value of a benefit that would otherwise not be 
provided under the plan. The Secretaries of 
Labor, Health and Human Services, and the 
Treasury may increase the reward available 
under this subparagraph to up to 50 percent of 
the cost of coverage if the Secretaries determine 
that such an increase is appropriate. 
(B) The wellness program shall be reason-
ably designed to promote health or prevent dis-
ease. A program complies with the preceding 
sentence if the program has a reasonable 
chance of improving the health of, or preventing 
disease in, participating individuals and it is 
not overly burdensome, is not a subterfuge for 
discriminating based on a health status factor, 
and is not highly suspect in the method chosen 
to promote health or prevent disease. The plan 
or issuer shall evaluate the program’s reason-
ableness at least once per year. 
(C) The plan shall give individuals eligible 
for the program the opportunity to qualify for 
the reward under the program at least once 
each year. 
(D) The full reward under the wellness 
program shall be made available to all similarly 
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situated individuals. For such purpose, among 
other things: 
(i) The reward is not available to all 
similarly situated individuals for a period 
unless the wellness program allows— 
(I) for a reasonable alternative 
standard (or waiver of the otherwise 
applicable standard) for obtaining the 
reward for any individual for whom, 
for that period, it is unreasonably dif-
ficult due to a medical condition to 
satisfy the otherwise applicable stand-
ard; and 
(II) for a reasonable alternative 
standard (or waiver of the otherwise 
applicable standard) for obtaining the 
reward for any individual for whom, 
for that period, it is medically inadvis-
able to attempt to satisfy the other-
wise applicable standard. 
(ii) If reasonable under the cir-
cumstances, the plan or issuer may seek 
verification, such as a statement from an 
individual’s physician, that a health status 
factor makes it unreasonably difficult or 
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medically inadvisable for the individual to 
satisfy or attempt to satisfy the otherwise 
applicable standard. 
(E) The plan or issuer involved shall dis-
close in all plan materials describing the terms 
of the wellness program the availability of a 
reasonable alternative standard (or the possi-
bility of waiver of the otherwise applicable 
standard) required under subparagraph (D). If 
plan materials disclose that such a program is 
available, without describing its terms, the dis-
closure under this subparagraph shall not be re-
quired. 
(c) EXISTING PROGRAMS.—Nothing in this section 
shall prohibit a program of health promotion or disease 
prevention that was established prior to the date of enact-
ment of this section and applied with all applicable regula-
tions, and that is operating on such date, from continuing 
to be carried out for as long as such regulations remain 
in effect. 
(d) REGULATIONS.—Nothing in this section shall be 
construed as prohibiting the Secretaries of Labor, Health 
and Human Services, or the Treasury from promulgating 
regulations in connection with this section. 
Æ 
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