The Patient Protection and Affordable Care Act- Wellness Compliance - By AtoZ Compliance

Key Take Away
Get the latest information and the proper guidance necessary to implement an effective wellness program that is fully compliant with the law.

Overview
The Patient Protection and Affordable Care Act training program codified the Federal Wellness programs Guidelines first proposed in 2001 and then adopted as a part of HIPAA. You will learn what constitutes a participatory versus health-contingent wellness program. Many employers are anxious to move to an outcomes-based wellness program and get real results by taking advantage of the incentives now allowed by law.

You will learn the basic requirements of the law
You will learn the advantages and disadvantages of implementing a health-contingent program versus a participatory program
You will learn best practices of making your health-contingent program work to meet your goals. You will learn the differences between activity-based and outcomes-based health contingent wellness programs
You will learn which federal government entities are in alignment with the law and which ones are at odds with it
You will also learn about the limited case law that is in place providing some interpretation and application of the law
This webinar will provide the guidance necessary to implement an effective wellness program that is fully compliant with the law.

Why Should You Attend
A common reason employers avoid implementing health-contingent wellness programs is fear or uncertainty of compliance with the associated regulations and guidelines.

The Federal Departments maintain that changing lifestyles, such as overcoming a tobacco addiction or losing weight, sometimes requires a cycle of failure and renewed effort and evidence suggests that a number of environmental factors can influence an individual’s ability to achieve a desired health outcome. However, in the long run better health is a benefit to all concerned; the individual, the employer and society.

Under these final regulations, plans and issuers cannot cease to provide a reasonable alternative standard under any health-contingent wellness program merely because an individual was not successful in satisfying the initial standard before; plans and issuers must continue to offer a reasonable alternative standard whether it is the same or different and, to the extent the reasonable alternative standard is, itself, a health-contingent wellness program, it must meet the relevant requirements of the final regulations.

This webinar will provide clear guidance on how to implement alternative standards that will promote improved health but comply with the law. Employers don’t need to fear implementing wellness programs that have the greatest chance of moving their population to better health.

Areas Covered In This Webinar
Wellness programs still fall into 2 primary categories: Participatory Wellness Programs and Health-Contingent Wellness Programs.

The final rules subdivide health-contingent wellness programs into activity-only wellness programs and outcome-based wellness programs.

Activity-only Wellness Programs – an individual is required to perform or complete an activity related to a health factor in order to obtain a reward and do not require an individual to attain or maintain a specific health outcome.

Outcome-based Wellness Programs – an individual must attain or maintain a specific health outcome in order to obtain a reward. Generally, these programs have two tiers: (a) a measurement, test or screening as a part of the initial standard: and (b) a larger program that then targets individuals who do not meet the initial standard with wellness activities such as compliance with an educational program or an activity such as walking, diet, or an exercise program.

Requirements – The following requirements apply to health-contingent wellness programs and do not apply to participatory wellness programs:

Frequency of Opportunity to Qualify - Individuals must be given the opportunity to qualify to participate at least once-per-year.

Size of Reward - Total reward cannot exceed 30% of the total cost of coverage taking into account both employer and employee contributions.

Reasonable Design - Must be reasonably designed to have a reasonable chance of improving the health of, or preventing disease in, participating individuals, and is not overly burdensome, is not a subterfuge for discrimination based on a health factor, and is not highly suspect in its method.

Uniform Availability and Reasonable Alternative Standards - The full reward must be available to all similarly situated individuals. An individual who does not meet the standard may take some time to request, establish, and satisfy a reasonable alternative standard.

Notice of Availability of Reasonable Alternative Standard - Plans and issuers must disclose the availability of a reasonable alternative standard in all plan materials.

The final rules clarify that disclosure includes contact information for obtaining the alternative and a statement that recommendations of an individual’s personal physician will be accommodated.

Learning Objectives
Understand PPACA’s training regulations related to wellness programs
Learn how to implement a wellness program fully compliant with PPACA
Learn the advantages of implementing health-contingent wellness programs
Learn how to implement a fully compliant wellness program that will improve the health of the workforce and also drive down healthcare costs while at the same time create high levels of employee satisfaction in order to retain and attract good employees

Who Will Benefit
CEO’s
CFO’s
HR Directors
Benefit Managers
Wellness Professionals
Benefit Consultants
Health Plan Managers
Speakers Profile
Darrell T. Moon
Darrell founded Orriant in 1996 to change the dynamics of healthcare and give employers some control over the ever increasing costs of the healthcare benefits they offer their employees. Darrell believed that engaging individuals in the management of their own health was a key that had to be inserted back into the economic equation of healthcare. Darrell received both his Bachelor of Science in Finance and his Master of Healthcare Administration from Brigham Young University. As the CEO, COO, or CFO, Darrell managed medical and psychiatric hospitals throughout the country for over 10 years prior to creating Orriant. He also has more than a decade of experience managing insurance and managed care products.