Posts Tagged ‘benefits’

Helpful Information from 3 Presentations at the 2014 Compensation and Benefits Conference

Thursday, August 21st, 2014

Comp Ben Save Date 2014 (2)CAI hosted its 2014 Compensation and Benefits Conference at the McKimmon Center on Thursday, August 14 and Friday, August 15. More than 200 HR professionals and company executives attended the two-day event to review and discuss emerging workplace trends surrounding compensation, benefits and total rewards, as well as the impact these trends leave on culture and profitability.

This year’s conference speakers shared presentations on how to attract and motivate top talent, strategies to increase employee engagement, reinforcing a positive workplace culture, and more. Keynote presentations for the 2014 conference lineup included:

The Future of Attraction, Retention and Motivation: How Compensation Fits into the Process Anne Ruddy – WorldatWork

What Would Healthcare Look Like If Getting It at the Lowest Cost Was Your Key Priority? Skip Woody – Hill, Chesson & Woody Employee Benefit Services

Green Goldfish – 15 Ways to Drive Engagement & Reinforce Culture Stan Phelps – 9 INCH marketing

Leverage Marketplace Trends When Making Decisions about Compensation and Benefits Strategies Molly Hegeman – CAI

In addition to the keynote sessions, conference participants had the opportunity to attend several of the many breakout sessions. Why performance management fails, building high performing teams, work-site wellbeing, and understanding survey data are some of the topics of this year’s breakout sessions.

Below are three sets of insights conference speakers shared with last week’s audience:

–Anne Ruddy shared the changes in employee attitudes from recipients to consumers of rewards in her keynote presentation:

From:

Employer loyalty

Traditional work design

Pay = position

Retirement security

To:

Self-managed careers

Virtual, flexible environments

Pay = performance, market

Individual career management

 

–In the breakout session Why Performance Management Fails, Mike Maciekowich shared five reasons why companies need performance management systems:

  1. Help managers to observe their staff more closely and to do a better coaching job.
  2. Motivate employees by providing feedback on how they are doing.
  3. Provide back-up data for management decisions concerning advancement, transfers, dismissals, and so on.
  4. Improve organization development by identifying people with promotion potential and pin-pointing development needs.
  5. Establish a research and reference base for personnel decisions.

 

–CAI’s Sherry Hubbard-Bednasz explained the purpose of salary surveys in her presentation Taking the Mystery Out of Survey Data:

Salary surveys:

  • Provide a fair representation of pay practices occurring in the market
    • Sample reflects population
    • Consider source, methodology, transparency
  • Show how variables impact pay
    • Size of company
    • Industry/sector
    • Geography
  • Indicate trends in pay
    • Overall market movement
    • Movement in certain segments
  • Inform compensation decisions as a guide, not absolute

For additional information on CAI’s conferences, please go to https://www.capital.org/eweb/DynamicPage.aspx?site=cai&webcode=cai-training-conferences.

 

In An Environment Of Uncertainty, Prepare To Comply With The ACA

Thursday, August 14th, 2014

The post below is a guest blog from Mike Beck who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

hcw 8 14In the last few weeks, there’s been multiple Affordable Care Act (ACA) developments, ultimately impacting large employers with 50 or more employees. How and when will they occur is another story, and it is easy to see why some employers are perplexed. Predicating what the ACA will look like a year from now is very difficult with some saying the employer mandate may be delayed again. Let’s review the recent events and how they are contradictory in many ways.

On July 22, the United States Court of Appeals for the District of Columbia Circuit concluded that PPACA’s subsidies should only be available to individuals purchasing health insurance in exchanges operated by a state – calling into question all the subsidies that have been obtained to date through the Federal exchange. Hours later in Richmond, Va., the United States Court of Appeals for the Fourth Circuit decided that legislative intent was to make tax subsidies available to individuals purchasing health insurance through a federally funded exchange or a state-based exchange if the state failed to create one. These two conflicting rulings are likely to go to the Supreme Court. For now, subsidies/tax credits will continue to be granted on the Federal Exchange. If the D.C. Circuit’s decision is upheld, it could strike a serious blow to the employer mandate since receiving a subsidy is a primary trigger of the employer mandate.

On July 24, the IRS published draft forms for the Code 6056 employer Minimum Essential Coverage reporting and disclosure requirement to the IRS and to individuals. This reporting requirement has multiple purposes as it allows the IRS to enforce the employer mandate, enforce the individual mandate, and confirm eligibility for premium tax credits for coverage purchased through an Exchange. This reporting along with the associated forms take effect in 2015 and are due in January 2016.

