EEOC Opinion Letter – Requiring a HRA in Order to Obtain ERISA Plan Health Coverage Violates the ADA

May 12th, 2009

The U.S. Equal Employment Opportunity Commission (EEOC) issued an opinion letter in March which recently became public regarding the use of health risk assessments (HRA) and the Americans with Disability Act (ADA).  While opinion letters from the EEOC are not official opinions, this letter does provide guidance for employers to clarify the use of HRAs.

The letter indicates an employer’s requirement that employees participate in a health risk assessment in order to obtain coverage under the employer’s self-funded health plan violates the ADA.  The circumstances that the EEOC official assessed were where the employer had employees take an assessment that involved answering a short health-related questionnaire, taking a blood pressure test, and providing blood for use in a blood panel screen.  Information from the assessment went directly and exclusively to the employee, and the employer received only aggregate information.  Employees who declined to participate in the assessment and their family members became ineligible for coverage under the health plan.

The ADA requires disability-related questions or medical examinations to be job-related and consistent with necessity or, part of a voluntary wellness program.  The EEOC stated that in the above instance, the HRA was neither job-related nor consistent with necessity.  As part of a wellness plan, refusing to participate in an HRA would penalize an employee, violating ADA.

However, the letter did reaffirm that disability-related inquiries and medical examinations are permitted as part of a voluntary wellness program, and that a wellness program is voluntary if employees are neither required to participate nor penalized for non-participation.  In the case the EEOC considered, employees were both required to participate and were penalized for non-participation.  The opinion letter may be found here.

This is important guidance in clarifying what an employer can and cannot do with regarding to its wellness efforts.  Please contact us if you have any questions or need more information on this letter or other wellness guidance.

8 Responses to “EEOC Opinion Letter – Requiring a HRA in Order to Obtain ERISA Plan Health Coverage Violates the ADA”

  1. kathyon 09 Nov 2012 at 10:42 am

    Just for claridication,
    Assume a client pays 60% of the employee medical premium.
    Credits are available of 10% is the employee is a nonsmoker( thereby offering 70%payment by employer)
    Credits of additonal 10% if the employees voluntarily particpate in in wellness screenings AND ACTIVITES.

    Would this be viewed as being in compliance with the law?? They are not penalized under this scenario.


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