It is the latest employer weapon in the battle to control healthcare costs and head off employee medical problems: free or subsidized genetic testing offered as a perk. Tests to detect genetic markers associated with metabolism, weight gain and overeating are typical of those being offered. Some companies go further, offering tests that detect genetic mutations associated with breast and ovarian cancer. Ann Toth, a Vice President at Slack, which offers such testing, a perks “arms race” among tech companies is being waged. “We want to offer things that could make a big difference in their lives,” she said.

So far little hard data on the frequency of such offerings exists. But some insurers are known to be covering the cost of genetic testing for people who have had cancer or a family history of cancer.  Genetic testing may also be covered for other medical conditions if there is a family history or other risk factors, and if there's both a reliable test and some potential benefit, such as a medical treatment that's recommended by a standard-setting organization like the U.S. Preventive Services Task Force. In fact, under the Affordable Care Act, women who have a high risk of developing breast cancer can receive genetic counseling and testing for free as a preventive service.

But the genetic tests being offered as perks are typically ones not always covered by the employer’s health insurance coverage, or employees do not otherwise meet the eligibility criteria. Employers provide the testing primarily to deliver lifesaving information that prevents problems down the road. But secondly, it is to save money on health-related costs.  According to a recent survey conducted by Towers Watson and the National Business Group on Health, obesity-related conditions and Type 2 diabetes drive a significant portion of healthcare costs, averaging $12,000 per worker this year.

Jackson Laboratory, a genetics research center located in Maine, recently paired with an organization called Newtopia, Inc.to pilot a genetics-based wellness program.  Newtopia develops programs to help reduce a company’s healthcare cost through genetics, personalized coaching, and smart technology. The company offered testing to 110 of Jackson’s employees deemed to be at risk for metabolic syndrome, an umbrella term covering conditions that lead to heart disease, diabetes and stroke. The testing was looking to identify the DRD2 “eating behavior” gene, the MC4R “appetite” gene, and FTO, a “body fat” gene. Twenty-nine of the 110 employees signed up to take part. 

Besides test results, participants received personalized lifestyle plans designed to help them manage those factors and maintain healthy lifestyles. An online mobile app tracked their progress and provided health coaching and a social networking platform. The cost of testing was approximately $500 per employee annually, but according to Newtopia it provided a return of 1.4 times the initial investment in the first year. 

Aetna has also started using Newtopia’s wellness program, both internally for their own employees and for six additional companies that it solicited. Three quarters of the Aetna employee/participants who were at high risk for metabolic syndrome used the information to lose an average of 10 pounds each. Aetna saw an average savings in healthcare costs of $600,000 or $1,464 a person.

For all of its positive potential, the built-in downside to genetic testing is that some employees will resist it for fear of privacy loss and of being victimized by adverse employment actions later on.

Those employees and their employers need to know that the Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits discrimination in group health plan coverage based on genetic information. GINA also expands on the provisions in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) which protect against discrimination based on genetic information in the following ways:

• Group health plans and health insurers cannot base health care premiums for plans or a group of similarly situated individuals on genetic information.
• Plans and insurers are prohibited from requesting or requiring an individual to undergo a genetic test.
• Plans and insurers are prohibited from collecting genetic information (including family medical history) prior to or in connection with enrollment, or for underwriting purposes.

The EEOC has recently taken the issue up for review. This past October it put out proposed regs for legally requesting genetic information or health status information from employees and their spouses. Importantly, they will require that testing be voluntary and results cannot be linked to employment-related information. Further, employers will only be able to offer limited financial and other incentives to obtain the information.

Genetic testing as a perk tied to employee wellness programs is still in its infancy. But the way is being cleared for it to play a larger role in such programs, making them more personalized and less one-size-fits-all.

Sources:  WSJ 12/16/2015; NPR 12/10/2013; Workforce 11/23/2015