So in the same week, we witnessed a decision by an appeals court that called into question the viability of the Employer Mandate and suggested a possible delay, and then actions by the IRS which seem to indicate the Employer Mandate is moving forward as scheduled.

Regardless, large employers need to be prepared to comply with the employer mandate in 2015 and the associated reporting requirements. This should include a review of current payroll and HRIS systems to ensure they will be able to meet the new reporting requirements. The safe play is to assume that the employer mandate will go into effect without another delay, and if a delay occurs, organizations will have more breathing room to implement.

Are Gated Health Plans the Way of the Future?

Tuesday, July 22nd, 2014

The post below is a guest blog from Steve Byrd who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

hcw 7 14As employers continue to identify new ways to control their health plan costs, many employers are considering gated health plans as an option. A “gated” health plan, offers a different spin on the traditional wellness incentive that employers and employees have become used to.  Instead of offering employees lower payroll deductions through the completion of a health assessment or completion of a biometric screening, employers are now considering the option of offering richer benefits as well.

In a recent survey, more than 1,000 employers were asked to disclose current plan designs and changes they expect in the next three to five years. It’s a way for employers to control costs and reward employees for their healthy lifestyles.

52 percent of employers said their current health plan focuses on traditional trend mitigation approaches, such as employee cost shifting. Interestingly enough, it dropped to 21 percent when asked if this would be their preferred approach in three-to-five years.

Employers are beginning to lean more towards plans that require employee action.

In the upcoming years, over 60 percent of employers plan to introduce a gated plan, where employees must complete a task to obtain access to richer design options, compared to only 20 percent who “gate” their employees today. In the past we’ve seen incentives to help lower payroll deductions, but now with gated plans, there is an option to improve benefits.

Employees are also considering implementing the following tactics to mitigate health costs:

  • 72 percent of employers are or will be reducing subsidies for dependents
  • 52 percent of employers anticipate using unitized pricing—where employees pay per person and not individual versus family—up from 5 percent today
  • 42 percent of employers are considering offering high-deductible health plans as a full replacement plan, up from 15 percent today
  • 24 percent of employers plan to offer employees tools to guide decisions in plan selection and utilization, up from 19 percent today
  • 92 percent plan to offer cost transparency tools, up from 49 percent today

While employers are evaluating these new options, and continuing to ask their employees to become more engaged, it is important they evaluate their plan designs carefully.  These new gated plan options are permissible under HIPAA wellness rules.  However, it is very important to ensure they are designed correctly, as they must be carefully structured to comply with both ADA and GINA requirements.  Also, these plans would need to provide a reasonable accommodation to anyone who can’t participate due to a disability, as restricting eligibility in a plan based on participation could be seen as more of a penalty than a monetary premium differential.

Employer vs. Federal Marketplace Open Enrollment

Thursday, June 19th, 2014

The post below is a guest blog from Dax Hill who serves as Principal, Health & Welfare Consultant for CAI’s employee benefits partner Hill, Chesson & Woody.

hcw juneEmployers with “non-calendar” plan years may find themselves in the middle of a dilemma with the Marketplace open enrollment.

In preparation of the “pay or play” provision under PPACA, some employers are looking to shift contributions towards the employee portion and away from the dependents coverage.  This strategy will help employers avoid penalties under 4980h of the tax code and make coverage “affordable” for the employee only portion.  However, redistributing premium contributions towards employees only coverage could significantly increase the cost for those employees with dependents.  These employers might assume that the dependents could then go apply for coverage though the Federal Marketplace – which works only if the employer’s open enrollment coincides with the Federal Marketplace open enrollment period. For 2014, the Open Enrollment Period was October 1, 2013–March 31, 2014. In 2015, the proposed Open Enrollment Period is November 15, 2014–February 15, 2015.

What happens if the employer increases dependent premiums during their open enrollment and the employer’s open enrollment does NOT coincide with the Federal Marketplace open enrollment?  In this scenario, an increase in premium is NOT a qualifying event for the Federal Marketplace – meaning that the dependents would not be eligible to enroll for medical coverage until the next Marketplace open enrollment.  Things can get more complicated assuming that your Section 125 plan runs on the same non-calendar plan year as your medical insurance plan year.  If dependents decide to remain on the employer’s medical insurance plan and pay on a pre-tax basis, the dependents would not be allowed to come off of the employer’s medical insurance plan unless they experienced a life qualifying event. At which point, they would again miss the open enrollment for Federal exchange.  You can see that this could become a vicious cycle and lead to frustration to both employers and employees.

