ACA Wellness Rules


Though certain provisions of the Affordable Care Act (ACA) have received a moratorium on enforcement, federal regulations on wellness programs will be effective for all health plan years beginning on or after January 2014. In addition to the ACA, however, organizations need to be aware of how other legislation may impact their health promotion efforts. Choosing a new wellness program or bringing current programs into compliance will require a thorough understanding of the new and existing laws and, sometimes, complex decisions and structural redesign. Vitality has the solution.

Vitality meets the most stringent legal requirements.

Our comprehensive program design is ethical, accessible and verifiable, making it easy for clients to meet the fairness and privacy requirements of the new law.

Among the key components of Vitality’s comprehensive approach are:

  • The ability to track all key health outcomes
  • Monitoring and reporting of verifiable outcomes that enable multi-year program strategies
  • Privacy and confidentiality controls for protection of Personal Health Information (PHI)
  • A built-in Reasonable Alternative Standard (RAS) for all outcome-based metrics
  • A ready-made contribution manager strategy to align employer-employee incentives
  • An intuitive, step=by-step online member experience with multiple touchpoints that re fully compliant

Vitality Status®: A robust proprietary measure of health engagement

Using Vitality Status as the standard for obtaining a reward is the most straightforward, effective and efficient way to structure the Vitality program for any organization. This program design delivers built-in Reasonable Alternative Standards for every health factor-related requirement. Members of any age, health or fitness level can complete a multitude of different activity combinations to earn Vitality Points® and increase their Status.

One of the easiest wellness program strategies to implement to combine participator requirements such as a Vitality Health Review™  and a Vitality Check™ with a requirement to reach a certain Vitality Status. RAS options are offered for every health contingent factor in the program activities.

Adding a health factor requirement such as an in-range blood pressure goal will require additional lengths of time for a participant to achieve goals. This multi-year strategy is also well supported by Vitality with appropriate Reasonable Alternative Standards as needed.

Helping clients design an intelligent incentive strategy

Whether clients choose to incent their employees to adopt health lifestyle choices via merchandise or a discount or rebate of a health plan premium or contribution– or a combination of two– we can help them configure a simple-to-administrate, proven-effective wellness program to meet their objectives. The Vitality Mall™ our health club subsidies or rebates and our Vitality Contribution Manger™ are all available as reward options that can be included in the wellness program benefit structure.




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