Do you need a Wellness Plan Document? Wellness plans may be designed as participatory programs or as health-contingent programs. Participatory wellness plans are generally available without regard to an individual’s health status. These programs either do not provide a reward or do not include any conditions for obtaining a reward based on an individual satisfying a standard related to a health factor. These programs should be made available to all similarly situated individuals.
Health-contingent wellness plans require an individual to satisfy a standard related to a health factor in order to obtain a reward. The most commonly used health risk factors are Body Mass Index (BMI), tobacco use, cholesterol, blood pressure and blood glucose. There are two types of health-contingent wellness plans: activity-only programs and outcome-based. Activity-only programs require an individual to complete an activity related to a health factor in order to obtain a reward. Outcome-based programs require an individual to achieve a specific health outcome in order to obtain a reward.
A wellness plan that provides medical services or care, or a wellness plan that is part of a Group Health Plan is required to adhere to ERISA’s Plan Document and Summary Plan Description (SPD) requirements.
Medcom Benefit Solutions provides compliant plan documentation and expert guidance for all types of wellness programs. Our team of regulatory compliance specialists work closely with each employer to prepare a wellness plan document that describes the components of the wellness plan and meets the employer’s exact needs.
Medcom Benefit Solutions provides amendments to these documents as needed, including the Summary of Material Modifications for distribution to participants.