U.S. Department of Labor
Health Benefits Advisor for Employers
Determining Compliance with the HIPAA Provisions in Part 7 of ERISA
Compliance with the Wellness Program Provisions
The following questions will help determine whether the plan offers a program of health promotion or disease prevention that is required to comply with the Department's final wellness program regulations and, if so, whether the program is in compliance with the regulations.
Does the plan have a wellness program?
A wide range of wellness programs exist to promote health and prevent disease. However, these programs are not always labeled "wellness programs." Examples include: a program that reduces individuals' cost-sharing for complying with a preventive care plan; a diagnostic testing program for health problems; and rewards for attending educational classes, following healthy lifestyle recommendations, or meeting certain biometric targets (such as weight, cholesterol, nicotine use, or blood pressure targets).
Tip: Ignore the labels - wellness programs can be called many things. Other common names include: disease management programs, smoking cessation programs, and case management programs.
