Reduced Health Benefit Premium
Three federal agencies have issued guidance indicating that employers may legally offer a reduced health benefit premium to employees who are vaccinated for COVID-19.
However, employers must comply with federal wellness program regulations. The Departments of Labor, Health and Human Services, and Treasury addressed the issue in a Frequently Asked Questions (FAQs) document. The FAQ explains that since wellness programs are designed to promote health or prevent disease, they are allowed to offer a reward for completing an activity related to health. Therefore, a premium discount that requires an individual to perform or complete an activity, such as obtaining a COVID-19 vaccination, would be considered part of a wellness program.
However, the reward can’t exceed 30% of the total cost of employee-only coverage, and the plan can require that participants qualify annually for this premium discount.
In addition, employers must provide a reasonable alternative for certain employees who find it unreasonably difficult to get the vaccine to qualify for the discount. According to the FAQ, employees who would qualify for a waiver would include those who have certain medical conditions or for whom it is medically inadvisable to obtain the COVID-19 vaccination. For instance, the plan could mandate that the employee comply with the CDC’s mask guidelines for unvaccinated individuals.
The plan also must maintain a toll-free hotline to provide information to employees about the COVID-19 vaccine. The hotline also must include information about how to receive a COVID-19 vaccination or how to fulfill the requirements for the alternative.
What an employer offering a plan can’t do is discriminate against participants, beneficiaries, or enrollees in determining eligibility for benefits or coverage based on getting the vaccination.
Also, employers may not deny employee benefits coverage based on whether an employee obtained a COVID-19 vaccination.
Copyright © 2020 Smarts Publishing
About the Author
Share This Story
Related Blogs
Five Strategies for Reducing Workers’ Compensation Costs
When a company experiences significant increases in workers’ compensation costs, it usually triggers internal activities aimed at reducing insurance costs and spending. The key to spending fewer dollars is more than just stopping a few accidents; it is having a sound safety program designed to continuously improve. This is where a safety program that, at a minimum, is compliant with the Occupational Safety and Health Administration (OSHA) standards can yield significant savings for by reducing injuries and illnesses, saving workers’ compensation dollars.
Benefit Priorities & Strategies in 2025: Employee Benefits Market Check Survey
As another year has kicked off, employers have many areas of focus regarding their benefit programs. It can also be challenging to achieve all goals in a single year, so decision-makers must prioritize their efforts based on their unique circumstances.
Navigating Cybersecurity Challenges in the Healthcare Industry
Healthcare providers have been increasingly utilizing technology and turning to digitization. Innovations such as telehealth, artificial intelligence (AI), digital billing systems and connected devices continue to reshape the industry.