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Illustration: Annelise Capossela/Axios

Instead of mandating COVID-19 vaccination, more companies are offering employees cash, paid time off, and other financial incentives to get the shot.

The big picture: Employers are favoring "carrots" over "sticks" in the push to get more people vaccinated. But those carrots could run afoul of federal law — if the rewards are too big.

The buzz: Dollar General, Houston Methodist, Kroger, Petco, Target, Walmart, the Maryland state government, and numerous other companies have offered various-sized cash stipends to workers who get vaccinated. The bonuses usually don't exceed $500.

Yes, but: There is no clear standard for how large those rewards can be without violating federal disability, anti-discrimination, and privacy laws, as the U.S. Equal Employment Opportunity Commission continues to lag on issuing guidance.

  • The EEOC previously said rewards involved with employer wellness programs could equal up to 30% of someone's health insurance premium without being too coercive or invasive. But a federal court invalidated that rule.
  • The EEOC under the Trump administration then said companies could offer "de minimis" incentives, but the agency withdrew that guidance once the Biden administration took over.
  • Earlier this year, employers begged the EEOC to "define what qualifies as a permissible incentive."
  • The EEOC told Axios the update on "COVID-19 employer vaccine incentives and other issues is ongoing.”

One interesting example: Anthem is offering a credit to vaccinated employees that can be used to lower their health insurance premiums (Anthem provides Anthem insurance to its employees).

  • Anthem originally said the credit was worth $50, but later retracted that press release and removed how much the credit was worth.
  • "We aren't sharing the dollar amount ... and we've designed the program so it does not 'run afoul' of EEOC rules on wellness programs and vaccinations," an Anthem spokesperson said.

The bottom line: "Until the EEOC issues updated guidance, it's a bit risky to offer vaccination incentives," said Meghan O'Brien, an attorney at the law firm Archer who tracks this issue and recommends any vaccine incentive equal no more than one day's pay. "Reasonable minds can vary as to what can be considered too much of a monetary incentive."

Looking ahead: Vaccine requirements from employers are rare, but more employers may consider them if voluntary bonuses don't help reach national vaccination goals.

  • "I think we will see a very important role for employer mandates to move the needle," said Emily Largent, a medical ethicist at the University of Pennsylvania who has written about paying people to get vaccinated.

Go deeper

Florida withholds funds from 2 school districts over mask mandates

Gov. Ron DeSantis. Photo: Paul Hennessy/SOPA Images/LightRocket via Getty Images

Florida's Department of Education announced Monday it has withheld funds from two districts that defied Gov. Ron DeSantis' order banning mask mandates in schools.

Driving the news: Amid a surge of COVID-19 cases largely driven by the Delta variant, several Florida school districts have implemented mask mandates, despite threats from the Republican governor and state officials to withhold funds for doing so.

Sep 1, 2021 - Health

Idaho governor calls on National Guard to help hospitals as COVID-19 cases surge

Idaho Gov. Brad Little. Photo: Darin Oswald/Idaho Statesman/Tribune News Service via Getty Images

Idaho Gov. Brad Little on Tuesday announced he is reactivating the National Guard and directing up to 370 additional people to help hospitals as they reach capacity.

Why it matters: There were only four intensive care unit beds available Tuesday in the entire state, out of nearly 400, the Republican governor wrote in a news release. There are more COVID-19 patients in ICU beds in the state "than ever before. The vast majority of them are unvaccinated," the release states.

Updated 15 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Vaccines: Los Angeles County to require vaccination proof at indoor bars — France suspends 3,000 unvaccinated health workers without pay — Moderna suggests booster shots, citing clinical data.
  2. Health: 1 in 500 Americans has died — Cases are falling, but deaths are rising — Study: Gaps in data on Native Hawaiians, Pacific Islanders alarming amid COVID.
  3. Politics: Gottlieb says CDC hampered U.S. response — 26 states have limited state or local officials' public health powers — Axios-Ipsos poll: 60% of voters back Biden vaccine mandates.
  4. Education: Denver looks to students to close Latino vaccination gap — Federal judge temporarily blocks Iowa's ban on mask mandates in schools — Massachusetts activates National Guard to help with school transportation.
  5. Variant tracker: Where different strains are spreading.