Current through Register 1531, September 27, 2024
(1) The Wellness Program shall be
administered by the certified Group Purchasing Cooperative or by an entity that
has contracted with the certified Group Purchasing Cooperative. The certified
Group Purchasing Cooperative shall be responsible for all the features of the
Wellness Program(s) , which shall be conducted pursuant to a written plan,
under the supervision of a properly trained health practitioner and staffed by
appropriately trained and qualified personnel, and shall include a documented
process to:
(a) Conduct health risk
assessments, at least annually, of all Insureds participating in the Wellness
Program(s), according to a tool that has been accredited by the National
Committee on Quality Assurance;
(b)
Develop reasonable health maintenance or improvement goals with each Wellness
Program participant based upon factors derived from the participant's health
risk assessment;
(c) Record each
participant's activities designed to address wellness goals and, as
appropriate, provide workplace or other geographically convenient wellness
monitoring locations;
(d) Monitor
participants' progress toward meeting wellness goals and assign trained and
qualified lifestyle coaches to assist participants to keep on track with goals
and develop ways to encourage continued activities to achieve desired goals
including through financial or other incentives, periodic reminders and/or
motivational interviewing;
(e)
Measure, at least annually, the Wellness Program's effectiveness at developing
goals that improve participants' health status, promoting adherence to planned
goals and changing overall trends in health status, and redesigning the program
to address new or persistent health issues;
(f) Maintain the confidentiality of each
participant's health risk assessment and progress toward reaching the
participant's individualized health goals; and
(g) Maintain Wellness Programs consistent
with state and federal statutes, regulations and guidelines, including required
accommodations made for those with physical or other disabilities that could
prevent participation in standard programs.
(2) The Wellness Program shall, at minimum,
be designed to address the prevention and management of heart disease, stroke,
diabetes, asthma, cancer and the following risk factors:
(a) High blood pressure;
(b) Smoking;
(c) Substance abuse and prescription
non-compliance;
(d) Adult and child
obesity;
(e) Depression;
(f) Stress and work-life balance;
(g) Inactivity;
(h) Unhealthy diets (high sugar, high sodium,
high saturated fat and low fiber);
(i) Elevated cholesterol;
(j) Elevated blood glucose; and
(k) Workplace policies/environments that may
impact individual health.
(3) The criteria for the Wellness Program
shall be, to the maximum extent feasible, scientifically derived and
evidence-based, and developed with the input of appropriate medical
professionals.
(4) A certified
Group Purchasing Cooperative shall coordinate with a Carrier's Wellness Program
data processing systems to enable the certified Group Purchasing Cooperative to
effectively provide guidance to Eligible Association Members, Eligible Small
Businesses, Eligible Employees and Eligible Dependents regarding targeted
Wellness Programs.
