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Consumer Driven: wellness or else

As employers and insurers continue to navigate the intricacies of the Patient Protection and Affordable Care Act, theyre finding that managing wellness programs and non-discriminatory incentives (or disincentives) can be tricky.

By Amber Taufen | Updated on April 01, 2015

As employers and insurers continue to navigate the intricacies of the Patient Protection and Affordable Care Act, they’re finding that managing wellness programs and non-discriminatory incentives (or disincentives) can be tricky.

“PPACA extended HIPAA non-discrimination rules as to what is considered a non-discriminatory incentive or disincentive,” explains Amy Gordon, a wellness benefits attorney with McDermott Will & Emery. “It used to be that the incentive was capped at 20 percent of the total premium—or total contribution if the employer is self-insured. But PPACA raised that 20 percent to 30 percent for most programs and up to 50 percent for tobacco cessation.

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