An important portion of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) hold provisions that forbid group health plans and insurers from discriminating against individuals based on health factors. In 1997, the agencies with leading power under HIPAA —the 1RS, and Departments of Labor and Health and Human Services published provisional rules that interpret the HIPAA nondiscrimination provisions and introduce the perception of a “bona fide wellness program” as it relates to the nondiscrimination provisions. In 2001, proposed regulations were issued, providing more thorough guidance on permissible health incentives under bona fide wellness programs. (Hall, 2006)
HIPAA’s nondiscrimination provisions are intended to prohibit a medical plan from discriminating, ineligibility or premiums, based on health factors of individuals. As the proposed regulations clarify, however, they do permit the use of wellness incentives to encourage participants to contribute to health promotion and disease prevention programs and to attain exact outcomes. The bona fide wellness program provisions, in fact, define specific circumstances in which it is absolutely permissible to provide discounts, rebates, or modifications to otherwise applicable copayments or deductibles in return for observance to wellness and disease management programs. Although these regulations have been around for a few years, a large number of benefits professionals remain ignorant of their relevance. Because they can be critical to the design and management of health benefits, these rules must be observed in the plan design process. (Hall, 2006)
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