory wellness programs are programs that either: do not provide a reward or do not include any conditions for obtaining a reward that are based on an individual satisfying a standard that is related to a health factor. In addition, participatory wellness programs must be made available to all similarly situated individuals, regardless of health status. Examples of participatory wellness programs include: A program that reimburses all or part of the cost of membership in a fitness center A diagnostic testing program that provides a reward for participation in the program (ex: taking a biometric screening) and does not base any part of the reward on the test result A program that encourages preventive care through the waiver of the copayment or deductible requirement under a group health plan for the costs of, for example, prenatal care or well-baby visits (reminder: the PPACA's preventive services mandate requires non-grandfathered plans to provide certain preventive health services without participant cost sharing) A program that provides a reward for or reimburses employees for participating in a smoking-cessation program without regard to whether the employee quits smoking A program that provides a reward to employees for attending a monthly, no-cost health education seminar A program that provides a reward to employees who complete a health risk assessment regarding current health status, without any further action required Below you will find a sample breakdown of a basic, recommended participatory program. This sort of program is perfect for boosting engagement and providing practical incentives in the early years of your company s wellness program. Of course, all programs are entirely customizable through Wellworks For You and as your program grows, your events and incentives should adjust to meet changing needs. For more sample breakdown charts, contact Wellworks For You to talk to an account specialist and request a free trial. We can help you formulate the perfect combination to match your company s current needs.

4 PROGRAMS & EVENTS General Health Assessment Attend onsite Health Fair Meet with a Health Coach onsite Attend onsite Lunch & Learn Gym Membership Track Workouts on Wellness Portal SAMPLE INCENTIVES Gift Cards or Promotional Items Cash Incentive Gym Reimbursement Movie Tickets Free Pedometer Additional PTO For more details about the various wellness activities and events that we can help you facilitate, please see our programs information page. Health Contingent Wellness Program In contrast, health-contingent wellness programs require an individual to satisfy a standard related to a health factor to obtain a reward or require an individual to undertake more than a similarly situated individual based on a health factor in order to obtain the same reward. This standard may be performing or completing an activity relating to a health factor, or it may be attaining or maintaining a specific health outcome. Ostensibly, this represents discrimination among plan participants and beneficiaries based on their health status, which is generally prohibited under current HIPAA rules and the PPACA. However, if a group health plan or insurer complies with the five special (and revised) requirements for health-contingent wellness programs, the final regulation continues to permit such rewards, similar to the permissibility of such wellness program rewards under current HIPAA rules. The final regulation subdivides the category of health-contingent wellness programs into two new subcategories: 1. Activity-only Wellness Programs 2. Outcomes-based Wellness Programs Under an activity-only wellness program, an individual is merely required to perform or complete an activity related to a health factor in order to obtain a reward. Activity-only wellness programs do not require an individual to attain or maintain a specific health outcome. Examples of activity-only wellness programs include:

5 1. Activity-only Wellness Programs 1. Walking programs 2. Diet programs 3. Exercise programs Download a FREE Guide to Implementing Wellness Challenges *PLEASE NOTE: Some individuals may be unable to participate in an activity-only wellness program due to a health factor. For example, an individual may be unable to participate in a walking program due to a recent surgery or pregnancy, or may have difficulty participating due to severe asthma. As described later, the final regulation, therefore, provide safeguards to ensure these individuals are given a reasonable opportunity (i.e., a reasonable alternative standard) to qualify for the reward. 1. Outcomes-based Wellness Programs Alternatively, under an outcomes-based wellness program, an individual must attain or maintain a specific health outcome (such as not smoking or attaining certain results on biometric screenings) in order to obtain a reward. Generally, in order for outcome-based wellness programs to comply with the final regulation, the program generally has two tiers: Tier 1: A measurement, test, or screening as part of an initial standard Tier 2: A program that targets individuals who do not meet the initial (healthy) standard in Tier 1 with required follow-up wellness activities, for example, for individuals who do not attain or maintain the specific healthy outcome in Tier 1, compliance with an educational program or another activity may be offered as an alternative to achieve the same reward as Tier 1 healthy individuals Examples of outcome-based wellness programs include a biometric screening that tests individuals for specified medical conditions or risk factors (such as high cholesterol, high blood pressure, abnormal BMI or high glucose level) and provides a reward to employees identified as within a normal or healthy range (or at low risk for certain medical conditions), while requiring employees who are identified as outside the normal or healthy range (or at high risk) to take additional steps (such as meeting with a health coach, taking a health or fitness course, adhering to a health improvement action plan or complying with a health care provider's plan of care) to obtain the same reward.

6 5 Requirements for Health-Contingent Programs As under current HIPAA rules, health-contingent wellness programs will be permitted in a group health plan only if they satisfy all five special requirements, as restated and revised in the final regulation. The five special requirements are: Frequency of opportunity to qualify Size of reward Reasonable design Uniform availability and reasonable alternative standards Notice of availability of reasonable alternative standards These five requirements will generally be familiar from the current HIPAA health status nondiscrimination rules. However, some of the five requirements, in particular, the size of the reward and the uniform availability and reasonable alternative standard, have been modified in the final regulation in several important ways. The five requirements apply only to wellness programs that are health-contingent programs (i.e., a wellness program that both provides a reward and conditions the reward on satisfying a standard that is related to a health factor). Participatory wellness programs are not required to comply with any of the above-referenced five requirements 1 Solution: Implement a Corporate Wellness Program Wellworks For You was created as a vehicle to assist employers in designing and implementing a comprehensive wellness program. We recognize that healthy minds and healthy bodies are the catalyst to a successful working environment. Corporate wellness programs have a proven track record of Return on Investment (ROI). The pitfalls of many programs is that they are still one dimensional, not personalized, and passive with minimal participation. The Wellworks For You Program commits to a strong focus on your employees by promoting organizational integration and strong communication. We believe the key to a successful program is engagement! Our proprietary platforms, systems and incentive management systems deliver the highest employee participation with a measurable return on investment. CONTACT US info@wellworksforyou.com