Wellness programs and health care reform: Where are we?
Posted on May 6, 2013 | Written by Sean McManamy | Comments (0)
As new regulations roll out in 2013, staying up to date with the Affordable Care Act is a top focus of employer’s health care strategy this year. In addition, improving employee health also remains a top priority, according to a recent Towers Watson and National Business Group on Health survey.Click to see more
The Affordable Care Act has several provisions designed to help improve employee health and expand health promotion activities. Below is the status of several health care reform provisions related to wellness programs:
- The proposed regulations on wellness program incentives technically have not been finalized. However, the provision that allows an employer to increase the incentive amount under a health-contingent wellness program, from 20% up to 30% of the cost of coverage as of the first plan year on or after Jan. 1, 2014, is part of the statute. This means an employer could increase the incentive amount to 30% in 2014, even if the regulations aren’t yet final, without “breaking the law.” From a practical standpoint, it might be prudent to wait until the regulations are final, but this decision is up to each employer. (NOTE: As of May 29, 2013, the Department of Health and Human Services, Department of Labor, and Department of Treasury published the final regulations on this, consistent with the Affordable Care Act. Click here to read more about this final wellness programs rule.)
- The Affordable Care Act established a technical assistance role for the Centers for Disease Control and Prevention (CDC) to provide resources for evaluating employer wellness programs. This includes training employers on how to evaluate their programs and providing a survey to help assess employer-based wellness policies and programs. These resources are available and you can find them here on the CDC’s Website.
- The Affordable Care Act called for $200 million to be set aside for wellness program start-up grants for small businesses to develop wellness programs between 2011 and 2015. This funding has not yet been made available.
- A 40% excise tax on high-cost or “Cadillac” plans takes effect in 2018 for plans with an annual cost of more than $10,200 for individuals and $27,500 for families. In response, employers may decide to step up their wellness efforts today to better control their future health care costs.
With the ongoing demands of new regulations, staying on top of health care reform is a challenge. To learn more about health care reform changes affecting employer health coverage, I encourage you to visit our parent company’s blog: Trustmark & Healthcare Reform.
To learn more about how HealthFitness partners with employers to effectively improve employee health, please visit Our Approach.
As Senior Vice President, Strategy and Product, Sean brings strategy, product and marketing together in leading the development and introduction of innovative, quality products designed to meet the expanding needs of a rapidly-changing market. Prior to joining HealthFitness he served in a series of leadership positions within The Trustmark Companies, including vice president, product development and marketing for HealthFitness sister company CoreSource. Prior to joining Trustmark, Sean served as assistant vice president, state government affairs for the American Insurance Association.