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Wellness Programs

By Patricia Anderson Pryor

Wellness programs have become a popular tool for insurance companies and employers. Insurance companies market wellness programs as a method to reduce health insurance costs. Employers use these programs as both a benefit to employees and a cost-saving measure to reduce insurance costs, improve productivity and reduce absenteeism caused by injury or illness. The term 'wellness program' applies to a wide variety of programs designed to improve employee health, including fitness classes, smoking cessation programs, weight loss programs, and medical exams with medical goals based upon the results. Many programs begin with a health-risk assessment in which employees complete a health questionnaire and/or submit to height, weight, cholesterol and other screenings to obtain an assessment of their risk factors and health status. Incentives are often provided for program participation and/or achievement of health goals. Although at first glance these wellness programs seem to be a win-win for everyone ' improved health for employees and reduced costs ' they carry with them a number of inherent legal risks.

However, wellness programs have the potential to run afoul of both the Americans with Disabilities Act of 1990 ('ADA') and the Health Insurance Portability and Accountability Act of 1996 ('HIPAA'). The ADA prohibits discrimination against an individual with a disability, and prohibits certain medical exams and inquiries of employees. HIPAA prohibits discrimination in the provision of health insurance or its costs due to a health-related factor. Both laws provide exceptions for certain wellness programs. Unfortunately, a wellness program that complies with one law does not necessarily comply with the other.

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