Health Wellness Newsletters

Compliance with health insurance portability and accountability act (HIPAA) non-discrimination rules is a big challenge for wellness programs.  The old rules were unclear about which incentives passed muster.

That’s all changed, with the rules established earlier this year by the DOL and U.S.  Treasury Department.  The rules themselves haven’t changed, but they’ve been clarified. Here is what you need to know -

â..Participation incentives’ are fine

As long as you structure incentives as rewards for wellness participation, the new rules provide a lot of freedom. All of these are fine under health insurance portability and accountability act (HIPAA) -

o  reimbursing all or a portion of the cost of gym membership

o  financial rewards for undergoing health risk assessments so long as the reward is based on participation rather than test results

o  encouraging preventive care by waiving co-pays or deductibles for these services (i.e., well-baby visits or prenatal care)

o  reimbursing staff for the cost of use of tobacco-cessation programs without regard to the result, and

o  offering rewards tied to workforce attending a monthly health education seminar or working with a wellness Coach.

Conditional rewards OK ifâ..

But what when you want to make the reward conditional on participants meeting specific health goals? Example - Employees who achieve a cholesterol count under 200 get a 20 percent reduction in the cost of their health plan contributions pending results of an annual cholesterol test.

The feds say it’s OK under health insurance portability and accountability act (HIPAA) to do this, too, but your plan must meet five additional requirements -

o  The reward can’t exceed 20% of the cost of employee-only (or, when you allow dependents to participate, employee-plus-dependent) coverage under your health plan.

o  The standards ought to be reasonable (e.g., you can’t limit rewards to folks who can run a marathon).  The rewards also can’t be used as a backhanded way to adversely single out certain staff members (e.g., rewards for all non-diabetics).

o  Participants must’ve the opportunity to qualify for the reward at least once a year (e.g., a smoker who fails to quit this year gets another chance next year).

o  Rewards ought to be available to all “similarly situated individuals.” In other words, you can’t make a company-compensated weight management program available to certain workforce but not others.

When, for medical reasons, it’s unreasonably challenging for an individual to satisfy conditions that are otherwise reasonable, you must offer an alternative. Example -  A pregnant staff member may not be able to meet certain standards, so you must offer her an alternative.

Negative incentives violate HIPAA

So what’s not allowed under health insurance portability and accountability act (HIPAA)’s non-discrimination rules? Anything that punishes individuals  for their health conditions or health risks.

The rules prohibit companys from charging different premiums, contributions, co-pays or deductibles based on personal health factors like obesity or smoking. Nevertheless, it’s OK to reimburse these expenditures based on someone’s participation in your wellness program, without regard to success.

In addition, the feds have added an important new non-discrimination rule - Businesss’ healthcare plans can’t deny benefits for treatment of injuries resulting from a health condition, even if the condition wasn’t diagnosed before the injury.

For example, some healthcare programs have a “suicide exclusion” that denies payment for treating self-inflicted wounds from a suicide try. Now let’s suppose the staff member suffers from clinical depression. Even if the depression was undiagnosed before the suicide try, it’s illegal for your plan to deny benefits to this staff member.

A lot of employers try to reward staff members during the holidays. But be careful -

There’s a common misbelief that the IRS considers gift cards worth $20 or less de minimus benefits and, consequently, they’re tax free. Regretfully, that’s not true.  With few exceptions, the IRS considers almost anything with cash value a taxable form of compensation.

Practically speaking, the IRS is unlikely to go after your firm or an staff member over a few small-value gift cards for which you withheld no taxes. But they could, in particular when your firm regularly hands out gift cards.

At some firms, those $5 to $20 cards can add up to several thousand dollars worth of unpaid taxes in several years. Each $15 gift card would usually require about $5.55 withheld.

To be safe, you are able to use gift cards sparingly and pay the tax for the recipient. Or else you are able to educate folks proactively that Uncle Sam requires you to take out for taxes.

Read the fine print

Gift cards can be money-wasters or or morale-killers when employees have a bad experience trying to redeem them. Read the fine-print before you buy. Three common pitfalls to watch -

o  expiration dates. Some retailers offer cards that last forever. But many have expiration dates, rendering the cards worthless after a period of time

o  dormancy fees. A $50 card can end up worth only $40 at stores that deduct “dormancy fees” after a certain period of time, and

o  redemption fees. Some stores charge a fee for redeeming cards that can be used in multiple locations.

The good news -  There are some good deals out there. Business use of gift cards has doubled since 2001, and related sales bring in $20 billion a year to retailers. With such fierce competition, it pays to shop around.