There is a push to modify the regulations to allow individuals to obtain coverage mid-year through the Marketplace for non-calendar year plans.  In the meantime, employers should understand the regulations and strategies allowing individuals to enroll onto the Marketplace.

Contact an HCW consultant regarding possible solutions to this problematic situation.

 

Total Rewards and Business Strategy Are Not Aligned at Most Companies

Tuesday, June 10th, 2014

Expensive giftThe Total Rewards Survey developed by Mercer analyzes the practices companies use to align compensation, benefits, training and career development with today’s business priorities. Findings from the survey show that while more than half (56 percent) of organizations made a significant change to their total rewards strategy in the past three years, less than one-third (32 percent) said their total rewards and business strategies fully align.

Eighty-nine percent of organizations that participated in the survey ranked attracting and retaining the “right” talent as the most noteworthy challenge of their overall total rewards strategy. Additional challenges that were noted as very important included: collecting relevant market compensation data, keeping rewards affordable, communicating the value of rewards to employees, and ensuring pay for performance and performance differentiation.

From experiences with many clients, Mercer has highlighted several actions employers can put in place to address the holes between total rewards strategies and their business strategies:

“As companies focus on the cost of their talent, attracting and retaining the ‘right’ employees and differentiating rewards for top performers are challenges that can be made easier by incorporating the use of workforce analytics,” said Mary Ann Sardone, Partner in Mercer’s Talent practice and Regional Leader of the firm’s Rewards segment.

“Additionally, incorporating offerings such as career development and work/life balance initiatives into total rewards strategies caters to the needs of [employees] in the workplace.”

Leading the list of ways to enrich the employee experience in other ways than pay is giving employees the ability to make a difference in their job functions. Other contenders on the list were career progression, healthy living/wellness and recognition.

For additional information on recent trends and developments in total rewards strategy, including an in-depth look at what North Carolina employers are doing, please join us for the 2014 Compensation and Benefits Conference on August 14 and August 15 at Raleigh’s McKimmon Center.

This year’s keynote presenters and presentations include:

The Future of Attraction, Retention and Motivation: How Compensation Fits into the Process Anne Ruddy – WorldatWork

Green Goldfish – 15 Ways to Drive Engagement & Reinforce Culture Stan Phelps – 9 INCH marketing

What Would Healthcare Look Like If Getting It at the Lowest Cost Was Your Key Priority? Skip Woody – Hill, Chesson & Woody Employee Benefit Services

Leverage Marketplace Trends When Making Decisions about Compensation and Benefits Strategies Molly Hegeman – CAI

Additional topics that speakers will cover at the conference include: how compensation affects retention, the future of healthcare cost, driving employee engagement, analysis of the latest market data in total rewards, building high-performing teams, and understanding survey data.

For more information on conference speakers and topics, please visit www.capital.org/compconf.

Wellness Programs Provide Measurable Improvements in Company Medical Costs and Risk Profiles

Tuesday, May 6th, 2014

office wellnessIn an effort to beat rising health care costs, employers are implementing programs that directly influence employees’ individual behaviors and health habits, according to the Willis Health and Productivity Survey conducted by Willis North America Human Capital Practice. Nine hundred employers, ranging in fewer than 100 employees to more than 10,000 employees, participated in the survey.

The health-focused survey shows that the return on investment from wellness programs is positive. Nearly half (49 percent) of the respondents with a wellness program cited measurable improvement in their organization’s medical costs or an improved risk profile among employees. Seventy-eight percent of the respondents with wellness plans said they were using an incentive to drive participation in employer-sponsored programs.

Companies are using their wellness programs to address behavioral change and lifestyle issues, like exercise and nutrition. Some key findings of the survey included:

  • Sixty-one percent of employers said that employees’ health habits are the number one challenge in controlling health care costs. High catastrophic cases ranked second with 47 percent and compliance due to health care reform was third with 34 percent.
  • Ninety-three percent of employers believe that healthier employees are more productive. However, few are measuring the impact on productivity of employee absenteeism (22 percent) and FMLA (19 percent).
  • The number one strategy organizations say they are using to address health care costs is to provide employees with tools and information in order to be better consumers. Sixty-four percent of respondents reported that as their best strategy.

