Migliaccio & Rathod LLP is investigating whether Elara Caring’s employee health plan administers tobacco-related health insurance surcharges in compliance with ERISA and federal wellness program regulations.
Publicly available 2026 benefits materials indicate that Elara Caring charges a $100 monthly tobacco surcharge for each covered employee and spouse who used tobacco during the applicable lookback period. The publicly available guide reportedly describes the surcharge but does not clearly explain whether employees may earn the full premium discount merely by participating in a reasonable alternative tobacco cessation program, whether previously paid surcharges are refunded, or how employees may request physician accommodations or other reasonable alternatives.
Because the surcharge may apply separately to both employees and covered spouses, some families may pay thousands of dollars in additional health insurance premiums each year.
What Employees Report
Employees report:
- Paying tobacco-related premium surcharges for themselves, their spouses, or both.
- Receiving limited information regarding how to remove the surcharge.
- Participating in cessation efforts without understanding whether they qualified for full premium relief.
- Continuing to pay increased premiums despite attempting to satisfy program requirements.
- Uncertainty regarding physician accommodations and reasonable alternatives.
- Difficulty determining whether previously collected surcharges could be reimbursed.
Why Employees Should Be Concerned
Federal wellness program regulations generally require outcome-based tobacco surcharge programs to provide every participant who does not satisfy the tobacco-free standard with a reasonable alternative standard that permits the participant to earn the full premium reward.
Where substantial monthly surcharges are imposed, employees and covered spouses may pay significant additional premiums if reasonable alternatives are not adequately offered or communicated. The manner in which surcharge refunds, physician accommodations, and alternative standards are administered may materially affect participants’ rights under ERISA.
This investigation seeks to determine whether Elara Caring properly administered its tobacco surcharge program and whether employees and covered spouses paid tobacco surcharges that should not have been assessed.
Potential Claims May Include
- ERISA Violations
- Failure to Provide a Reasonable Alternative Standard
- Improper Wellness Program Administration
- Breach of Fiduciary Duty
- Recovery of Improperly Assessed Tobacco Surcharges
- Declaratory and Injunctive Relief
Signs You May Be Affected
You may be affected if:
- You participated in Elara Caring’s employee health plan.
- You or your covered spouse paid a tobacco-related premium surcharge.
- You participated in a tobacco cessation activity.
- You were not clearly informed how to earn the full premium discount.
- You requested an accommodation or reasonable alternative.
- You still possess payroll records, enrollment materials, or benefits communications concerning the surcharge.
If you believe you encountered these issues, we would like to hear from you. Please complete the contact form on this page, send us an email at [email protected], or give us a call at (202) 470-3520.