Migliaccio & Rathod LLP is investigating whether T.J. Samson Community Hospital employees were required to pay higher health-insurance premiums, lost premium discounts, or missed out on other health-plan benefits because they did not complete certain wellness-program requirements.
Publicly available benefits materials indicate that T.J. Samson Community Hospital offers health-plan incentives through its wellness program. The program reportedly requires employees to complete an annual biometric screening or physical examination, submit a tobacco-use affidavit, complete a health-risk assessment, and satisfy other wellness requirements to qualify for reduced health-insurance costs or available wellness incentives.
These requirements may have included:
- completing a biometric screening or annual physical examination;
- taking a health-risk assessment or medical questionnaire;
- submitting a tobacco-use affidavit or certification;
- meeting targets for blood pressure, cholesterol, glucose, weight, or BMI;
- participating in health coaching or wellness activities;
- submitting medical information by a particular deadline; or
- completing other wellness-program requirements necessary to receive the full premium discount.
Federal law places limits on how employers and health plans may use wellness programs to charge employees different amounts for health coverage. In many circumstances, employees must be given a reasonable alternative way to earn the same reward or avoid the same penalty. Employees may also be entitled to clear notice of that alternative and, after completing it, the full value of the discount or benefit.
Additional protections may apply when a wellness program requires medical examinations, disability-related questions, or medical information collected through health-risk assessments.
We Are Interested in Hearing From Current and Former T.J. Samson Community Hospital Employees Who:
- paid more for medical coverage because they did not complete a wellness requirement;
- lost a premium discount or wellness incentive;
- did not complete a biometric screening, annual physical, health assessment, or tobacco affidavit;
- were not told that an alternative was available;
- requested an alternative but were denied or delayed;
- completed an alternative but did not receive the full discount;
- were required to provide medical information they did not wish to disclose; or
- believe the wellness program was confusing, unfair, or difficult to complete.
You may have rights even if the additional charge appeared on your paystub as a “wellness surcharge,” “premium differential,” “non-wellness rate,” “standard premium,” or as the loss of a premium discount.
If you participated in T.J. Samson Community Hospital’s health plan and were affected by its wellness program, please contact Migliaccio & Rathod LLP. There is no charge to speak with us, and there is no obligation to take legal action.
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.