Considering COVID-19 vaccine mandates and other strategies for workplace safety

By Orma Smith

This article originally appeared in the Memphis Business Journal.

As employers transition their teams back into the office, many  are struggling to determine the best strategy to protect their employees from contracting COVID-19 in the workplace. The Biden executive order mandated COVID-19 vaccine requirements for businesses with more than 100 employees. Though the parameters of the emergency rule are still being sorted out for these large companies, what options do small businesses have? If you’re a small business owner with fewer than 100 employees, there are several considerations, but some come with greater risk.

Vaccine Mandates

Some small businesses are also following the executive order’s footsteps and requiring all employees to be fully vaccinated by a determined date, or employees will face termination. If you don’t want to present an ultimatum, you can request those employees present a negative COVID-19 test each week, though questions about who is financially responsible for the test need to be answered before making an announcement. 

Exemptions for medical or religious reasons must also be accepted, and the process to request exemption can get complicated. Ensure you designate a team member, such as a human resources officer, to review exemption requests for legitimacy. For medical exemptions, you can request employees present a doctor’s note that states they do not recommend the vaccine for that individual due to a condition. For religious exemptions, consider requesting a letter from the worker’s religious official stating their beliefs against vaccines. You can even request employees to cite specific excerpts from their religion’s scripture to reinforce their stance.

Insurance Premium Surcharges

In lieu of a mandate, some companies have announced that unvaccinated workers would face a surcharge to their group health insurance. Enforcing a higher premium cost for these employees may come with legal hurdles. According to employee benefits law firm Fisher Phillips, a company treating an employee differently based on a health factor can violate compliance with the Health Insurance Portability and Accountability Act of 1996. However, instead of “punishing” an employee for refusing the vaccine, you can reward someone who receives it by contributing more money to their health care premium, thus reducing the employee’s contributions to their employee health plan. This strategy encourages an employee’s participation in a wellness program, which is very common among businesses. This incentive is similar to smoking cessation programs, in which employers contribute less to smokers’ health care premiums. However, keep in mind that wellness incentive limits cannot exceed 30% of the total cost of the employee’s coverage, per the Affordable Care Act. 

If your company is one of the millions approaching open enrollment next month, now is the time to consider if an extra health care premium contribution is the route you want to take in an effort to encourage vaccinations among your workers. 


Monetary or gift incentives are common among employers. A one-time bonus, paid time off or a gift card to Amazon or a local favorite eatery are just a few examples of the incentives many employers currently offer to encourage their team members to get vaccinated. This method has also become common on many university campuses across the country for students. Incentives can create a more mutual benefit for the employer and employee. By making it voluntary instead of mandated, employees will be more inclined to receive the vaccine. Opting in to receive an incentive can lighten some employees’ feelings that their privacy is being violated. If they don’t feel comfortable sharing their vaccination status, there’s nothing for them to lose. It also minimizes any potential resentment employees may feel toward their employers, if they feel forced to provide their vaccination status or ultimately face termination.

Even though positive cases of COVID-19 are on a steady decline, many employers are faced with navigating the best return-to-work strategies. Before opening back up, leaders must be clear about the expectations they have for their staff regarding vaccination. Be prepared to answer employees’ questions and be ready to explain the reason behind your decision. If your company is participating in open enrollment this fall, determining your path now may also influence the type of group health plan to enroll in for 2022, as vaccinations can impact health costs for hospitalizations and other treatments for employees who contract COVID-19.