As part of corporate wellness initiatives, many employers encourage employees to take health risk assessments (HRAs).  HRAs are intended to identify warning signs such as high cholesterol, high blood pressure, or blood sugar issues that if left untreated, may lead to chronic medical conditions.  If employees use the HRA to change behaviors that contribute to these conditions, the employer may reduce the expense of having to treat the medical conditions in future years.

While most employers provide some incentive to get employees to participate in the HRA, some consider taking a more aggressive approach.  Last month, the Equal Employment Opportunity Commission issued an opinion letter to an employer that asked whether taking a HRA can be a mandatory precondition to an employee participating in the group medical insurance plan.

In response, the EEOC stated that such mandate would in its opinion violate the Americans with Disabilities Act, even if the employer never sees the results of the individual assessments.  The ADA prohibits employers from requiring medical examinations of employees in the absence of business necessity relating to their particular jobs.  The EEOC stated that the employer’s general goal of managing health care costs does not meet this business necessity test, because there is no connection between the HRA and the employees’ ability to perform their jobs.

The EEOC made clear that the ADA does not prohibit voluntary HRAs.  While employers can provide reasonable incentives for participation, or even additional costs for those who decide not to take the HRA, the size of these “sticks and carrots” must be small in relation to the overall premiums.  Pending federal legislation may change these rules, but for the time being, the HRA cannot be used as a gateway requirement for obtaining employer-sponsored medical insurance.