Want to encourage your employees to maintain a healthier lifestyle? Check out some of the blogs below that focus on fitness and healthy living for tips:

Review this blog for tips in helping your employees achieve the right balance for their life at work and outside of work: http://blog.capital.org/help-your-employees-achieve-and-maintain-worklife-balance/.

Looking for ways you can incorporate fitness into the office? This blog includes several work-friendly exercises: http://blog.capital.org/enhance-your-health-and-productivity-with-work-friendly-exercises/.

Stress can lead to serious health consequences for your employees. Read this blog to find out how you can help your employees manage their stress levels: http://blog.capital.org/america-is-stressed-five-tips-to-help-your-employees-prevent-the-effects-of-workplace-stress/.

Employee-sponsored wellness programs provide organizations with many benefits. If you’re interested in starting one at your organization, you will want to take a look at this blog: http://blog.capital.org/create-a-healthier-workplace-with-a-company-wellness-program/.

American Workers Are More Interested in Money Than Time

Tuesday, April 29th, 2014

money over timeA recent survey from national finance recruitment firm Accounting Principals indicates that money is more important than time for most Americans. More than 1,000 adults participated in the survey that the finance firm conducted from January 17 to January 24 in 2014.

According to the survey results, 79 percent of working Americans would prefer a 5 percent raise instead of an extra week of vacation. Of the respondents, only 20 percent preferred the extra week. Statistics from the survey show that income level and seniority within a company does not make a difference when it comes to the participants’ preferences.

Revelations from the survey show that Americans can’t afford to shorten their work schedule if that means taking a pay cut. Eighty-five percent of respondents wouldn’t give up any of their salary for their workday to be shortened by one hour each day. Half of the participants who said they wouldn’t give up any of their salary report not doing so because they can’t afford to do so.

How American workers use their spare time was also analyzed for Accounting Principals’ survey. When participants do have time off, 48 percent choose to spend time with their family while 45 percent use the time to run errands. Fitness is also a priority for American workers. One-third of survey respondents chose to go to the gym if they were given an extra hour each day. Additional activities Americans would choose to do if they had an extra hour include sleeping/napping, watching TV and going to happy hour.

Although the survey shows that Americans value money over time, many employers are not able to give bonuses or raises for the year. Money is not always the reason why employees stay at a company either. Employers can provide their workers with several valuable perks that recognize and reward their contributions, make their work life and home life easier, or help them stay on track with their career goals.

Below are some blogs to help you reward and motivate your staff with or without money, check them out:

In this video blog, CAI’s Vice President of Membership, Doug Blizzard, explains how making praise a priority, helps employee morale and motivation soar — http://blog.capital.org/what-is-the-best-employee-reward/ .

You can find 19 easy ways to recognize and reward employees at no or low cost to the employer in this blog — http://blog.capital.org/19-low-cost-ways-to-recognize-employee-achievements/ .

Doug Blizzard encourages employers to not make the common mistakes of overlooking or devaluing the importance of pay to employees’ motivation in this video blog — http://blog.capital.org/are-you-paying-your-employees-enough-money/.

Looking to build a positive employer-employee relationship at your organization? Review the four tips on this blog to achieve your amicable goal — http://blog.capital.org/4-steps-for-building-positive-employer-employee-relationships/.

Photo Source: Jay Sumlin

How Communication And Education Can Reduce Drug Costs

Thursday, November 21st, 2013

The post below is a guest blog from Steve Byrd who serves as Principal, Health & Welfare Consultant  for CAI’s employee benefits partner Hill, Chesson & Woody.

hcw pillWith the cost of healthcare increasing steadily, everyone is constantly looking for ways to reduce claims and slow the trajectory. Since the passage of the Patient Protection and Affordable Care Act (ACA), discussion over how much healthcare utilization actually costs has become a central focus for both providers and consumers. One often overlooked method of lowering costs is better prescription drug management.

One of the most trusted relationships that can exist is one between a patient and a physician. When a drug is prescribed, there is rarely any second-guessing or further questioning from the patient. While it goes without saying that the doctor has the patient’s best interests in mind, it may be that there are other, more cost effective solutions that should also be considered.

The first and most obvious cost saving measure is to ask for generic prescriptions. Generic drugs can cost fractions of what name-brand drugs cost and are identical in their chemical makeup. Name brand drugs are more expensive because the pharmaceutical company has to pay for research and development, marketing, and then try to make a profit. However, once the patent on that drug expires, companies can come in and produce them for much cheaper without having to conduct the research or safety studies. This results in much lower costs to the healthcare system.

