Smart Benefits: Certain Wellness Program Incentive Limits Eliminated Jan 1

Monday, November 12, 2018
Rob Calise, GoLocalWorcester Business/Health Expert

In 2016, the EEOC issued final rules describing how ADA and GINA apply to employer-sponsored wellness programs.

The final ADA rule said that incentives to employees who answer disability-related questions or undergo medical exams as part of a program couldn’t exceed 30 percent of the total cost of self-only health coverage, while the final GINA rule stated that employers could offer an incentive of up to 30 percent of the total cost of coverage to an employee whose spouse provides information about their health status as part of the employer’s wellness program.

Following a challenge to the EEOC over the ADA and GINA wellness program incentive limit rules, a federal court ordered them vacated as of January 1, 2019. What does that mean for employers?

If you sponsor a wellness program that has elements subject to the ADA and/or GINA such as a health risk assessment or biometric screening, you’ll need to:

  • Review your current program for compliance, carefully considering whether to make design changes to eliminate or reduce any incentives for activities subject to the ADA or GINA
  • Continue to comply with the rest of the EEOC’s wellness rules since only the incentive portion was vacated
  • Keep abreast of future EEOC rules that may impact your wellness program


Rob Calise is the Managing Director, Employee Benefits of The Hilb Group of New England, where he helps clients control the costs of employee benefits by focusing on consumer-driven strategies and on how to best utilize the tax savings tools the government provides. Rob serves as Chairman of the Board of United Benefit Advisors, and is a board member of the Blue Cross & Blue Shield of RI Broker Advisory Board, United HealthCare of New England Broker Advisory Board and Rhode Island Business Healthcare Advisors Council. He is also a member of the National Association of Health Underwriters (NAHU), American Health Insurance Association (AHIA) and the Employers Council on Flexible Compensation (ECFC), as well as various human resource associations. Rob is a graduate of Bryant University with a BS in Finance

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