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Wellness Programs                                    

This page covers the following topics regarding wellness programs:

  • Overview
  • HIPAA and ACA Requirements
  • ADA Requirements
  • GINA Requirements
  • Additional Information

Overview

Wellness programs are health promotion and disease prevention programs and activities offered to employees as part of an employer-sponsored group health plan or separately as a benefit of employment.   

Wellness programs generally come in two different forms:    

  • Participatory Wellness Programs: Generally available without regard to an individual’s health status. Either no reward is offered, or none of the conditions for obtaining a reward are based on an individual satisfying a standard related to a health factor. 
  • Health-Contingent Wellness Programs: Requires participants to satisfy a standard related to a health factor in order to obtain a reward. There are two types of health-contingent wellness programs:
    • Activity-only programs require an individual to perform or complete an activity related to a health factor in order to obtain a reward. Examples include a walking, diet or exercise program.
    • Outcome-based programs require an individual to attain or maintain a specific health outcome (such as not smoking or attaining certain results on biometric screenings) in order to obtain a reward.

Wellness programs are generally subject to certain requirements under the Health Insurance Portability and Accountability Act (HIPAA), the Americans with Disabilities Act (ADA), and the Genetic Information Nondiscrimination Act (GINA).

HIPAA and ACA Requirements


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