Donald J. Walsh, Esq. Offit Kurman, PA. Benefits Costs Absenteeism Disability Presenteeism.
-
Upload
cathleen-west -
Category
Documents
-
view
212 -
download
0
Transcript of Donald J. Walsh, Esq. Offit Kurman, PA. Benefits Costs Absenteeism Disability Presenteeism.
WELLNESS &
THE LAWDonald J. Walsh, Esq.
Offit Kurman, PA
BenefitsCostsAbsenteeismDisabilityPresenteeism
Types of Wellness ProgramsHotlinesEducation seminarsEmployer sports teams/equipmentFlu shotsHealth risk assessmentsSmoking cessationWeight management
General NondiscriminationCannot be denied eligibility for benefits
based on “health factors”Health statusMedical conditionClaims experienceReceipt of health careMedical historyGenetic historyEvidence of insurabilityDisability
Legal ImplicationsHealth Insurance Portability and
Accountability Act (HIPAA) Employee Retirement Income Security Act
(ERISA) by virtue of HIPAAAmericans with Disabilities Act (ADA)Age Discrimination in Employment Act (ADEA)Genetic Information Nondiscrimination Act
(GINA)State LawMisc. Liability
HIPPAProtected and confidential health information
Prohibits using health factor as a basis for discrimination with regard to:Eligibility to enroll or Premium contributions
“Bona Fide Wellness Program” Targets obesity, nicotine addiction, high cholesterol,
etc.
Qualified ProgramsProgram that reimburses cost of fitness
membershipDiagnostic testing that rewards for
participation and not resultsProgram which encourages preventative care
through waiver of co-payment for certain activities (pre-natal, well baby, etc)
Program which rewards for costs of stop smoking clinic regardless of whether quit
Rewards for attending monthly health seminar
Bona Fide Wellness ProgramTotal reward to employee is limited to 10% to
20% of total cost of employee-only coverageProgram must be reasonably designed to
promote good health or prevent diseaseReward available to all similarly situated
employeeIf unreasonably difficult due to medical
condition, must offer a reasonable alternative (may get verification)
Plan must disclose the reasonable alternative
ADANothing prohibits such program but prohibits
employers from denying employees from participating in activity or benefit based on disability
Programs must be voluntary (value of benefits may influence whether voluntary)
Reasonable accommodation
ADA (continued)
Types of PoliciesNo smokingAchieving particular health scoreHigh cholesterol
ADEADisparate Impact Claims
TBA
GINAProhibits requesting/requiring genetic
informationCan’t collect through health risk assessments
including family historiesMay do a program that is not tied to
providing info or voluntarily provide
State LawOut of Office StatutesState Smoking Discrimination
Misc. LiabilitySports Teams and Fitness EquipmentWorker’s CompensationFair Labor Standards ActTaxes for incentives which are more than
deminimisSecondary liability as employer
Huffman v. SmithKline Beecham