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.
STATE OF NEW YORK
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4329
2021-2022 Regular Sessions
IN SENATE
February 3, 2021
___________
Introduced by Sen. BRESLIN -- read twice and ordered printed, and when
printed to be committed 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
S. 4329 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.
