Disclosure of Alternative Standard AvailabilityFor Health-Factor-Related Wellness Programs

If a wellness program requires individuals to meet a standard related to a health factor in order to obtain a reward, the HIPAA nondiscrimination rules require the program to comply with five conditions, including a disclosure requirement (see the wellness programs HIPAA compliance checklist). Examples of such health-factor-related wellness programs include programs providing premium discounts or richer benefits for those who have positive health factors such as not smoking, cholesterol below 200, blood pressure within normal range, body mass index below 30, etc. All of the materials describing such programs must disclose that certain individuals may obtain the reward by meeting a reasonable alternative to the health-factor-related standard. The materials need not specify what that reasonable alternative will be – only that some reasonable alternative standard will be made available. The following language (or substantially similar language) can be used to satisfy this disclosure requirement:

If it is unreasonably difficult due to a medical condition for you to achieve the standards for the reward under this program, or if it is medically inadvisable for you to attempt to achieve the standards for the reward under this program, call us at 904-432-0176 and we will work with you to develop another way to qualify for the reward.