Employee Wellness Screenings: Can They Be Forced?
The controversial programs are under fire from the Equal Employment Opportunity Commission, which filed suit against Honeywell International in October charging, among other things, that the company’s wellness program, with significant financial penalties, isn’t voluntary. It’s the third lawsuit filed by the EEOC in 2014 that takes aim at wellness programs, and it highlights a lack of clarity in the standards these programs must meet to comply with both the 2010 health law and the landmark Americans With Disabilities Act.
What is more well accepted are programs like the one at Tampa General Hospital, where employees can earn discounts on health insurance for participating in wellness programs. JoAnn Shea, director of employee health and wellness at TGH, said about 95 percent of employees participate voluntarily. “But we incentivize, we don’t penalize,” she said.
In the Honeywell wellness program, employees and their spouses are asked to get blood drawn to test their cholesterol, glucose and nicotine use, as well as have their body mass index and blood pressure measured. Employees who refuse face a $500 surcharge on health insurance and could lose up to $1,500 in Honeywell contributions to their health savings account. Plus, an employee and spouse each could face a $1,000 tobacco surcharge — an increasingly common practice — for a possible combined $4,000 in financial penalties.
“Under the (Americans With Disabilities Act), medical testing of this nature has to be voluntary,” the EEOC said in a news release announcing its request for an injunction. “The employer cannot require it or penalize employees who decide not to go through with it.”
Honeywell got a reprieve when a federal district court judge declined to issue a temporary restraining order preventing the company from proceeding with its wellness program incentives next year. But the EEOC is continuing its investigations.
For its part, Honeywell defends the program as a way to lower claims costs while helping workers avoid health problems.
“Wellness is a win-win,” said Kevin Covert, Honeywell vice president and deputy general counsel for human resources. Sixty-one percent of employees who participated in the company’s screening last year reduced at least one health risk, he said.
Further, Covert said, it’s easy for employees and their spouses to avoid the tobacco surcharge. Smokers can take a 15-minute online tobacco cessation course, while nonsmokers can call the health plan and certify that they don’t smoke.
Jay Wolfson, an expert in health law at the University of South Florida, praised Honeywell for making “a great investment in their workforce.” But he cautioned that the penalty-driven approach raises questions about legal protections, privacy rights, whether actions against employees are based on health, rather than job performance.
“Honeywell will have to demonstrate that there is a business purpose to making employees participate or be penalized,” he said.
Eighty-eight percent of employers with 500 workers or more offer some sort of wellness program, according to a 2014 national survey of employer-sponsored health plans by the benefits consultant Mercer. Of those, 42 percent offer employee incentives to undergo biometric screening, and 23 percent tie incentives to actual results, such as reaching or making progress toward blood pressure or BMI targets.
Despite employers’ enthusiasm for wellness programs, “there’s no good research that shows these programs actually improve health outcomes or lower employer costs,” said JoAnn Volk, a senior research fellow at Georgetown University’s Center on Health Insurance Reforms.
Do it or else. Increasingly, that’s the approach taken by employers who are offering financial incentives for workers to take part in wellness programs that incorporate screenings that measure things like blood pressure, cholesterol and body mass index.
The health law encourages employers to offer workers financial incentives to participate in wellness programs. It allows plans to incorporate wellness incentives — both penalties and rewards — that can total up to 30 percent of the cost of employee-only coverage, an increase over the previous limit of 20 percent. If the wellness activity aims to help someone reduce or quit smoking, the incentive can be even higher, up to 50 percent of the plan’s cost.
Under the ADA, employers aren’t allowed to discriminate against workers based on health status. They can, however, ask workers for details about their health and conduct medical exams as part of a voluntary wellness program. What constitutes a voluntary wellness program under the law is what the EEOC is being asked to spell out under the ADA.
Consumer advocates say it’s critical not to confuse incentive programs with comprehensive workplace wellness.
“The incentives are meant to engage employees,” said Laurie Whitsel, director of policy research at the American Heart Association, “but they’re not the comprehensive programming we’d like to see employers offer.” It’s important to have a culture of health, Whitsel said, with features like a smoke-free work environment and healthy food in the cafeteria.
Patient advocates worry that wellness program financial penalties may be so onerous they limit access to the medications and care they need to get and stay healthy.
“When penalties become that high, it really is a deterrent to affordable, quality health care,” Whitsel said.
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Article By: Michelle Andrews, Kaiser Health News Visit: www.TampaBay.com