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Health Care Reform News

Incentives for Non-Discriminatory Wellness Programs in Group Health Plans

November 26, 2012


The Department of Health and Human Services (HHS) has published a series of proposed rules implementing several Affordable Care Act (ACA) insurance reforms, including Incentives for Non-Discriminatory Wellness Programs in Group Health Plans, to promote employer wellness programs and encourage opportunities to support healthier workplaces.


The proposed rules support workplace wellness programs, including "participatory wellness programs" which generally are available without regard to an individual's health status. These include:

  • Programs that reimburse for the cost of membership in a fitness center
  • That provide a reward to employees for attending a monthly, no-cost health education seminar
  • That provide a reward to employees who complete a health risk assessment without requiring them to take further action

The rules also outline amended standards for non-discriminatory "health-contingent wellness programs," which generally require individuals to meet a specific standard related to their health to obtain a reward.  Examples of health-contingent wellness programs include:

  • Programs that provide a reward to those who do not use, or decrease their use of, tobacco
  • Programs that provide a reward to those who achieve a specified cholesterol level or weight
  • Programs that reward those who fail to meet that biometric target but take certain additional required actions.

The proposed rules would apply to plan years beginning on or after January 1, 2014.


There is a 60-day comment period on the proposed rule.


For a complete review of the proposed ruling, please see the attached document. Additional information on health care reform can be found on


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