Can my employer's wellness program reward only employees who meet a certain weight loss goal?


The workplace wellness program at my company has a bunch of different activities, medical screenings, and other programs we can participate in to earn financial rewards. One of them is a weight loss challenge. Anyone who participates in the program and loses a certain amount or percentage of their body weight gets $300. I am obese, and I think this would be a great way to kick start a healthier eating and exercise program. But, I also have a number of other medical conditions, and my doctor has said that it would be a health risk to lose weight as quickly as the program requires. Can the program disqualify me for following my doctor's orders as to healthy weight loss?


The short answer is no. The Affordable Care Act (commonly referred to as Obamacare) includes a number of provisions dealing with workplace wellness programs. These programs seek to provide incentives for employees to identify their health challenges and work to improve them by, for example, receiving regular screenings for common ailments, losing weight, exercising, lowering their cholesterol, or quitting bad habits, like smoking. Employers have a strong incentive to improve employee health because of the associated costs of serious health problems, from higher rates of absenteeism to more expensive insurance.

Some wellness options provide a reward simply for participation. For example, every employee who takes a health screening assessment might receive $100. These rewards are equally available for all without regard to disability, health status, or other factors that might vary from employee to employee.

If a program is "health-contingent," however, it must offer alternatives. A health contingent standard could be an activity-based segment that some employees might not be able to participate in, such as a walking challenge or a diet. Or, it could be an outcome-based segment that rewards an employee only for reaching a set goal, such as a five-point reduction in body mass index (BMI) or a weight-loss target.

Among other things, these health-contingent programs must be reasonably designed to prevent disease or promote health. In other words, they may not be a subterfuge for discrimination against those with disabilities or medical conditions, and they may not be highly suspect in the methods used to achieve those goals (such as requiring employees to go on an extreme fad diet to earn the reward). And, the reward must be equally available to all similarly situated employees. This means, in your case, that your employer must adjust the goal in light of your health condition or must simply allow you to follow the recommendations of your physician. For example, if the wellness program rewarded employees for losing 5% of their body weight, it could be tailored to your situation by allowing you to earn the reward by either losing 2% of your body weight or following the diet and exercise recommendations of your physician for the duration of the challenge. For more information, see Final Rules for Wellness Programs Under Obamacare.

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