Evidence-based medicine has become a large buzzword in healthcare over the last few years. But certain non-traditional treatments, like chiropractic care, may also prove effective in certain cases.

The key -  Using these treatments also to â.” not in lieu of â.” conventional medicine may prove more cost-efficient in the long term.

What the latest research says

Do these five common complimentary treatments belong on your health plan? Here is what recent research suggests -

1) Chiropractic care. Studies suggest these treatments might help cut absenteeism for personnel with uncomplicated lower back pain, particularly for individuals  who’ve had it for less than a month.

2) Acupuncture. Research studies show acupuncture can help relieve osteoarthritis, chronic migraines, post-operative pain, low-back pain, fibromyalgia and carpal tunnel syndrome. There’s less evidence about its effectiveness as a tandem treatment for other conditions.

3) Acupressure. There’s no significant research to show this needle-free variation of acupuncture (a therapist applies pressure to specific points on the body) has the same medical benefits.

4) Biofeedback. As reported by the Mayo Clinic, there’s now some research to suggest this treatment can help with some kinds of chronic pain, in particular tension headaches and muscle pain.

Just how it works -  Monitors display a patient’s heart rate, breathing patterns, body temperature and muscle activity. A therapist then teaches the patient how to lower these readings via relaxation.

5) Aromatherapy.  As yet, there’s no evidence of direct medical benefits. While it can be a relaxing treatment to reduce stress, few firms â.” if any â.” foot the bill on employees’ behalf.

Having even one problem drinker on your health plan - including a covered family member with abuse issues â.” can cost your business big.

Some estimates place the potential cost as high as $35,000 a year per case. What’ your company’s risk?

A lot of wellness programs are geared toward managing employees’ health risks associated with diseases like diabetes or asthma.

But unless the wellness program is integrated with an worker assistance program (EAP), chances are alcohol abuse-related risks go undetected. Here are two strategies that’re getting good results.

1. Include alcohol in biometric screenings

If you already sponsor confidential employee health-risk assessments, it’s easy to screen for alcohol risks, too. This could be as simple as making sure three questions are added to the current appraisal -

o  How often do you have a drink containing alcohol?

o  Exactly how many alcoholic drinks do you’ve on a typical day? And

o  Precisely how often in the last month have you’d six or more drinks?

For male staff, more than 14 drinks per week, or one or more episodes of heavy drinking suggests a possible problem. for women, more than seven drinks in a week, or one or more episodes of drinking four or more drinks, is a red flag.

Alternative - When you don’t offer appraisals, you can refer personnel to a free, confidential internet based screening.

Benchmarking tools

Many experts say drug-free workplace policies and staff member assistance programs (EAPs) are the two most proven solutions within companies’ grasp for minimizing the risks and costs of alcohol abuse by health plan enrollees.

To see when sponsoring an employee assistance program makes financial sense, you are able to calculate your own firm’s current cost risk for free here. Plug in your company type, locale and number of staff.

You’ll get a customized estimate of annually direct (absenteeism, disability, ER visits) and indirect (presenteeism, turnover) costs from alcohol misuse by a covered employee or family member.

To design a drug-free workplace policy â.” or check when your existing one is up to par and compliant with the law - more guidance is available here.

The best staff member recognition practices are often the simplest.

Here’s one that’s lately been adopted at the publishing business where I work -  a progam called “See something good, say something good.”  It’s a way for staff members to bring positive attention to things that their colleagues, managers and the company’s different departments do well.

Precisely how it works -  the organization provides colorful index cards, placing them conspicuously in a few widely traveled areas in the building. When workers and supervisors want to publically recognize someone else’s efforts, they are able to grab a card and fill it out. It takes very little time.

When the index card is filled out, the worker drops it into a wrapped box (there are two in the building).  The boxes are later collected and the cards displayed in a room the business uses periodically for meetings, presentations and quarterly worker appreciation events.

In order to build awareness and participation in “Say Something Good,” management put up fliers around the building, so people  from every department can see them, in addition to visitors and job applicants who’ve come in for interviews.

The health promotion program, which was originally thought up by the head of our product marketing division, doesn’t cost anything apart from the cost of the index cards and paper. There’s minimal administration time, and it takes staff members only a moment or two to fill out a card on a fellow employee’s behalf.

But the return is tremendous, and the recognition possibilities are endless. It’s a good way to improve morale, encourage productivity and differentiate the company culture from work environments where the negative things seem to get the lion’s share of the attention.