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ACA Wellness Caps

Meaning

The regulatory maximums imposed on incentives offered within wellness programs, often tied to health factors like biometric screening or activity metrics, under the framework of the Affordable Care Act. These caps establish the financial boundary for rewards or penalties related to an individual’s participation or achievement of specific health-related outcomes. Clinically, this translates to the maximum allowable financial encouragement for engaging in behaviors that positively influence hormonal and metabolic health parameters. The purpose is to promote preventative care while maintaining equitable access to wellness benefits for all participants.