11.10.09
New IRS Law Regarding Genetic Nondiscrimination
Employers are prohibited from collecting genetic information, defined as family medical history, in health risk assessments (HRA) if that information will be used for “under-writing” purposes, which includes offering employees discounts on their monthly premium contributions or lowering deductibles for completing an HRA. However, employer sponsored group health plans may collect such information after enrollment has closed. Failure to comply with the new Genetic Information Nondiscrimination Act of 2008 (GINA) rules could result in fines beginning at $2,500, starting with plans which become effective on or after December 7.
Employers are prohibited from implementing the following:
· Any group health plan that provides a premium reduction to employees who complete an HRA prior to enrollment that includes questions about family medical history.
· Any group health plan that requests employees to complete an HRA prior to enrollment that includes questions about an individual’s family medical history, but does not offer a reward.
Any group health plan that waives its annual deductible for individuals who complete an HRA after enrollment that does not include any direct questions about family medical history but asks, “Is there anything else relevant to your health that you would like us to know or discuss with you?” the answers to which may divulge genetic information.
However, the following are permissible:
· Any group health plan that requests enrollees to complete two distinct HRAs after and unrelated to enrollment: one that doesn’t include questions about family medical history, but offers a reward, and one that includes family medical history questions, but offers no reward.
· Any group health plan that waives its annual deductible for individuals who complete an HRA after enrollment that includes the question, “Is there anything else relevant to your health that you would like us to know or discuss with you? In answering this question, you should not include any genetic information. That is, please do not include any family medical history or any information related to genetic testing, genetic services, genetic counseling or genetic diseases for which you may be at risk.”
· Any group health plan that normally provides coverage for mammograms only for women 40 and older may choose to extend coverage to younger women who demonstrate they are at increased risk of getting breast cancer, such as through genetic testing or a family history of the disease.
· From www.federalregister.gov, reported in Business Insurance, October 12, 2009 issue, pp. 3 and 18.