Posts Categorized: Wellness Programs

Wellness Benefits Case Arising Before the 2016 ADA Regulations Is Dismissed

in Court Cases, Welfare Benefits, Wellness Programs

The debate on the interaction between wellness programs, the ADA prohibition on involuntary medical exams and the ADA safe harbor relating to employee benefit plans will not be clarified.  Last week, the U.S. Court of Appeals for the 7th Circuit upheld the lower court’s dismissal of the case, EEOC v. Flambeau, Case No. 3:14-cv-00638-bbc.  The 7th Circuit dismissed the EEOC’s case against Flambeau on the basis that it was moot – the employer had dropped its mandatory wellness program which included biometric screenings as a condition for enrolling in its subsidized health benefits, and there had been no harm to… Continue Reading

The Latest Win for Wellness Programs May Be More of a Win for the EEOC

in Health Benefits, Wellness Programs

Although the U.S. District Court for the Eastern District of Wisconsin held that the employer wellness program at issue in EEOC v. Orion Energy Systems did not violate the ADA, the EEOC may find much it likes in this court’s rationale.  The Americans with Disabilities Act (ADA) prohibits employers from requiring employees to undergo medical examinations or answer disability-related questions, but provides certain exceptions that relate to benefit plans or wellness programs.  There have been several recent cases interpreting these exceptions, many of which had been clear wins for employer wellness programs. In this case, Orion (the employer) waived the… Continue Reading

Certain Mental Health/Substance Abuse Plan Provisions Raise Red Flags

in Health Benefits, Wellness Programs

The Department of Labor has provided sample mental health/substance abuse (MH/SA) plan provisions that require scrutiny to determine compliance with the federal Mental Health Parity rules (MHPAEA).  Here are some common red flags: Pre-Authorization or Pre-Service Notification requirements – Blanket requirements for all MH/SA services – Review required following a certain number of days of in-patient treatment – Medical necessity and prescription drug reviews that differ from those imposed on medical services (such as deferring to attending physicians for medical reviews but not MH/SA or requiring authorization every 90 days for prescriptions relating to MH benefits but not medical) –… Continue Reading

Reminder: Cash Rewards for Participating in a Wellness Program are Taxable

in Health Benefits, Tax Issues, Wellness Programs

The IRS Office of Chief Counsel has released a memorandum (Number 201622031) confirming that the following rewards and incentives result in additional taxable wages to the employee: – Cash rewards payable to an employee for participating in a wellness program (such as a program providing health screening); – The value of certain fringe benefits, such as gym memberships, for participating in a wellness program; and – Reimbursements of premiums for participating in a wellness program when the premiums were originally paid pre-tax through a cafeteria plan (this is similar to the issue previously addressed in Revenue Ruling 2002-3). Although the… Continue Reading

EEOC Issues Two Final Rules Regarding Employer Wellness Programs

in Health Benefits, Welfare Benefits, Wellness Programs

The EEOC issued two final rules today relating to wellness programs, as well as questions and answers, explaining how the ADA and Title II of GINA apply to employer wellness programs that request information from employees and their spouses.  These guidelines provide welcome direction to employers who have faced some uncertainty as to whether they could provide incentives for spouses who participate in their wellness programs and whether their wellness programs comply with the ADA. Here are links to these rules; more detailed information about the requirements of these new rules will be provided shortly. GINA Final Rules:  These FAQs… Continue Reading