Do all wellness programs have to adhere to the incentive limit, or are there exceptions?
Only outcomes-based wellness plans (those based on “an individual satisfying a standard that is related to a health factor”) must adhere to this limit as outlined in HIPAA’s nondiscrimination regulations. Wellness programs that do not base rewards on the achievement of a health factor (participation-based) are not considered to be discriminatory and are therefore not subject to the regulations. Additionally, only programs associated with a group health plan are subject to these regulations, therefore wellness benefits that are not connected to your health plans such as gym memberships, healthy food subsidies, etc., are not regulated by HIPAA. Read the most recent Department of Labor FAQs for more information.