If there is not an available generic, ask for a free sample. Pharmaceutical companies are constantly supplying physicians with samples of their drugs in hope that they will prescribe them. If you are treating a short-term problem, a free sample may keep you from filling your prescription at all.

In some instances generics are not available. In these cases, ask for less costly therapeutic equivalents. This may be a different chemical or drug, but the treatment result is the same.  Instead of one more expensive prescription, you may get another, cheaper, prescription that has the same effect on your condition.

It is also important to shop pharmacies and utilize savings found at retail stores. Even though a patient may pay a small copay for whatever prescription they are having filled, the actual cost of the drug can vary from pharmacy to pharmacy, and even from location to location of chain pharmacies. Most people tend to fill all of their prescriptions at one pharmacy without ever following up on the cost. This may result in paying higher prices for the same drug. It is also important to shop at retail stores, especially for generics. Stores such as Costco, Wal-Mart, and many chain supermarkets will often fill generic prescriptions for less than the copay. This results in double savings: the customer doesn’t spend as much out of pocket and there is no pharmacy claim against the health plan.

Healthcare insurance costs are going to continue to rise. In order to minimize the impact that these rising costs have, it is becoming more critical for the consumer to use the system effectively and efficiently. It is essential to communicate with your employees the importance of good prescription drug utilization. To help keep costs under control, inform employees of potential cost saving measures, supply them with good consumer guides such as Healthier at Home, and keep them aware of how good utilization affects insurance rates.

There are a variety of ways to communicate with employees. Many companies are turning to social networks such as Facebook and Twitter to get the message out. Other methods such as lunch and learns, email communications, and face to face meetings are also effective in educating your workforce. No one solution is going to be a silver bullet, and maybe your employees need to be communicated to in a variety of ways.

Hill, Chesson and Woody works as a partner with our clients to develop communication strategies that ensure their employees understand their benefits and cost-effective utilization.

All About Grandfathered Health Plans

Tuesday, September 24th, 2013

The post below is a guest blog from W. Hunter Walton, JD who serves as Principal, Health & Welfare Consultant  for CAI’s employee benefits partner Hill, Chesson & Woody.

GrandfatherGrandfathered status is a designation with great significance because grandfathered plans are exempt from certain requirements of the Patient Protection and Affordable Care Act (PPACA). Though most employers understand the term, questions remain about the exceptions to grandfathered status when it comes to healthcare reform.

What Qualifies As Grandfathered Status?

A grandfathered health plan is one in which the plan has not made significant changes to the benefits provided since March 23, 2010 (the PPACA enactment date). This includes the cost-sharing provisions, even if the plan design has not changed. Any plan that has more than a 5 percent cost adjustment for the employee loses grandfathered status.

A plan will lose grandfathered status if any of the following occurs:

  • Elimination of a benefit that treats a particular condition.
  • An increase in a percentage cost-sharing requirement (i.e., coinsurance), regardless of the amount.
  • An increase in a deductible or out-of-pocket maximum by more than 15 percent (plus medical inflation).
  • An increase in co-payment that exceeds the greater of $5 (adjusted for medical inflation) or medical inflation plus 15 percentage points.
  • A decrease in the employer contribution rate toward the cost of any tier of coverage by more than 5 percentage points.

How Does A Grandfathered Health Plan Differ?

Grandfathered plans are exempt from certain market reform requirements, including: preventive care mandates; internal and external review; nondiscrimination based on income; choice of provider; emergency care at in-network rates; clinical trial coverage; cost-sharing and deductible maximums; guaranteed issue and renewal; and rating restrictions.

Grandfathered health plans are not exempt from requirements related to annual and lifetime limits, they are not required to offer dependent coverage to age 26, they are not limited in their rescission of coverage or pre-existing condition exclusions, they are not subject to new waiting period limits, employer mandates and many new tax provisions.

Grandfathered Status Annual Notification

Employers have an annual requirement to notify participants regarding their grandfathered status. The notice must include a statement that the plan is believed to have grandfathered status and contact information for an employee who has questions or complaints. A notice must be provided in any plan materials describing benefits for participants or beneficiaries. Generally, this includes a Summary Plan Description (SPD), a Summary of Material Modification (SMM) or benefit enrollment materials.

