BSG^® WellBlog

For my discussion today, let’s look at an employer who wants to impose a premium contribution surcharge on participants who smoke or use tobacco. In announcement materials, the employer includes a statement that an alternative way to avoid the premium surcharge is to attend stop-smoking classes, but only if there is a physician certification that quitting smoking is unreasonably difficult due to a medical condition. When the program kicks in, only the employees who brought in the physician statement qualify for the alternative standard and avoid the premium surcharge. Other smokers who did not get the physician statement must pay the surcharge, even if they have agreed to attend the same stop-smoking program as their fellow employees. 

The physician statement requirement is a good way to put some immediate teeth into a wellness program, but it is just one aspect in the design of a solid smoking cessation strategy. Next time, I will outline the main elements of a HIPAA-compliant smoking cessation program.

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Permalink | March 15, 2010 11:07

My earlier post used an example of a meeting a health standard (no tobacco use) in order to qualify for a wellness reward. Is it possible for smokers to assert it is “unreasonably difficult due to a medical condition” or “medically inadvisable” to stop smoking?

A smoker certainly may claim that it is unreasonably difficult to stop smoking and demand an alternative standard. In this case, the employer has the right to request a statement from the employee’s physician verifying the unreasonable difficulty. The employee must bear the cost of any expense incurred in obtaining the statement. Once provided, the employer may then establish the reasonable alternative standard, such as attending smoking cessation classes. The key here is the word “reasonable”. It would be unreasonable, for example, for the employee to travel 10 miles a week and pay $50 for the classes.

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Permalink | January 21, 2010 08:34