Health and Wellness Program: US

This Health and Wellness Program policy explains how your organization can offer a wellness stipend or reimbursement benefit for health-related expenses like gym memberships, fitness classes, and other approved wellness activities or products.

The History Behind Health and Wellness Program Policies in the US

Health and wellness stipends became a common Benefit after employers started treating health costs as a business problem, not just an insurance renewal problem. Large employers, especially those that self fund their health plans, pay medical claims directly, which means healthier employees can translate into fewer claims and lower long term costs. Beginning in the 70s and 80s, many employers added fitness programs, smoking cessation efforts, and preventative health initiatives alongside group health plans as medical spending climbed. The 1996 Health Insurance Portability and Accountability Act (HIPAA) later introduced early federal limits on wellness incentives tied to health factors, because some employers were experimenting with rewards and penalties that could drift into discrimination.

The Affordable Care Act accelerated the trend in 2010 by expanding how big certain wellness incentives could be under HIPAA's nondiscrimination rules, and by pushing prevention as a cost-control strategy. Employers also learned that a wellness program could create legal risk if it crossed into medical exams, disability-related inquiries, or pressure to disclose health information. That is why the Americans with Disabilities Act (ADA) and the Genetic Information Nondiscrimination Act (GINA) became part of the wellness conversation, especially once biometric screenings and health risk assessments turned into mainstream offerings.

The most awkward chapter came from the Equal Employment Opportunity Commission's stop-and-start rule-making on what "voluntary" means under the ADA and GINA for wellness programs that collect health data. A D.C. federal court vacated the EEOC's 2016 incentive rules in AARP v. EEOC (2017), and the agency later pulled those rules back, which left employers with less clarity on incentive size. Many organizations responded by keeping wellness benefits simple and low-pressure, like reimbursements for gym memberships and classes, because it avoids the hardest questions about medical data, voluntariness, and privacy.

Which Law is the Health and Wellness Program Policy Meant to Comply With?

There's no federal law that specifically requires a Health and Wellness Program policy for US-based employees, but those who have one should take steps to ensure it aligns with HIPAA, ADA, and GINA requirements, and steers clear of anything that could be construed as discrimination.

How to Write an US-Specific Health and Wellness Program Policy

• Start with "why" and introduce the concept.
• Explain that your organization offers financial support for employee health and wellness expenses.
• Define the types of wellness expenses and activities your program may cover.
• State that eligibility, covered items, and reimbursement limits can vary.
• Tell employees where to go internally for program details and reimbursement access.

When to Include this Policy in Your Employee Handbook

There's no law that requires you to publish a policy or issue a specific notice. If you have a Health and Wellness program, a clear, consistent policy is a widely used best practice because it sets expectations, supports equitable access, and helps HR administer the program in a consistent way.

Other Considerations

None.

Exceptions

None.