February 15, 2008
By Julie Ann Sullivan*
As healthcare costs continue to increase, employers continue to search for ways to lower those costs. The newest approach: penalize the unhealthy. Though it may sound illegal and discriminatory, the theory behind it is to provide incentives for employees to improve their health: sort of an "employer knows best" mindset. Companies such as the Tribune Co. and Clarian Health Partners are charging their employees for unhealthy behaviors. For example, the Tribune Co. charges employees who smoke a $100 per month "medical fee." Similarly, Clarian charges its employees $5 more per risk per pay period for health risks in the following categories: tobacco use, body mass index, blood pressure, blood glucose, and cholesterol. Both companies reward improved health or improved wellness efforts however. The Tribune Co. stops charging the "medical fee" to any employee who completes a smoking cessation course, and even reimburses fees paid to those who successfully quit smoking. Clarian provides similar rewards and alternatives. HIPAA regulations appear to allow for rewards or fines, so long as they do not exceed 20 percent of the total cost of insurance and provide alternatives for employees who cannot meet the standards due to medical reasons. Paternalistic? Probably. Effective? Maybe. Legal? To be determined.
Access a more detailed article from the Chicago Tribune, Feb. 10, 2008.
*We would like to thank Julie Ann Sullivan (Law Clerk to the Honorable William J. Bauer, United States Court of Appeals for the Seventh Circuit, Chicago, IL) for writing this email alert.