As employers and insurers continue to navigate the intricaciesof the Patient Protection and Affordable Care Act, they're findingthat managing wellness programs and non-discriminatory incentives(or disincentives) can be tricky.
“PPACA extended HIPAA non-discrimination rules as to what isconsidered a non-discriminatory incentive or disincentive,”explains Amy Gordon, a wellness benefits attorney with McDermottWill & Emery. “It used to be that the incentive was capped at20 percent of the total premium—or total contribution if theemployer is self-insured. But PPACA raised that 20 percent to 30percent for most programs and up to 50 percent for tobaccocessation.
“Just in the last year, when the new incentive and disincentiveregulations went into effect, we have definitely seen employersramping up their penalties and incentives,” Gordon says.
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