On May 29, 2013, the IRS, DOL and HHS issued final regulations on employer wellness programs under PPACA. The final rules are largely consistent with, but reorganize the content of, the proposed rules issued in November 2012 (on which the agencies received approximately 5,000 comments). Effective for plan years beginning on or after January 1, 2014, the final rules apply to insured and self-funded health plans, regardless of grandfathered status. Certain provisions of the final rules:
- increase the maximum permissible reward or penalty under a health-contingent wellness program offered in connection with a group health plan to 30% of the total cost of coverage, and 50% for components designed to prevent or reduce tobacco use
- clarify the reasonable design of health-contingent wellness programs (now subdivided into "activity-only programs" and "outcome-based programs") and the reasonable alternatives they must offer to avoid prohibited discrimination
- establish criteria for an affirmative defense against a claim that the plan discriminated based on health status in violation of HIPAA
The final regulations take effect 60 days after the June 3, 2013 publication in the Federal Register.
The DOL has also posted on its website the Workplace Wellness Programs Study: Final Report, a study commissioned by the DOL and HHS that investigates the impact of workplace wellness programs on health and medical cost, facilitators of their success, and the role of incentives.
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