Dive Brief:

• Starting Nov. 1, 2021, unvaccinated employees of Delta Air Lines who are enrolled in its healthcare plan will be subject to a $200 monthly surcharge, CEO Ed Bastian said in a memo to employees shared publicly Aug. 25.
• "This surcharge will be necessary to address the financial risk the decision to not vaccinate is creating for our company," Bastian said. "In recent weeks since the rise of the B.1.617.2 variant, all Delta employees who have been hospitalized with COVID were not fully vaccinated."
• Unvaccinated workers also will be required to wear masks in all of the company's indoor settings, and beginning Sept. 12, unvaccinated workers will be required to take a COVID-19 test each week while community case rates remain high, Bastian said. The memo noted that 75% of Delta Air Lines' workforce was vaccinated.

Dive Insight:

Health plan surcharges have traditionally been associated with activities such as tobacco use, but the strategy is now gaining attention from employers during a time of increased community COVID-19 transmission rates in the U.S.

The Food and Drug Administration's approval of the Pfizer-BioNTech COVID-19 vaccine may bolster employer efforts to increase vaccination rates, including mandates. Bastian cited the FDA's decision in his memo, telling those who had taken a wait-and-see approach toward getting the vaccine that "the time for you to get vaccinated is now."

"We can be confident that the Pfizer vaccine is safe and effective, and has undergone the same rigorous review for other approved medications to treat cancer and heart disease, as well as other vaccines," Bastian continued. "If you aren't fully vaccinated, I strongly urge you to discuss the issue with your personal physician or health provider."

While the aim of such a strategy may be to increase vaccination rates, sources recently told HR Dive that there are a number of questions employers may need to consider ahead of implementing a surcharge. For example, surcharges may need to comply with regulations on wellness programs set forth by the Affordable Care Act and HIPAA. Health plan surcharges also do not impact employees who waive coverage, sources noted.

Clarity is important when setting COVID-19 guidelines, attorneys told HR Dive, whether an employer opts for a vaccination requirement or not. Employers also may need to set forth the process of obtaining an exemption from a vaccination requirement, provided an employee qualifies.