Top 7 Effects of the PPACA on Corporate Wellness Programs

By Shawn Siegel, first posted on Human Resources IQ

The Affordable Care Act (ACA) of 2010 was the most expansive overhaul of U.S. healthcare in over thirty years and represents an “ideological shift” from a reactive to a proactive model of healthcare.

This ideological shift put a new focus on corporate health and wellness programs. The hope is that the proactive approach will help reduce the projected $4.2 trillion that chronic diseases will cost the U.S. healthcare system. Further, workforces are changing, and there’s also a focus on preventing depression and other mental disabilities.

There are many different ways in which the ACA will impact corporate health and wellness programs, particularly now that the proposed changes of 2012 are becoming a reality. Below are 7 important effects that your company should be aware of:

Top 7 ACA Effects on Corporate Health and Wellness Programs

1 – The most overarching macro change is the new attention paid to wellness programs. On the positive side, this can lead to funding opportunities (for example through the PPHF), but on the downside this means more regulatory scrutiny. For example The Department of Health and Human Services, Labor, and Treasury created new proposed rules that will go into effect for plan years starting on January 1st, 2014.

2 – A major change of the proposal is that plan participants can receive a reward of up to 30 percent of total annual coverage (instead of 20 percent) and allows up to 50 percent for programs that stop tobacco use. Further, this will apply to non-grandfathered plans as well as grandfathered plans.

3 – Although the ACA was an “ideological shift”, it is not like wellness programs were completely beyond the federal radar. There were of course various regulations under HIPAA, the PHSA and ERISA in the previous two decades relating to wellness programs. A large focus of these rule related to anti-discriminatory efforts. When contemplating the new regulations, always keep in mind that that although health is the overall goal, the competing interest is preventing discriminatory abuse.

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