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A08617 Summary:

BILL NOA08617
 
SAME ASSAME AS S04329
 
SPONSORMeeks
 
COSPNSR
 
MLTSPNSR
 
Amd 3239, Ins L
 
Authorizes life insurers to establish wellness programs in conjunction with the issuance of life insurance policies; provides for full or partial reimbursement for the cost of a device and associated subscription that can be used to track activity and/or biometric data; provides for discounts on life insurance and on products or services intended to incent positive behavioral changes.
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A08617 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          8617
 
                   IN ASSEMBLY
 
                                    January 10, 2022
                                       ___________
 
        Introduced  by M. of A. MEEKS -- read once and referred to the Committee
          on Insurance
 
        AN ACT to amend the insurance  law,  in  relation  to  authorizing  life
          insurers to establish wellness programs
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. Section 3239 of the insurance law, as added by chapter  592
     2  of  the  laws  of 2008 and subsections (b) and (c) as amended by chapter
     3  180 of the laws of 2016, is amended to read as follows:
     4    § 3239. Wellness programs. (a)  An  insurer  licensed  to  write  life
     5  insurance may establish a wellness program in conjunction with its issu-
     6  ance  of  life insurance policies and an insurer licensed to write acci-
     7  dent and health insurance, a corporation organized pursuant  to  article
     8  forty-three of this chapter, a health maintenance organization certified
     9  pursuant  to article forty-four of the public health law and a municipal
    10  cooperative health benefits plan may establish  a  wellness  program  in
    11  conjunction  with  its issuance of a group accident and health insurance
    12  policy or group subscriber contract. A "wellness program" is  a  program
    13  designed  to promote health [and], longevity and/or prevent disease that
    14  may contain rewards and incentives for participation.  Participation  in
    15  the wellness program shall be available to similarly-situated members of
    16  the  group  or to all insureds within the same class and shall be volun-
    17  tary on the part of the member or insured.   The terms of  the  wellness
    18  program shall be set forth in the policy or contract.
    19    (b) A wellness program may include, but is not limited to, the follow-
    20  ing programs or services:
    21    (1) the use of a health risk assessment tool;
    22    (2) a smoking cessation program;
    23    (3) a weight management program;
    24    (4) a stress and/or hypertension management program;
    25    (5) a worker injury prevention program;
    26    (6) a nutrition education program;
    27    (7) health or fitness incentive programs;

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD08784-01-1

        A. 8617                             2
 
     1    (8)  a coordinated weight management, nutrition, stress management and
     2  physical fitness program to combat  the  high  incidence  of  adult  and
     3  childhood obesity, asthma and other chronic respiratory conditions;
     4    (9) a substance or alcohol abuse cessation program; [and]
     5    (10) a program to manage and cope with chronic pain; and
     6    (11) a preventative care or chronic disease management program.
     7    (c)(1)  A  wellness program may use rewards and incentives for partic-
     8  ipation provided  that  where  the  group  health  insurance  policy  or
     9  subscriber  contract  is required to be community-rated, the rewards and
    10  incentives shall not include a discounted premium rate or  a  rebate  or
    11  refund of premium.
    12    (2) Permissible rewards and incentives may include:
    13    (A)  full  or  partial  reimbursement  of the cost of participating in
    14  smoking cessation, weight management, stress and/or hypertension, worker
    15  injury prevention,  nutrition  education,  substance  or  alcohol  abuse
    16  cessation,   preventive   care   programs,  chronic  disease  management
    17  programs, or chronic pain management and coping programs;
    18    (B) full or partial reimbursement of  the  cost  of  membership  in  a
    19  health club or fitness center;
    20    (C) the waiver or reduction of copayments, coinsurance and deductibles
    21  for  preventive services covered under the group health insurance policy
    22  or subscriber contract;
    23    (C-1) a premium refund, discount or policy value credit under  a  life
    24  insurance policy;
    25    (D)  monetary  rewards in the form of gift cards or gift certificates,
    26  [so long as the recipient of the reward is encouraged to use the  reward
    27  for  a  product  or a service that promotes good health, such as healthy
    28  cook books, over the counter vitamins or exercise equipment] vouchers or
    29  discounts on products or services that are intended to incent behavioral
    30  changes that improve the health or reduce  the  risk  of  death  of  the
    31  insured;
    32    (E)  full  or  partial reimbursement of the cost of participating in a
    33  stress management program or  activity,  including  participation  in  a
    34  meditation,   mindfulness,  sleep  improvement  or  similar  program  or
    35  service; [and]
    36    (F) full or partial reimbursement of the cost of  participating  in  a
    37  health or fitness program;
    38    (G)  full  or  partial  reimbursement  of the cost of a device and any
    39  associated subscription membership that can be used  to  track  physical
    40  activity  and/or  biometric  data, such as heart rate, body composition,
    41  tone of voice, sleep or similar information to incent behavioral changes
    42  that improve the health or reduce the risk of death of the insured; and
    43    (H) full or partial reimbursement of biometric screenings.
    44    (3) Where the reward involves a group  member's  meeting  a  specified
    45  standard  based  on  a  health  condition,  the wellness program under a
    46  health insurance policy must meet the requirements of 45 CFR Part 146.
    47    (4) A reward or incentive which involves a discounted premium rate  or
    48  a  rebate  or refund of premium under a health insurance policy shall be
    49  based on actuarial demonstration that the wellness program  can  reason-
    50  ably  be expected to result in the overall good health and well being of
    51  the group. A reward or incentive which  involves  a  discounted  premium
    52  rate  or rebate or refund of premium under a life insurance policy shall
    53  be supported by data and research that such incentives,  in  the  aggre-
    54  gate,  are  directed  to sharing the benefit of improving mortality risk
    55  experience.
    56    § 2. This act shall take effect immediately.
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