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 or biometric data; provides for discounts on life insurance and on products or services intended to incent positive behavioral changes.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A2853B
SPONSOR: Meeks TITLE OF BILL:
An act to amend the insurance law, in relation to authorizing life
insurers to establish wellness programs
PURPOSE:
To expressly permit life insurers to establish wellness programs with
incentives designed to incent lifestyles that improve health or reduce
the risk of death of the policyholder.
SUMMARY OF PROVISIONS:
This bill amends § 3239 of the Insurance Law to include preventive care,
screenings or chronic disease management programs in the categories of
allowable wellness programs. The proposal will also make corresponding
changes to the categories of permissible rewards and incentives associ-
ated with the wellness programs, including premium refunds, discounts,
credit, discounts on products/services intended to indent behavioral
changes that improve health or reduce the risk of death, and full or
partial reimbursement of the cost of a wearable device and any associ-
ated subscription membership that can be used to track physical activity
and biometric data. The programs must be voluntary on the part of the
insured and offered to all insureds within the same class in a not
unfairly discriminatory manner. The insurer is also prohibited from
increasing premiums or charges stated in the policy as a result of
participation or non-participation in the program.
JUSTIFICATION:
Substantial improvements in individual and population health can be
realized through adoption of healthy living choices, including diet,
regular exercise and consistently getting enough sleep. Research shows
that improved well-being over time through healthy behaviors results in
people living longer. Life insurers have a vested interest in their
policyholders living long lives and therefore insurers' interests and
policyholders' interests are in alignment. As a result, wellness
programs have become increasingly popular in other states throughout the
country.
The National Association of Insurance Commissioners (NAIC) and a number
of states have worked for some time to update outdated anti-rebating and
inducement laws that have stifled innovation with no appreciable consum-
er benefit. One critical facet of this involves efforts to permit life
insurers to offer wellness programs with incentives designed to incent
behavioral changes that improve health or reduce the risk of death of
the insured. Current law permits health writers and HMO's to offer well-
ness programs without having them considered to be illegal rebates or
inducements.
This bill extends this authority to life writers and expands it by
adding promotion of longevity as a permissible program component and
including "preventative care, screenings or chronic disease management
programs" in the list of allowable programs or services. The bill also
amends the current law by updating the permissible incentives to include
full or partial reimbursement of preventative care, screenings, or
chronic disease management programs; premium refunds, discount or policy
value credit; discounts, vouchers gift cards or certificates intended to
incent behavioral changes that improve health or reduce the risk of
death of the insured; full or partial reimbursement for participation in
meditation, sleep improvement or similar programs or services; full or
partial reimbursement of the cost of a wearable device, along with any
associate subscription, to incent behavioral changes to improve health
or reduce the risk of death; and full or partial reimbursement of biome-
tric screenings. The programs must be voluntary on the part of the
insured and insurers are prohibited from charging higher premiums as the
result of the establishment of, or participation in, a wellness program.
Through the enactment of this legislation, the State will be able to
take a progressive leadership role promoting insurance innovation and
enable its residents to access education, support, incentives and
rewards to live longer, healthier lives.
LEGISLATIVE HISTORY:
2022: Passed Both Houses - Vetoed by Governor
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect immediately.
STATE OF NEW YORK
________________________________________________________________________
2853--B
2023-2024 Regular Sessions
IN ASSEMBLY
January 27, 2023
___________
Introduced by M. of A. MEEKS, CLARK, LUPARDO, STECK, WEPRIN, McDONALD,
BUTTENSCHON -- read once and referred to the Committee on Insurance --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee -- again reported from said committee
with amendments, ordered reprinted as amended and recommitted to said
committee
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 or prevent disease that may
14 contain rewards and incentives for participation. Participation in the
15 wellness program shall be available to similarly-situated members of the
16 group or with regard to life insurance, to all insureds within the same
17 class in a manner that is not unfairly discriminatory and shall be
18 voluntary on the part of the member or insured. With regard to life
19 insurance, an insurer is prohibited from increasing premiums or charges
20 stated in the policy as a result of participation or non-participation
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD07895-05-3
A. 2853--B 2
1 in the program. The terms of the wellness program shall be set forth in
2 the policy or contract.
