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Wednesday, October 20, 2010

Health risk assessments: avoid family history

Did you include a health risk assessment (HRA) as part of your open enrollment planning for 2011?

If so, take note of a recently-released set of FAQs from EBSA. These question/answer sets detail what group health plans must do to comply with the Genetic Information Nondiscrimination Act.

GINA bars a plan from collecting genetic information (including family medical history) prior to or in connection with enrollment. Thus, under GINA, health plans must ensure that any health risk assessment (HRA) conducted prior to or in connection with enrollment does not collect genetic information, including family medical history.

Health plans are allowed to have employees complete an HRA, but must comply with two provisos. First, the genetic information that is obtained must not be used for underwriting purposes. Second, if it is reasonable to anticipate that the collection will result in the plan receiving health information, the plan must explicitly notify the person providing the information that genetic information should not be provided.

Wellness program rewards. For plans that give out wellness program awards, an HRA that requests family medical history may be used, says EBSA, but only if it is requested to be completed after enrollment, if it is in no way related to enrollment, and if there is no premium reduction or any other reward for its completion.

In the FAQ, EBSA suggests that plans use two separate HRAs: one that would collect genetic information, and one that would not. The first would have to be conducted after enrollment and could not be connected to any kind of reward program.

The FAQs are here. Go here for more answers on the rules governing genetic information and employee benefit plans.

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