HRA Design Principles
- Keep it short: 15–20 questions maximum; longer HRAs have lower completion rates
- Cover key risk factors: tobacco use, physical activity, nutrition, stress, sleep, chronic conditions
- Separate genetic information: Family medical history questions must be voluntary with no incentive (GINA)
- Provide immediate feedback: Show employees their risk score and personalized recommendations
- Protect privacy: Aggregate data only; no individual results to employer
HRA Compliance
HRAs must comply with ADA and GINA requirements. Participation must be voluntary — incentives cannot be so large that they effectively coerce participation. Family medical history questions (genetic information under GINA) must be separated from the incentivized portion of the HRA. Work with ERISA counsel to confirm your HRA design is compliant.
Using HRA Data
IQ Insight
HRA data is most valuable when combined with claims data. Claims data tells you what is happening (high diabetes costs); HRA data tells you why (high rates of uncontrolled diabetes, poor medication adherence, sedentary lifestyle). Together, they provide a complete picture of your workforce's health profile and the specific interventions that will deliver the most value.