The Affordable Care Act (ACA) in 2014 allows employer incentives (or disincentives) for health outcomes to rise from 20% of total premiums to 30%, including both the employer and employee share of the premium. This is one additional reason that increasingly popular wellness programs, notably smoking-cessation efforts, will become more and more widespread.
Employers and their health plan partners see a golden opportunity to control costs by getting workers to adhere to a more disciplined lifestyle. The trick is to do this without breaking any federal or state laws, or alienating employees. Employers’ efforts to operate, manage and enforce wellness at the workplace received a boost after a recent U.S. Court of Appeals ruling concerning a Florida case, Seff v. Broward County.
In the ruling, an employer's wellness program was held not discriminatory under the Americans with Disabilities Act despite certain "penalty" provisions being part of the plan design. The nuances of how employers can or cannot install these programs without running afoul of various protections for workers is something that may limit outcomes if not done properly, but there are ways to get results nonetheless.
And it’s not just smoking in play nowadays, with the 800-pound gorilla in the room being obesity. This issue is not as easily tested for, though, since straight-on measures of height and weight don’t always make sense. A famous BMI measure once found that many NFL football players actually were considered “obese” under the standard, despite being in near-perfect health and condition.
How health plans and employers work in the wellness area will determine the amount of savings that can be found in such efforts by preventing illnesses before they happen. Curbing diabetes, certain cancers and heart conditions is worth the attempt. Do you think wellness programs will be the “it” issue in the coming years? And does the ACA do enough to incent more programs, or does it do too much?
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