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Legal Articles

Final HIPAA Wellness Program Regulations Issued Under Affordable Care Act
On June 3, 2013, the United States Department of Labor, Department of Health and Human Services, Internal Revenue Service, Employee Benefits Security Administration and Department of the Treasury (collectively "the Departments") published in the Federal Register final guidance regarding nondiscriminatory wellness programs under employer-sponsored group health plans. This final guidance was issued in the form of much-anticipated joint final regulations on such wellness programs (the "Final Regulations"). It is important to note that the Final Regulations will apply to wellness programs offered under all group health plans [regardless of whether the plan is "grandfathered" under the Patient Protection and Affordable Care Act (the "Affordable Care Act")]. Moreover, these Final Regulations will be effective for plan years beginning on or after January 1, 2014. The Final Regulations largely mirror the prior rules on nondiscriminatory wellness programs published by the Departments in 2006 and 2012. In addition to clarifying and modifying some aspects of these prior rules, the Final Regulations are designed to implement the Affordable Care Act requirement to increase the permissible reward available to a participant under a discriminatory wellness program to 30 percent of the cost of employee-only coverage. As a result, the Final Regulations increase the maximum reward available under a health-contingent wellness program to 30 percent of the cost of employee-only coverage and up to 50 percent of the cost of employee-only coverage if the wellness program is designed to prevent or reduce tobacco use.

United States | 06/10/2013

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