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S06466 Summary:

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S06466 Committee Votes:

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S06466 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         6466--B
            Cal. No. 283
 
                    IN SENATE
 
                                    January 13, 2016
                                       ___________
 
        Introduced  by  Sens. KLEIN, CARLUCCI, SAVINO, VALESKY -- read twice and
          ordered printed, and when printed to be committed to the Committee  on
          Health -- reported favorably from said committee, ordered to first and
          second  report,  ordered  to  a  third  reading,  amended  and ordered
          reprinted, retaining its place in the order of 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 expanding the kinds of
          qualified wellness programs that can be offered to enrollees
 
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
 
     1    Section  1.   Subsections (b) and (c) of section 3239 of the insurance
     2  law, as added by chapter 592 of the laws of 2008, paragraphs 6 and 7  of
     3  subsection  (b)  and  subparagraphs  (C)  and  (D)  of  paragraph  2  of
     4  subsection (c) as amended, and paragraph 8 of subsection (b) and subpar-
     5  agraphs (E) and (F) of paragraph 2 of subsection (c) as added by chapter
     6  519 of the laws of 2013, are amended to read as follows:
     7    (b) A wellness program may include, but is not limited to, the follow-
     8  ing programs or services:
     9    (1) the use of a health risk assessment tool;
    10    (2) a smoking cessation program;
    11    (3) a weight management program;
    12    (4) a stress and/or hypertension management program;
    13    (5) a worker injury prevention program;
    14    (6) a nutrition education program;
    15    (7) health or fitness incentive programs; [and]
    16    (8) a coordinated weight management, nutrition, stress management  and
    17  physical  fitness  program  to  combat  the  high incidence of adult and
    18  childhood obesity, asthma and other chronic respiratory conditions[.];
    19    (9) a substance or alcohol abuse cessation program; and
    20    (10) a program to manage and cope with chronic pain.
    21    (c)(1) A wellness program may use rewards and incentives  for  partic-
    22  ipation  provided  that  where  the  group  health  insurance  policy or
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13293-05-6
        S. 6466--B                          2
 
     1  subscriber contract is required to be community-rated, the  rewards  and
     2  incentives  shall  not  include a discounted premium rate or a rebate or
     3  refund of premium.
     4    (2) Permissible rewards and incentives may include:
     5    (A)  full  or  partial  reimbursement  of the cost of participating in
     6  smoking cessation [or], weight management, stress  and/or  hypertension,
     7  worker  injury  prevention,  nutrition  education,  substance or alcohol
     8  abuse cessation, or chronic pain management and coping programs;
     9    (B) full or partial reimbursement of  the  cost  of  membership  in  a
    10  health club or fitness center;
    11    (C) the waiver or reduction of copayments, coinsurance and deductibles
    12  for  preventive  services  covered  under the group policy or subscriber
    13  contract;
    14    (D) monetary rewards in the form of gift cards or  gift  certificates,
    15  so  long  as the recipient of the reward is encouraged to use the reward
    16  for a product or a service that promotes good health,  such  as  healthy
    17  cook books, over the counter vitamins or exercise equipment;
    18    (E)  full  or  partial reimbursement of the cost of participating in a
    19  stress management program or activity; and
    20    (F) full or partial reimbursement of the cost of  participating  in  a
    21  health or fitness program.
    22    (3)  Where  the  reward  involves a group member's meeting a specified
    23  standard based on a health condition, the wellness program must meet the
    24  requirements of 45 CFR Part 146.
    25    (4) A reward or incentive which involves a discounted premium rate  or
    26  a  rebate or refund of premium shall be based on actuarial demonstration
    27  that the wellness program can reasonably be expected to  result  in  the
    28  overall good health and well being of the group.
    29    § 2. This act shall take effect on the one hundred eightieth day after
    30  it  shall  have  become  a law; provided that, effective immediately any
    31  rules and regulations necessary to implement the provisions of this  act
    32  on  its  effective date are authorized and directed to be added, amended
    33  and/or repealed on or before such date.