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Knowledge Hub > HRA

Health Risk Assessment

Definition, Taxes & Typical Amounts

Reviewed by Zikea McCurdie

MSHS, NBC-HWC, CYT, Director of Wellness

What Is a Health Risk Assessment (HRA)?

A Health Risk Assessment (HRA), sometimes called a health risk appraisal, is a confidential questionnaire employees complete to identify potential health risks. It typically covers lifestyle habits, medical history, and self-reported symptoms. Employers use HRAs to understand the health needs of their workforce and personalize wellness programming accordingly.

What Does an HRA Typically Include?

Most HRAs combine a few core elements:

  • A self-reported questionnaire covering lifestyle factors (diet, exercise, sleep, stress, tobacco/alcohol use), personal and family medical history, and current symptoms
  • A risk score or summary report, generated from the questionnaire responses, that flags areas of elevated risk (for example, cardiovascular, metabolic, or mental health)
  • Optional integration with biometric data. Many programs pair the HRA with a biometric screening to combine self-reported and clinically measured data into a fuller risk picture.

An HRA on its own doesn’t involve any physical measurement or lab work. It’s entirely based on what the employee reports.

Why Do Employers Offer HRAs?

HRAs give employers, and employees themselves, a starting point for a wellness program. They surface which risk categories are most prevalent across a population and help route individuals toward relevant resources. When paired with biometric data, they also give a more complete baseline for measuring program impact over time. Aggregated, de-identified HRA data is commonly used to shape which wellness programming an organization prioritizes.

HRAs are also one of the most widely adopted wellness program components. According to KFF’s 2025 Employer Health Benefits Survey, 53% of large firms offering health benefits give employees the opportunity to complete a health risk assessment, and more than half of those firms use incentives to encourage completion.

Is Completing an HRA Mandatory?

No. For an HRA to comply with ADA and GINA, participation must be genuinely voluntary. Employers can offer incentives to encourage participation (see the compliance section below for current limits on that), but they cannot require completion as a condition of employment or health plan enrollment in most cases.

What Happens After I Complete an HRA?

Individual results are confidential and typically go only to the wellness program’s administrator, often a third-party vendor, not the employer directly. Most programs return a personal summary report to the employee, highlighting risk areas and suggested next steps. The employer only receives aggregated, de-identified data across the whole workforce, never individual results.

Is an HRA the Same as a Biometric Screening?

The two are often confused because they’re frequently offered together, but they measure different things:

Health Risk Assessment (HRA) Biometric Screening
What it captures Self-reported answers Objectively measured clinical data
Format Questionnaire Physical measurement (blood draw, blood pressure cuff, etc.)
Requires equipment/staff No Yes
Many wellness programs use both: the HRA for context and self-reported risk factors, biometric screening for objective clinical confirmation. See our full definition of biometric screening for how that process works.

Is This the Same as a Medicare Health Risk Assessment?

No, and this is a common point of confusion. Medicare Advantage plans also use something called a “health risk assessment,” but it’s a different thing. It’s typically conducted by the health plan, often during an Annual Wellness Visit, and it feeds into CMS risk-adjustment and billing, not an employer wellness program. If you’re an HR or benefits leader researching HRAs for a workplace wellness program, the CMS/Medicare version isn’t the one that applies to you. This page covers the employer-sponsored version.

How Accurate Are Health Risk Assessments?

Accuracy depends heavily on two things: how honestly the employee answers, since it’s self-reported and not verified, and how rigorous the underlying questionnaire and scoring methodology are. This is a real point of variation between vendors. A shallow, generic questionnaire produces a shallow, generic risk score. Pairing an HRA with objective biometric data (see above) is the standard way programs improve on self-report alone, since it cross-checks stated lifestyle factors against measured clinical indicators.

What Are the Compliance Rules for HRAs?

Because an HRA collects health information, it falls under both ADA and, where family history is involved, GINA. Both require that participation be genuinely voluntary, and both impose confidentiality obligations on how the data is stored and who can access it. HRA results should never be visible to anyone making employment decisions.

One area to flag for your legal or compliance team specifically: the incentive limits that apply to HRAs are less settled than many assume. HIPAA’s 30% (or 50% for tobacco-related) incentive cap is well established for health-contingent wellness programs generally. But the incentive rules specific to ADA/GINA-covered programs, which is what applies when a program includes health questionnaires or medical exams, have been in flux since a 2016 EEOC rule’s incentive provisions were struck down in court. A proposed 2021 replacement was never finalized. Current guidance points toward only a “de minimis” incentive being reliably safe for these programs. This is worth a compliance review before setting incentive levels, not something to assume from older guidance. See our Wellness Program Compliance page for more, our broader compliance and certification standards, or hear our team walk through this in practice on the Wellness Program Compliance podcast episode.

How Does Wellness360 Approach HRAs?

Wellness360’s health assessment tools combine HRA data with biometric inputs and ongoing engagement data to build a continuously updated picture of workforce health, not just a once-a-year snapshot. Our HRA is NCQA-accredited and surfaces personalized recommendations based on actual biometric data rather than just a generic score. See a full walkthrough in our Health Risk Assessment feature overview.

If you’re comparing vendors more broadly, see how Wellness360 stacks up in The Top 11 Corporate Wellness Platforms in 2026, against Personify Health specifically, or explore the full Wellness360 platform from the homepage.

Written by Aryaman Rakhit

Wellness360 Content Team

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