Migliaccio & Rathod LLP is investigating whether Nuvance Health’s employee health plan administers tobacco-related health insurance surcharges in compliance with ERISA and federal wellness program regulations.
Federal wellness program regulations generally allow employers to charge tobacco-related premium surcharges only if employees who do not satisfy the tobacco-free standard are offered a reasonable alternative standard that permits them to earn the full premium reward.
Publicly available 2026 Nuvance Health benefits materials reportedly impose a tobacco-related surcharge while describing a tobacco cessation program available to employees. The publicly available materials raise questions regarding whether participants are adequately informed of all available reasonable alternative standards, physician-directed alternatives, timing requirements, and whether employees who satisfy an alternative standard receive appropriate premium adjustments or refunds.
What Employees Report
Employees report:
- Paying tobacco-related health insurance surcharges.
- Enrolling in tobacco cessation programs but continuing to pay increased premiums.
- Receiving limited information regarding reasonable alternative standards.
- Uncertainty about physician accommodations or other qualifying alternatives.
- Difficulty determining when surcharge relief becomes effective.
- Questions regarding refunds for surcharges previously collected.
Why Employees Should Be Concerned
Employees should generally have a genuine opportunity to qualify for the full wellness reward even if they continue using tobacco products, provided they satisfy an approved reasonable alternative standard.
If the administration of a tobacco surcharge program limits access to reasonable alternatives or fails to clearly communicate participants’ rights, employees may pay more for health insurance than federal wellness program regulations contemplate.
This investigation seeks to determine whether Nuvance Health properly administered its tobacco surcharge program and whether affected employees may be entitled to reimbursement of improperly assessed premium surcharges.
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 Nuvance Health’s employee health plan.
- You paid a tobacco-related premium surcharge.
- You participated in a tobacco cessation or wellness program.
- You were not clearly informed of other reasonable alternatives or physician accommodations.
- You continued paying the surcharge despite participating in the program.
- 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.