Are you Compliant? – Complete Wellness Solutions

Wellness Program Audit

Is your wellness program compliant? Complete this assessment by selecting the response that best describes your wellness program. Email a copy of your completed assessment to info@cws4life.com for more information on how to deliver a complete and compliant wellness program.

1. Does Your Employer offer a wellness program?

2. Is the wellness program part of a group health plan?

3. Is your wellness program a Participation Based Program or Health Outcome Based Program?

Participation Based Program-encourages attendance in activities such as a health screening, wellness presentations, or health coaching.
Health Outcome Based Program - awards participants based on completing specified health activities or meeting health outcomes.

4. If your wellness plan is a Health Outcome Based Program, is it activity based or a health standard based program?

Activity based
Hybrid program
Health standard based
Not applicable

5. Is the plan reasonably designed to promote health or prevent disease?

6. If you provide wellness screenings, do you provide educational information regarding their risk factors to the participant?

Yes
No
Do not provide wellness screenings

7. If you provide wellness screenings or health risk assessments (HRA), do you use aggregate data to design your wellness program?

Yes
No
Do not provide wellness screenings or HRA

8. Are the eligible individuals given a chance to qualify for the incentive at least once per year?

9. Is the amount of the incentive (reward or penalty) offered under the plan limited to 30% of the employee only coverage of the lowest cost plan you offer?

Yes
No
Employer does not offer employee health coverage

10. If you do not offer health coverage, is the incentive offered under the wellness plan limited to 30% of the second lowest silver plan under the ACA?

Yes
No
Not applicable

11. If the wellness program includes a 50% incentive for tobacco, does the wellness plan simply ask if the individual uses tobacco/nicotine products or are they also asked to complete a Health Risk Assessment (HRA) or health screening?

Tobacco questionnaire only
Program includes any type of health/nicotine screening or HRA
Wellness program offers 30% incentive or less for tobacco/nicotine use

12. Is the wellness program considered voluntary? (Does not require employees to participate, deny coverage or limit benefits under any of its group health plans, and does not retaliate against or coerce those who choose not to participate.)

13. Is the reward available to all similarly situated individuals?

14. Does the program offer a reasonable alternative standard?

15. If you offer a reasonable alternative standard, is it provided to the participant at no cost with a reasonable time commitment?

Yes
No
Do not offer a reasonable alternative standard

16. Does the wellness plan request physician verification if a participant is unable to qualify for a health standard?

Yes
No
Do not offer a health standard based program

17. If an individual submits a request, will the wellness plan work with the individual’s physician to help determine a reasonable alternative standard or waive the standard?

18. Do the wellness plan materials include wording about the availability of a reasonable alternative in all plan material describing the program?

19. Does your Health Risk Assessment ask any questions regarding family health history?

20. Do you allow dependent children to participate in the wellness program?

21. Do you have access to participants’ Personal Health Information (PHI)? If so, are you compliant with the HIPAA Privacy and Security policies and procedures?

22. Do you provide a wellness program notice regarding what information will be obtained, how it will be used, who will receive it, restrictions on disclosures, etc.?

23. Do you have a wellness plan document?

Your Company Name *

Your Email *

Phone

Click on Submit to Email a copy of your completed assessment to info@cws4life.com for more information on how to deliver a complete and compliant wellness program.