In a much anticipated decision, a Wisconsin federal district court has granted Orion Energy Systems, Inc.’s summary judgment on the EEOC’s challenge to its wellness program design. See Sept 19, 2016 Decision and Order. While largely good news for Orion, the ruling creates even more confusion for employers seeking clarity on wellness program design principles.  In short, the Court: 1) rejected the EEOC’s claim that the wellness program violated the ADA because it was “involuntary;” 2) upheld the EEOC’s position that the ADA’s “safe harbor” for insurance could not be used to defend the wellness program design; and 3) held there was a triable issue on whether the employer’s termination of an employee who refused to participate in the wellness program was unlawful retaliation under the ADA. The case lives on due to the retaliation claim but many employers are scratching their heads on what the ADA requires for wellness programs going forward.

The EEOC’s complaint alleged that Orion required employees to complete a health risk assessment, as part of the wellness program, or pay 100 percent of their health insurance premiums and retaliated against an employee who declined to participate in the screenings. Orion claimed its wellness program was protected by the ADA’s “safe harbor” provision satisfied the ADA requirements of “voluntariness” under 42 U.S.C. §12112(d)(4)(B).

In analyzing whether the ADA’s “safe harbor” provision applies to Orion’s wellness program, the Court applied retroactively the EEOC’s new ADA wellness regulation, which specifically states that the “safe harbor” provision does not apply to wellness programs. This ruling should concern employers who have relied on the ADA’s “safe harbor” provision in designing wellness programs.

However, in a surprising move, the Court concluded, contrary to the EEOC’s position, that the medical inquiries that triggered potential ADA’s protection – the requirement that employees complete a health risk appraisal – were voluntary. Although the Court briefly mentions the 30 percent cap on financial incentives found in the EEOC’s new ADA wellness regulations, because the EEOC did not argue that the cap applied retroactively, the Court did not consider its effect on Orion’s wellness program.  Instead, the Court focused on a question the EEOC likely thought was a “slam dunk” – whether requiring employees who chose not to answer the HRA to pay 100 percent of their health premiums rendered the medical inquiries “involuntary.”  The Court found that the wellness design was “voluntary” because, while the options of either participating in the screening or pay 100 percent of premiums could be considered a hard choice, it was still a choice and the employee had the option of deciding whether or not to participate in the wellness program without the risk of losing participation in the group health insurance plan.  As a result of the determination that participation was optional, the Court held that Orion conducted voluntary medical examinations as part of its wellness program pursuant to 42 U.S.C. § 12112(d)(4)(B).

This ruling renders a completely different result than the decision of the Western District of Wisconsin in EEOC v. Flambeau, Inc. Only time will tell whether the Court’s ruling is followed by other federal courts. Stay tuned!

Photo of Francis P. Alvarez Francis P. Alvarez

Francis P. (Frank) Alvarez is a Principal in the White Plains, New York, office of Jackson Lewis P.C. He is the Leader of the Disability, Leave and Health Management Practice Group, which assists employers in meeting the legal and practical challenges posed by…

Francis P. (Frank) Alvarez is a Principal in the White Plains, New York, office of Jackson Lewis P.C. He is the Leader of the Disability, Leave and Health Management Practice Group, which assists employers in meeting the legal and practical challenges posed by federal and state laws protecting injured and ill employees.

Counseling hundreds of employers each year, Mr. Alvarez spearheads the firm’s effort to provide imaginative and creative solutions to the complex array of workplace disability and health management issues faced by both large and small companies. In the Jackson Lewis tradition, Mr. Alvarez counsels clients with the goal of either avoiding litigation entirely or improving outcomes before administrative agencies, courts and juries.

Mr. Alvarez especially enjoys assisting clients conduct the “individualized assessment” required by a growing number of federal and state laws. These efforts include helping employers effectively communicate with employees and medical providers in an effort to evaluate potential risks to health and safety posed by employee injuries or illnesses. In an area of law in which there often are few bright lines, Mr. Alvarez attempts to develop practical and constructive solutions centered on the concept he calls “tc2” — taking care of employees and taking control of risks.

Recently, Mr. Alvarez has begun leading the Firm into another exciting and fast-developing area of workplace law called “health management.” Challenged by increases in health care and work injury costs, employers are searching for innovative ways to motivate employees to participate in wellness and health promotion programs. Mr. Alvarez leads a team of Jackson Lewis attorneys who advise employers on ways to implement these important programs while complying with emerging and largely undeveloped federal and state law protections.

Mr. Alvarez writes and speaks frequently on disability management issues, including legal developments under the Americans with Disabilities Act and the Family and Medical Leave Act. He has delivered presentations at major speaking engagements, including SHRM’s national and legislative conferences. Throughout his legal career, Mr. Alvarez has represented employers as lead counsel in both trial and appellate courts and has successfully tried employment discrimination claims to verdict.