No. Wellness programs that provide rewards for completing HRAs that request genetic information, including family medical history, violate the Genetic Information Nondiscrimination Act of 2008's (GINA) prohibition against requesting genetic information for underwriting purposes. This is the result even if rewards are not based on the outcome of the assessment, which otherwise would not violate the HIPAA nondiscrimination rules regarding wellness programs.

A plan or issuer can collect genetic information through an HRA as long as no rewards are provided. A plan or issuer also can provide rewards for completing an HRA as long as the HRA does not collect genetic information.

What is genetic information? Genetic information is information about the individual’s genetic tests or the genetic tests of family members, the manifestation of a disease or disorder in family members of such individual (i.e., family medical history), or any request of or receipt by the individual or family members of genetic services. Genetic information does not include information about the sex or age of any individual.

Who is considered a family member? GINA defines a “family member” with respect to any individual as a dependent of such individual and any other individual that is a first-, second-, third-, or fourth-degree relative of the individual or of the dependent of the individual. In determining who is a first-, second-, third-, or fourth-degree relation of an individual, interim final regulations treat relatives by affinity (such as by marriage or adoption) the same as relatives by consanguinity (relatives who share a common biological ancestor or blood relatives). The definition also treats relatives who are not full blood relatives (such as half siblings) the same as full blood relatives.

Source: 74 FR 51664, October 7, 2009.