A company launches a voluntary wellness program that discounts health premiums for employees who hit step-count and biometric targets. Legal signs off on it as ADA compliant, and the executive team loves it. Then employees with disabilities that put those targets out of reach describe three bad options: disclose private health information, ask for an exemption, or pay more than their coworkers. Adam Goldman, Chief Human Resources Officer at Cacique Foods, took the case with host Rebecca Taylor on HR Voices.
Adam recognized it right away. Across several companies, he has run step challenges that doubled as team building, with fundraising walks and internal competition. His diagnosis was blunt: most of these programs are built around the process, not the outcome. The scenario asks HR to unwind a program without torching it, and Adam’s answer was that it never needs to be torched.
Why a Missed Discount Still Shuts People Out
The legal defense of a premium discount is simple. Nobody pays more than before. Adam’s reply was that employees who cannot reach the target are “missing the opportunity to pay less,” and that gap can create both an ADA issue and an employee relations problem. EEOC enforcement guidance on disability-related inquiries and medical exams calls a wellness program voluntary only when an employer neither requires participation nor penalizes employees who do not participate.
State law can go further than the Americans with Disabilities Act. Having spent most of his career in California, Adam knows that some jurisdictions frown on any incentive program that not every employee can join.
The deeper flaw is who these programs reward. Adam has never seen a corporate wellness program engage the people who would benefit most; it is “rewarding the people who are already predisposed to wellness behaviors.” A gym discount pays the person already paying for the gym. The Illinois Workplace Wellness Study, a randomized trial at an employer with more than 12,000 employees, found strong patterns of selection: participants already had lower medical spending and healthier behaviors before the program began.
What a Wellness Program Is Supposed to Do
Adam’s first question is always the intent. A program meant to build camaraderie needs a different design from one meant to lower health risk. Sometimes, he admitted, the real reason is that the boss heard about it at a peer group meeting. Whatever the reason, Adam’s rule is to keep it in view.
If the goal is better health outcomes, the step count is the wrong metric. Adam sees “little evidence that 10,000 steps a day makes any difference,” and the research agrees. A 2022 Lancet Public Health meta-analysis of fifteen cohorts found little evidence behind the 10,000-step goal, and the drop in mortality risk leveled off between 6,000 and 8,000 steps for adults 60 and older.
His alternative is plainer. Encouraging people to get their annual physical “is much more valuable than encouraging people to get 10,000 steps a day,” and an annual physical is open to every employee, whatever their disability. “We take better care of our cars in some cases than we do of ourselves,” Adam said.
What Actually Works
Build a Starting Line for Every Employee
A good program, in Adam’s view, “meets people where they are.” Employees state where they are today, and incremental improvement from that point counts. A step goal rewards Adam, who runs 10Ks, for what he already does.
Cacique shows why one target fails. The company has a small headquarters, two manufacturing plants, and remote sales reps in fourteen or fifteen states. Pedometers are banned on the production floor for sanitary reasons, plant work racks up steps anyway, and field reps spend 40 to 50 percent of the day in a car. Adam will not build 500 versions for 500 employees, but the design has to “cast a wide enough net.” Broker and insurer programs often offer broader activities to fill the gaps.
Design the Program So HR Never Sees Health Data
Coercive disclosure is the other half of the scenario. Adam runs wellness programs through third-party partners, which creates an arm’s-length relationship: the company learns that someone met the goal, not their starting weight or blood pressure. The company never asks for that information. Cacique looks at health risk only in aggregate, such as diabetes and pre-diabetes rates in claims, and works with its broker on interventions.
Firewalls have a limit. In a low-trust organization, Adam noted, employees will not share biometrics however many safeguards exist.
Make the Fix Phase Two, Not a Do-Over
HR has to own the miss with leadership, but the fix does not need to be a confession. Adam would announce phase two, which gives employees more ways to earn the discount, and “call them enhancements.” Nobody has to admit defeat.
The barrier is usually pride. People teams spend much of their time on bad news, so a program the CEO loves becomes a rare win, and Adam described a “huge pride of authorship” in it. His standard is harsher: “The most mediocre HR folks focus on the process more than the situation.” The old tech line applies: “if you launch a program without any bugs, you waited too long.” That is change management on a short cycle, with a pilot or a focus group where possible.
Where Employee Relations Fits
A program that excludes people becomes an employee relations problem before it becomes a lawsuit. Rebecca argued that the skill underneath is emotional intelligence at work: imagining how someone unlike you will experience a program, then asking for specific employee feedback about who it misses. Her view is that inclusion is a muscle.
Adam’s version is to “get out of your office.” He learns the most by walking a grocery store with a salesperson or having coffee at the plant, the kind of presence frontline employees need from HR. Employees who will not disclose a disability in a meeting still need a way to say a program shuts them out, and two-way anonymous reporting gives that concern a channel HR can act on.
Frequently Asked Questions About Wellness Program Incentives
It can work like one. Adam points out that employees who cannot hit the target miss the chance to pay less, and the EEOC calls a program voluntary only when nonparticipants are not penalized. Have counsel review the design.
The evidence is weak. In Adam’s experience they mostly reward employees already inclined to be healthy, and a randomized Illinois study found no significant first-year effect on medical spending.
Enhance it rather than scrap it. Adam would tell leadership something was missed, then launch a phase two that lets every employee start from where they are, through options such as a nutritionist or an annual physical.
Run it through a third party. Adam’s programs use outside partners, so the company sees only whether someone met a goal, and claims data reaches HR only in aggregate.
Design for each group, not one target. At Cacique, plant workers cannot wear pedometers, sales reps spend much of the day driving, and headquarters roles differ again, so Adam builds one program with a wide enough net.
The Bottom Line for HR Leaders
Adam Goldman’s framing turns a compliance problem into a design problem. A program can pass legal review and still shut people out, and the repair starts with the goal it was meant to serve. His closing advice: “focus on the results, not the process.”
The other half is humility about version one. Adam warns against being “so married to phase one” that HR cannot hear what the program is missing.
See how AllVoices helps People teams hear from employees a new program leaves out, wherever they work.
