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Wellness Programs

Effective or 90 days out
Last Updated: December 9, 2015

Effective Date

Plan years beginning on or after January 1, 2014.

Recommended Action

Provision is already in effect or the effective date is within 90 days. Implementation should be complete or close to completion.

Provision Description

Health Contingent wellness programs may increase rewards to 30% of the cost of employee only or family coverage (if dependents are allowed to participate fully in the program). Regulatory agencies may increase this limit to 50% at their discretion (as was done in the case of tobacco v. non-tobacco users).

Current Status

  • Final regulations regarding increase from 20 to 30% and up to 50% for programs designed to prevent or reduce tobacco use.
  • Final regulations issued May 2013.
  • Proposed regulations issued April 2015 regarding EEOC interpretation of "voluntary"

This document is a general summary of regulatory issues and does not constitute legal advice. Readers should contact legal counsel for legal advice. M3 Insurance Solutions for Business, Inc assumes no legal liability for the contents of this document.