Delta Airlines announced this week that it would require employees who did not receive the COVID-19 vaccine to pay $ 200 more per month for their health insurance.

“This is the first headline I’ve seen where a large company has gone so far as to charge a higher premium if you don’t get vaccinated,” said Norbert Kiegel, a partner at Warner’s Employee Benefits / Executive Compensation Practice Group. “And the dollar is also quite significant. $ 200 a month is an eyebrow lift. ”

Can other employers across the country do that?


The answer is yes.

If the plan is designed under the Affordability և Accountability Act համապատասխան Affordable Care Act rules, employers may require employees covered by their health plan to pay higher bonuses if they are not vaccinated.

Although we typically consider HIPAA a privacy policy, it also includes non-discriminatory health rules that prohibit employers from charging higher health insurance premiums to employees based on health factors. However, under the HIPAA Regulations ի Affordable Care Act, an employer can offer financial incentives to people who participate in his or her health plans.

And, the health plan may include incentives to get the COVID-19 vaccine, such as a premium for people who have not been vaccinated.

If the company adopts this policy, they may pay a higher monthly fee to the unvaccinated person, as they are at greater risk of contracting COVID-19, according to Kugele.

About 49% of the country’s population receives employer-sponsored health insurance (also called group health insurance), according to the Kaiser Family Foundation.

“When an employer sponsors its employees’ health plan, it usually does not charge employees the full cost of coverage,” Kugele said. »

“Employees usually pay a small percentage of the actual cost of a health plan,” Kougele continued. – There are laws, such as the Affordable Care Act և HIPAA, which are non-discriminatory medical laws that say an employer cannot charge an employee more than they are healthy. There are some exceptions to the word smoking or something like that, but this is a very narrow list of exceptions. And, as a rule, you can not discriminate against your workforce with bonuses based on their health. ”

Employers can circumvent these laws of medical discrimination by using health programs that are reasonably designed to improve health or prevent disease.

“Many programs try to encourage people to stay healthy, not to turn to chronic diseases, things like that. You can get promotions in the form of premiums or premium discounts. So if you participate in health planning, do what is required of you, you will pay less for your health coverage. The same rules apply to COVID-19 vaccines. You can encourage people to be vaccinated as part of you. Health plan. Thus, those who are vaccinated will pay less for their health insurance, and those who are not vaccinated will pay more. That’s what Delta Airlines did. “They mostly used their health plan to try to encourage people who were not involved.” t vaccinated to receive COVID-19 vaccine.

There are restrictions on health programs under the law. According to the regulations, incentives or bonuses, as a rule, can not be more than 30% of the total cost of coverage.

This news crosses the line between different states. Every company has these federal laws that apply to it, so technically any company can adopt such a program. This is an alternative to the vaccination mandate that employers should consider, according to Kougele.

“It would not be a surprise to me to see other companies in the nation do that. “I know some of the clients we work with really do not want to go the route of forcing vaccination,” Kougele said. “I know some of them will address that.”

“Of course, anyone who gets COVID-19 and goes to the hospital can incur significant medical costs,” he continued. “So I think it’s fair for employers to try to encourage people to get the vaccine, because it will probably save the plan some money.”

According to Warner Norcross & Judd Corporation, the surcharge for unvaccinated persons must comply with the following HIPAA / ACA rules:

• The participant should be given the opportunity to receive a prize every year (ie to avoid overpayment).
• The maximum reward for all health plans (including vaccine promotion) may not be more than 30% of the total cost of an employee’s health insurance (employee և employer contributions), although smoking incentives may be as high as: 50. % of expenses.
• The must plan must be reasonably designed to improve health or prevent disease.
• The must plan must meet the common accessibility և reasonable alternative criteria. The COVID-19 Vaccine Promotion Program should include the following two options:
• The must plan should provide a reasonable alternative activity (or withdrawal) for any individual for whom it is unreasonably difficult due to a medical condition or activity that is medically unacceptable (which can be confirmed by the individual’s personal physician when it is reasonable to do so). Offering an alternative may not be easy, so refusing may be the most practical solution.
• The full award should be available to anyone who completes the program or meets a reasonable alternative standard (or waives the standard). Depending on the structure of the plan, if the premium payer is vaccinated, the employee may be entitled to reimburse (or credit) for the premiums the employee has paid up to that point in the plan year.
• All materials describing the health plan should also describe the existence of a reasonable alternative activity / standard (or, if applicable, the abandonment of the activity / standard).