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Law Educator, Esq.
Law Educator, Esq., Attorney
Category: Employment Law
Satisfied Customers: 116215
Experience:  20+ Years of Employment Law Experience
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How does the so-called annual wellness assessment and

Customer Question

how does the so-called annual wellness assessment and development of a health plan affect my medicare coverage? I believe it is not mandatory, but what happens if I decline to have such an every year will coverage be denied on certain services in the future. Same question if I complete the assessment, come up with a health plan, but do not follow that plan (example, health plan says to quite smoking but the person does not)
Submitted: 1 year ago.
Category: Employment Law
Expert:  Law Educator, Esq. replied 1 year ago.

Thank you for your question. I look forward to working with you to provide you the information you are seeking for educational purposes only.

Under VA law, an insurer may offer a voluntary wellness program and may offer discounts (some can be substantial) to those members who participate in the programs. If a person refuses to participate, then the insurer can charge those persons full price for benefits and give them no discount.

If you complete the assessment and do not follow the suggestions, then in the following year, you could lose any discounts provided for participating.

See: Virginia Code § 38.2-3540.2 (2010, enacted, VA HB 548): Each group accident and sickness insurance policy and health care plan may provide a premium discount to every employer instituting and maintaining an employee wellness program satisfying such criteria as each insurer may establish. An employer instituting and maintaining an employee wellness program in accordance with the insurer's criteria may require that any employee wishing to enroll in such program undergo a health assessment as a condition of enrollment.