QuitLogix & the Affordable Care Act (ACA)


 

QuitLogix Meets Reasonable Alternative Guidelines

Employers can be assured that our QuitLogix program meets the guidelines of the Affordable Care Act (ACA). The ACA allows employers to provide a wellness incentive program that is based on specific employee health standards (known as “health-contingent wellness programs”). Incentives can be tied to participating in a wellness activity or achieving a health outcome for any of these five health risk factors:

  • BMI
  • Blood pressure
  • Cholesterol
  • Glucose
  • Tobacco free

Under the ACA, employees can be charged a differential of up to 30% on their health insurance premiums if they don't meet their wellness plan's goal for BMI, blood pressure, cholesterol or glucose and up to a 50% differential if they are a tobacco user. However, to charge this differential employers or health plans must offer a “reasonable alternative” program to employees.

The ACA considers a program to be in compliance with tobacco use counseling and intervention coverage if the following are covered without cost sharing: 

  • At least two tobacco cessation attempts per year
  • Four tobacco cessation counseling sessions of at least 10 minutes each (including telephone counseling, group counseling and individual counseling) without prior authorization
  • All Food and Drug Administration (FDA)-approved tobacco cessation medications (including both prescription and over-the-counter medications) are provided for a 90-day treatment regimen when prescribed by a health care provider without prior authorization

QuitLogix is a comprehensive tobacco cessation program that can be used to satisfy this requirement of the ACA, allowing employers to charge a premium differential.


QuitLogix