If a plan is grandfathered, any changes to plan design should be compared to what the plan’s terms were as of March 23, 2010. A plan will not lose its grandfathered status if insurance carriers or third-party administrators are changed, which was a later amendment to the grandfathered rules issued for insured policies that changed carriers on or after Nov. 15, 2010. It is becoming increasingly difficult to maintain grandfathered status. Most plan sponsors who have a grandfathered plan are aware of that fact and are familiar with the requirements to maintain that status. However, it is possible that a plan that was previously believed to be grandfathered could lose that status due to a seemingly minor change in plan design.

Hill, Chesson & Woody can help your business understand some of the more complex details of the Patient Protection and Affordable Care Act. For more detail, visit the healthcare reform section of our website..

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Know What Regulations To Consider For Your Corporate Wellness Plan

Thursday, August 22nd, 2013

The post below is a guest blog from Twyla Hutchins, RN, BSN, COHN-S who serves as Health Management Officer for CAI’s employee benefits partner, HCW Employee Benefit Services.

Twyla-HutchinsAs more companies add wellness programs to keep healthcare claim costs down, they should consider what compliance regulations need to be followed for successful program implementation. Otherwise, workplace wellness plan savings can vanish due to penalties resulting from a failure to follow the rules.

There are a few key rules to remember when setting up and monitoring a corporate wellness program that can reduce the likelihood of violations allegations for employers. Here is an overview of what to factor into an employee wellness program.

Americans with Disabilities Act (ADA)

The ADA prohibits employment discrimination against disabled individuals and limits the circumstances in which an employer may require physical examinations or answers to medical inquiries. For wellness plans to comply with ADA guidelines, voluntary medical exams and inquiries are permitted if:

  • Participation in the program is voluntary;
  • Information obtained is according to the confidentiality requirements of the ADA; and
  • Information obtained is not used to discriminate against an employee.

The gray area here is determining exactly how “voluntary” is defined, as the Equal Employment Opportunity Commission (EEOC), which oversees ADA complaints, has not issued formal guidance. However, if the wellness program requires an employee to complete a health risks assessment to become eligible for the group, the health plan would violate the ADA. Additionally, a wellness program that complies with HIPAA’s wellness regulation may not meet the requirement of the ADA.

COBRA

COBRA allows employees who lose their health benefits to choose to continue benefits provided by their group health plan for limited periods of time under certain circumstances. For wellness programs that provide physical examinations, cholesterol screenings, flu shots and similar benefits that qualify as medical care, these offerings can trigger the program to be a group health plan and thus incur COBRA responsibilities for participants.

Internal Revenue Code (IRC) Taxation

If you are offering incentives to reward employees who reach or surpass certain wellness plan goals, some may be considered taxable income, such as cash or gift cards. Other incentives may avoid taxation, including lower employee premium contributions, smaller deductibles for employees, and employer contributions to company savings and retirement accounts.

Incentives such as cash and prizes are considered taxable unless they qualify as “de minimis” in value by the Internal Revenue Service. As with the EEOC and the “voluntary” designation, what qualifies legally as “de minimis” is unclear, with amounts ranging from $10-$50 in gifts being offered by businesses with wellness programs that they believe fit this definition.

State Laws

North Carolina is one of 31 states with a lawful products protection law prohibiting discrimination against employees who use products such as tobacco outside the workplace. Employers can prohibit smoking on company property, however, as well as refuse to provide smoking breaks or other accommodations to smoking employees.

If an employer uses a wellness program that is part of an employee welfare benefit plan subject to the Employee Retirement Income Security Act (ERISA), then North Carolina’s lawful products law may be preempted. Employers that are considering charging tobacco users a higher premium for health insurance should be aware of these issues.

HIPAA

Rules for the Health Insurance Portability and Accountability Act of 1996 (HIPAA) require that, a group health plan may not discriminate against any individual or dependent because of a “health factor.” Health factors include health status, medical condition (including both mental and physical illness), claims experience, receipt of healthcare, medical history, genetic information, evidence of insurability, and disability. A group health plan may vary benefits, however, including premiums based on whether an individual has met the standards of the wellness program, if the wellness program itself meets certain requirements.

This is a tricky distinction to make, and the rules of what qualify continue to change. HCW is developing tools and a webinar to explain further the impact of HIPAA and its new rules that go into effect on Jan. 1, 2014. These items will be available in the near future.

Be cognizant of all these regulations and how they can affect your employee wellness program. If you need more immediate information on any of these considerations, contact HCW at (919) 403-1986 or visit us online.