After a 13-year debate, the Genetic Information Nondiscrimination Act (GINA) was finally signed into law in May 2008. The act, which went into effect in November 2009, prohibits group health plans and health insurers from denying coverage to a healthy individual or charging that person higher premiums based solely on a genetic predisposition to developing a disease in the future.
“The legislation also prevents employers from using individuals’ genetic information when making hiring, firing, job placement, or promotion decisions,” says Sally Stephens, president of Spectrum Health Systems.
Smart Business spoke with Stephens about what employers need to know about GINA.
Why do business owners need to be aware of GINA?
There are two main practice areas in which an employer must remain compliant with GINA regulations: group health plans and employment practices. GINA amends the Employee Retirement Income Security Act, the Public Health Service Act and the Internal Revenue Code. The new law prohibits plans and insurers from imposing enrollment restrictions and premium adjustments on the basis of genetic information or genetic services, requiring employee contributions to differ on the basis of genetic information, or requesting or requiring an individual to take a genetic test. A health professional is permitted to request an individual to undergo a genetic test.
How can businesses remain compliant in employment practices?
According to GINA, employers may not disclose genetic information except:
- To the employee or member upon request or to an occupational safety or other health researcher
- In response to a court order
- To government officials investigating GINA compliance
- In connection with the employer’s compliance with medical certification provisions of the federal Family and Medical Leave Act or similar state laws
- To a public health agency
Are there any programs businesses are currently using that may violate GINA?
Many employers continue to use wellness programs that manage their group health plan costs, recognizing that a healthier work force may lower health care expenditures and increase productivity. Many programs use financial incentives to encourage employees to complete health risk assessments and biometric testing as well as practice healthy behavior.
However, wellness programs that provide rewards for completing HRAs that request genetic information, including family medical history, violate GINA, even if rewards are not based on the assessment outcome. GINA does, however, permit employers to acquire genetic information as part of an employer’s health or genetic services, including services offered as part of a voluntary wellness program and that are not part of open enrollment or health plan underwriting.