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S05890 Summary:

S05890 Actions:

S05890 Committee Votes:

S05890 Floor Votes:

S05890 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5890--A
            Cal. No. 631
 
                               2023-2024 Regular Sessions
 
                    IN SENATE
 
                                     March 21, 2023
                                       ___________
 
        Introduced  by  Sens.  BRESLIN,  FERNANDEZ,  GOUNARDES -- read twice and
          ordered printed, and when printed to be committed to the Committee  on
          Insurance  -- reported favorably from said committee, ordered to first
          and second report, ordered to a third reading, passed  by  Senate  and
          delivered  to  the  Assembly, recalled, vote reconsidered, restored to
          third reading, amended and ordered reprinted, retaining its  place  in
          the order of third reading
 
        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.
                                                                   LBD07895-04-3
        S. 5890--A                          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-
        S. 5890--A                          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.