ABC Comments on Proposed Rule’s Treatment of Wellness Programs

ABC July 2 submitted comments to the Internal Revenue Service (IRS) expressing disappointment in a proposed rule that would implement provisions in the Affordable Care Act (ACA) related to the minimum value of eligible employer-sponsored plans and the health insurance premium tax credit. 

Specifically, ABC expressed strong concerns regarding the treatment of wellness program incentives under the May 3 proposed regulations. Under the proposed rule, employers that offer wellness programs and premium pricing differentials to incentivize participation must assume that employees will fail to satisfy the requirements of the programs when determining minimum value and affordability. The rules permit employers to take into account only the value of the wellness programs designed to prevent or reduce tobacco use. 

“The wellness programs offered by ABC members have contributed to employees making healthier lifestyle choices and improving individual participant health,” ABC wrote. “Unfortunately, this effort could be undermined by limiting employers’ contributions to programs only designed to prevent or reduce tobacco use.”

ABC pointed out that by not appropriately capturing the full value of employer-sponsored wellness programs, many members may be forced to scale back their investment in such plans. ABC strongly encouraged the administration to revise the final rule to account for the full value of all employer-sponsored wellness programs under Internal Revenue Code (IRC) §4980H.  

The proposed minimum value regulations include a temporary transition rule for plan years beginning before Jan. 1, 2015, which permits employers to measure affordability and minimum value as if all employees have met an employer’s wellness program criteria. 

“ABC urges the administration to recognize the value of employer-sponsored wellness programs by applying the approach outlined in the transition rule to all plan years in the final rule, rather than providing such relief only on a temporary basis,” the letter stated. 

As part of the Employers for Flexibility in Health Care (E-FLEX) Coalition, ABC also submitted initial comments to the IRS and Treasury related to the method of determining minimum value and affordability in employer-sponsored plans on:

October 31, 2011
June 11, 2012
March 15, 2013