United States: Just What The Doctor Ordered: Court Denies The EEOC's Motion For Summary Judgment In ADA Suit Regarding Employer's Wellness Program

Last Updated: September 27 2016
Article by Gerald L. Maatman Jr. and Alex W. Karasik

Seyfarth Synopsis: After the EEOC brought an action under the Americans With Disabilities Act against an employer who implemented a wellness program requiring employees to take a health assessment to participate, the Court granted the employer's motion for summary judgment and denied the EEOC's motion for summary judgment after finding that the program was voluntary. As such, the ruling is a bench-slap to the Commission in terms of its position on challenging wellness programs.

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After an employer in Wisconsin implemented a wellness program that required employees to take a health risk assessment if they wanted to participate, the EEOC brought an action under the Americans With Disabilities Act ("ADA"), which generally prohibits employers from requiring employees to undergo medical examinations. In EEOC v. Orion Energy Systems, Inc., No. 14-CV-1019 (E.D. Wis. Sept. 19, 2016), Judge William C. Griesbach of the U.S. District Court for the Eastern District of Wisconsin granted in part employer Orion Energy Systems, Inc.'s ("Orion") motion for summary judgment and denied the EEOC's motion for summary judgment.

This ruling illustrates that for employers who implement wellness programs that require employees to take a health assessment if they wish to participate, those medical examinations do not violate the ADA as long as the program is voluntary.

Case Background

In 2008, Orion switched from a fully insured health plan to a self-insured health plan. In 2009, Orion implemented a multi-faceted wellness program. Relevant here, employees would have to either complete a health risk assessment ("HRA") at the beginning of the insurance year or pay the entire monthly premium equivalent amount. Employees who completed the HRA paid no premium equivalent, but still had to pay their own deductibles, co-pays and out-of-pocket expenses. The HRA consists of a health history questionnaire and biometric screen involving a blood pressure check, body measurements, and blood analysis. Orion did not receive any personally-identifiable information as a result of the HRA, as the information was compiled by outside entities who then transmitted it to Orion in an anonymous format. The anonymous, aggregated data allowed Orion to see the percentage of participants in its plan who had particular health risks such as high cholesterol, identify common health issues, and offer employees educational tools to improve their health.

In the spring of 2009, only one Orion employee chose to opt-out of the program. Orion management spoke with the employee regarding negative comments the employee made to co-workers about the amount of the premium being charged by Orion. The employee claimed she was told during this meeting to keep her opinions about the new wellness program to herself, while Orion claimed that such negativity was not welcome in the workplace, and that if the employee had concerns, she needed to speak with someone in management. The employee later sent an e-mail criticizing the tactics of Orion's former CEO. Shortly thereafter, the employee was terminated.

The EEOC brought suit against Orion alleging it violated the ADA by requiring employees who elect to enroll in Orion's self-insured health insurance plan to either complete the HRA or pay 100 percent of their monthly premium amount. The EEOC also alleged that Orion violated the ADA's anti-retaliation provisions, 42 U.S.C. § 12203(a) and (b), by instructing the employee not to discuss her concerns about the legality of this requirement with co-workers and by terminating her employment shortly after she voiced opposition to Orion's wellness program. Orion contended that its requirement that employees who elect to receive health insurance from Orion either participate in the wellness program or pay the full premium amount was lawful under the ADA's insurance "safe harbor" provision, which allows self-insured organizations to administer benefits plans, or alternatively, that its wellness program is voluntary under 42 U.S.C. § 12112(d)(4)(B). Both parties moved for summary judgment.

The Decision

The Court granted in-part Orion's motion for summary judgment and denied the EEOC's motion for summary judgment. Initially, the Court explained that Section 12112(d)(4)(A) of the ADA "shall not require a medical examination and shall not make inquiries of an employee as to whether such employee is an individual with a disability . . . unless such examination or inquiry is shown to be job-related and consistent with business necessity," but that Section 12112(d)(4)(B) permits employers to conduct "voluntary medical examinations . . . which are part of an employee health program available to employees at that work site." Id. at 6-7. The EEOC argued that the HRA was not "voluntary" given that Orion shifted 100 percent of the health benefit premium to employees who opted out. Orion argued its wellness initiative did not violate the ADA for three reasons: (1) the ADA's safe harbor relating to insurance applied to the challenged aspects of the wellness program; (2) Orion did not "make inquiries" since it received only anonymous, aggregated results from the HRA; and (3) the wellness program was voluntary because Orion's employees had a choice regarding whether to participate and sufficient time to make that choice.

Regarding the safe harbor provision, the Court rejected Orion's argument and found that the safe harbor provision did not apply to Orion's wellness program. Citing Congressional intent, the Court noted that the safe harbor provision was a limited exception that was created to protect the basic business operations of insurance companies, and that generally, wellness programs are unrelated to basic underwriting and risk classification. Id. at 15 (citations omitted). Applied here, the Court found that the wellness program was not used to underwrite, classify, or administer risk. Id. The Court explained that "[i]f an employee refused to complete the HRA and participate in the wellness plan, she could still be a member of Orion's insurance plan, provided she pay the full premium amount. In short, Orion's wellness program was wholly independent from its insurance plan." Id. at 16.

Next, the Court addressed Orion's argument that even if its wellness initiative was not immune under the safe harbor provision, Orion's program was still voluntary. Id. at 17. The EEOC argued that the wellness program was involuntary because shifting 100 percent of the premium cost to an employee who opted out of a program was so substantial that Orion's offer to pay the health benefit premium in exchange for the employee's participation in the program is more than a mere incentive. The Court rejected the EEOC's argument, noting that, "even a strong incentive is still no more than an incentive; it is not compulsion," and that, "Orion's wellness initiative is voluntary in the sense that it is optional." Id. at 18. Accordingly, the Court found that Orion was entitled to summary judgment and rejected the EEOC's claim that the wellness program, including the HRA, violated § 12112(d)(4)(A).

Finally, in regards to the EEOC's retaliation and interference claims, Orion argued that the employee was not engaged in any protected activity by complaining about aspects of the program that were lawful. The Court rejected Orion's argument, noting it was "undisputed that [the employee] expressed concern about the confidentiality of her medical information under the new wellness initiative. As that is a legitimate concern under the ADA, i.e., something the ADA actually does govern, her expression may have been protected." Id. at 20. Accordingly, the Court denied Orion's motion for summary judgment as to the retaliation and interference claims.

Implications For Employers

Employer's implementing wellness programs absolutely need to pay attention to decisions such as this one. So long as participation in the program and any accompanying health assessment are truly voluntary, employers can utilize such wellness programs without violating the ADA. Nonetheless, employers must be cautious in making sure their programs are truly voluntary or else face this risk of EEOC litigation.

Readers can also find this post on our EEOC Countdown blog here.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

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Gerald L. Maatman Jr.
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