PPACA Workplace Wellness Quick Reference
Contained in nearly 1,000 pages of the Patient Protection & Affordable Care Act (PPACA) – the recently passed healthcare reform law - are key workplace wellness provisions directly relevant to employers. Here’s a rundown.
Workplace Wellness Grant (PPACA Sec. 10408)
- Health and Human Services (HHS) to award grants to small employers (fewer than 100 employees who work 25 or more hours/week) who do not provide a wellness program as of date of enactment (March 23, 2010). As of May 5, 2010, details including application procedures are not yet available.
- To receive a grant, eligible employers must provide access to a comprehensive workplace wellness program to all employees.
- Workplace wellness program must include the following four components: health awareness initiatives, employee engagement efforts, initiatives to change unhealthy behaviors and lifestyle choices, and a supportive environment.
- Employers must submit an application including a proposal for a comprehensive wellness program that meets the criteria
- Effective Date: starting October 1, 2010. Funding: $200 million for FY 2011-2015.
Premium Incentive for Employer Wellness Program (PHSA Sec. 2705)*
- Increases the value of the wellness incentives that employers may provide for changes in an employee’s health status to up to 30% for the cost of employee-only coverage. Regulators may allow up to 50% discount.
- Effective Date: Plan years starting Jan 1, 2014.
CDC Technical Assistance for Employer Based Wellness Programs (PHSA Sec. 399MM)
- Centers for Disease Control and Prevention (CDC) to provide employers with technical assistance, consultation, tools, resources to evaluate wellness programs. This includes measuring participation and evaluating the impact on: health status, absenteeism, productivity, rate of workplace injury, and medical costs.
Studies and Demonstration Projects
National Worksite Health Policies and Programs Study (PHSA Sec. 399MM-1)
- CDC to conduct a national worksite survey to assess employer-based health policies and programs
- CDC to submit a report to Congress with recommendations for implementation of effective employer based health policies and programs
- Effective Date: Not later than 2 years after enactment (March 23, 2012)
Report on Wellness Programs (PHSA Sec. 2705)
- HHS, with the Department of Treasury and Department of Labor (DOL), to provide a report to Congress on the effectiveness of the following components of wellness programs:
- promoting health and preventing disease; impact on access to care and affordability
- impact of incentives on participant behavior and role of programs in changing behavior
- effectiveness of different types of rewards
- May gather information from employers who provide access to wellness programs
- Effective Date: Not later than 3 years after enactment (by March 23, 2013).
Individual Market Wellness Program Demonstration Project (PHSA Sec. 2705)
- HHS, with Department of the Treasury and DOL, to establish 10-state demonstration project for states to apply wellness incentives to individual plans.
- If project is effective, may be expanded to additional states starting on July 1, 2017.
- Effective Date: By July 1, 2014.
* (PHSA) Public Health Service Act as amended by the Patient Protection and Affordable Care Act