3 (b) A wellness program may include, but is not limited to, the follow-
4 ing programs or services:
5 (1) the use of a health risk assessment tool;
6 (2) a smoking cessation program;
7 (3) a weight management program;
8 (4) a stress and/or hypertension management program;
9 (5) a worker injury prevention program;
10 (6) a nutrition education program;
11 (7) health or fitness incentive programs;
12 (8) a coordinated weight management, nutrition, stress management and
13 physical fitness program to combat the high incidence of adult and
14 childhood obesity, asthma and other chronic respiratory conditions;
15 (9) a substance or alcohol abuse cessation program; [and]
16 (10) a program to manage and cope with chronic pain;
17 (11) a preventative care, screenings, or chronic disease management
18 program; and
19 (12) a meditation, sleep improvement or similar program or service.
20 (c)(1) A wellness program may use rewards and incentives for partic-
21 ipation provided that where the group health insurance policy or
22 subscriber contract is required to be community-rated, the rewards and
23 incentives shall not include a discounted premium rate or a rebate or
24 refund of premium.
25 (2) Permissible rewards and incentives may include:
26 (A) full or partial reimbursement of the cost of participating in
27 smoking cessation, weight management, stress and/or hypertension, worker
28 injury prevention, nutrition education, substance or alcohol abuse
29 cessation, preventative care programs, or screenings, chronic disease
30 management programs, or chronic pain management and coping programs;
31 (B) full or partial reimbursement of the cost of membership in a
32 health club or fitness center;
33 (C) (1) the waiver or reduction of copayments, coinsurance and deduct-
34 ibles for preventive services covered under the group health insurance
35 policy or subscriber contract;
36 (2) a premium refund, discount, or policy value credit, or other
37 increase in benefits or decrease in charges under a life insurance poli-
38 cy;
39 (D) monetary rewards in the form of gift cards [or], gift certif-
40 icates, [so long as the recipient of the reward is encouraged to use the
41 reward for a product or a service that promotes good health, such as
42 healthy cook books, over the counter vitamins or exercise equipment]
43 vouchers or discounts on products or services that are intended to
44 incent behavioral changes that improve the health or reduce the risk of
45 death of the insured;
46 (E) full or partial reimbursement of the cost of participating in a
47 stress management program or activity, including participation in a
48 meditation, sleep improvement or similar program or service, provided
49 that such program or activity shall be based on data and research that
50 the program or service can be reasonably expected to result in overall
51 good health, well being, or improved mortality risk; [and]
52 (F) full or partial reimbursement of the cost of participating in a
53 health or fitness program;
54 (G) full or partial reimbursement of the cost of a wearable device and
55 any associated subscription membership that can be used to track phys-
A. 2853--B 3
1 ical activity or biometric data, and which incents behavioral changes to
2 improve the health or reduce the risk of death of the insured; and
3 (H) full or partial reimbursement of biometric screenings.
4 (3) Where the reward involves a group member's meeting a specified
5 standard based on a health condition, the wellness program under a
6 health insurance policy must meet the requirements of 45 CFR Part 146.
7 (4) A reward or incentive which involves a discounted premium rate or
8 a rebate or refund of premium under a health insurance policy shall be
9 based on actuarial demonstration that the wellness program can reason-
10 ably be expected to result in the overall good health and well being of
11 the group. A reward or incentive that involves a discounted premium rate
12 or rebate or refund of premium under a life insurance policy shall be
13 actuarially supported by data and research that such incentives or
14 rewards, in the aggregate, are directed to sharing the benefit of
15 improving expected mortality risk experience. Data collected in
16 connection with a wellness program shall be subject to all state and
17 federal privacy and security laws.
18 § 2. This act shall take effect immediately.
