## Facts

- Broward County offered employees a group health insurance plan administered through its insurer, Coventry Healthcare.
- In 2009, Coventry offered a wellness program available only to employees enrolled in the County’s group health plan.
- The program required (1) a biometric screening (finger-stick glucose and cholesterol) and (2) an online Health Risk Assessment (HRA) questionnaire.
- Coventry used screening and HRA data to identify employees with specified chronic conditions (asthma, hypertension, diabetes, congestive heart failure, kidney disease).
- Employees identified with those conditions were offered disease-management coaching and became eligible for medication co-pay waivers after participation.
- Beginning in April 2010, the County imposed a $20 charge on each biweekly paycheck for plan enrollees who declined to participate in the wellness program; the charge was suspended effective January 1, 2011.
- Bradley Seff declined to participate, incurred the $20 biweekly charges from June 2010 to January 1, 2011, and brought a putative class action under the ADA.

## Issues

1. Whether the wellness program’s biometric screening and HRA were prohibited non-voluntary medical examinations and disability-related inquiries under the ADA.
2. Whether the program was exempt under the ADA’s safe harbor for bona fide benefit plans, 42 U.S.C. § 12201(c), as a “term” of the County’s group health plan.

## Decision

- The Eleventh Circuit affirmed summary judgment for Broward County.
- The court held the wellness program was a “term” of the County’s group health plan and therefore fell within the ADA § 12201(c) safe harbor.
- Because the safe harbor applied, the court did not decide whether the $20 surcharge rendered participation non-voluntary under the ADA’s medical examination and inquiry provisions.

## Legal Principles

- The ADA safe harbor, 42 U.S.C. § 12201(c), permits covered entities to establish, sponsor, observe, or administer the terms of a bona fide benefit plan involving underwriting, classifying, or administering risks, consistent with state law.
- A wellness program may qualify as a “term” of a group health plan when it is integrated into the plan’s structure, including insurer sponsorship, plan-exclusive availability, plan funding, and plan-related communication materials.
- When a challenged practice falls within § 12201(c), it may be exempt from ADA restrictions that would otherwise apply to employee medical examinations and disability-related inquiries under 42 U.S.C. § 12112(d).

## Conclusion

The Eleventh Circuit upheld the County’s wellness program against an ADA challenge because the program was integrated into and administered as part of a bona fide group health plan, bringing it within the ADA’s § 12201(c) safe harbor and eliminating the need to resolve whether the program was “voluntary” under § 12112(d).


Seff v. Broward County, 691 F.3d 1221 (11th Cir. 2012)