Many employers require their employees to participate in a health risk assessment (HRA) in order to be eligible for health insurance coverage. But in a recent informal opinion letter, the Equal Employment Opportunity Commission (EEOC) stated that requiring employees to participate in a health risk assessment in order to be eligible for health insurance would violate the ADA.
Disability-related inquiries prior to a job offer are prohibited by ADA, and they are permitted only if they are required of all employees in the same job category and if they are job-related and consistent with business necessity. The EEOC determined that requiring all employees to take this HRA that includes disability-related inquiries and medical examinations as a prerequisite for obtaining group health coverage does not appear to be job-related and consistent with business necessity, and therefore it would violate the ADA.
To be job-related and consistent with business necessity, the employer must have a reasonable belief based on objective evidence that a medical condition will impair the employee's ability to perform essential job functions, or that the employee's medical condition will cause a direct threat. As part of the HRA, employees are required to fill out a short health-related questionnaire, take a blood pressure test, and give a blood sample for screening. None of them related to the employee's ability to perform the essential job functions.
The EEOC noted that disability-related inquiries and medical exams are permitted as part of voluntary wellness programs. A wellness program is considered voluntary only if employees are neither required to participate nor penalized for non-participation. If employee’s decision not to participate will lead to rejection of a significant employment benefit, then such a program is not voluntary. Thus, employers should review their programs to determine whether such programs are truly voluntary.