Wellness Programs/Preventive Services

The Affordable Care Act (ACA) includes several provisions to promote wellness and prevention of chronic diseases. One of these provisions will allow health plan sponsors to offer stronger wellness program incentives in 2014. Another provision requires nongrandfathered plans to cover preventive health services without employee/participant cost sharing.

Government Resources
Analysis

Government Resources

HHS, DOL, and the Treasury released an Advanced Notice of Proposed Rulemaking regarding policy intended to provide women with access to recommended preventive services including contraceptives without cost sharing, while ensuring that non-profit religious organizations are not forced to pay for, provide or facilitate the provision of any contraceptive service they object to on religious grounds. The Advance Notice of Proposed Rulemaking provides opportunity to formally comment on ideas for implementing this policy. Comments are due by June 19, 2012.

Fifty-Four Million Additional Americans Are Receiving Preventive Services Coverage Without Cost-Sharing Under The Affordable Care Act, 2/21/12  

The EBSA, IRS and HHS have finalized regulations authorizing the exemption of group health plans and group health insurance coverage sponsored by certain religious employers from having to cover certain preventive health services under provisions of the Patient Protection and Affordable Care Act. These rules are effective on April 16, 2012. 

The Cost of Covering Contraceptives through Health Insurance, HHS, 2/13/12

HHS announced that ACA required coverage of women's preventive services, including contraceptive services, will apply to nonprofit religious organizations, but these groups are given a delayed compliance date of August 1, 2013. 1/20/12  

On August 1, 2011, HHS, EBSA and IRS released new rules requiring new health plans to cover women's preventive health services at no additional cost. The guidelines were developed by the Institute of Medicine. 8/1/11         

The Institute of Medicine (IOM) has released a report of recommendations of clinical preventive services for women. Under the ACA, the IOM was charged with reviewing what
preventive services are important to women’s health and well-being and then recommending which of these should be considered in the development of comprehensive guidelines.  7/19/11  

HHS has announced the availability of $10 million to establish and evaluate comprehensive workplace health promotion programs across the nation to improve the health of American workers and their families. The initiative, with funds from the Affordable Care Act’s Prevention and Public Health Fund, is aimed at improving workplace environments so that they support healthy lifestyles and reduce risk factors for chronic diseases like heart disease, cancer, stroke, and diabetes. 6/23/11  

The agencies have issued a request for information on how group health plans and health insurance issuers can employ value-based insurance  design in the coverage of recommended preventive services. Public comments in response to this request for information are due on or before February 28, 2011. 12/28/10 

On July 14, 2010, the EBSA, IRS and OCIIO released interim final regulations implementing the rules for group health plans and health insurance coverage in the group and individual markets under provisions of the Affordable Care Act regarding preventive health services. These rules spell out the requirements for health plans to cover preventive services without employee/participant cost sharing. These rules do not apply to grandfathered plans.

The HHS issued a press release outlining prevention and health promotion initiatives that will be implemented due to the Affordable Care Act. 6/22/10  

Analysis