S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  4238

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            January 29, 2015
                               ___________

Introduced  by  M.  of A. GJONAJ, LAVINE, JAFFEE, BROOK-KRASNY, ROBERTS,
  STIRPE, BENEDETTO,  COLTON,  CRESPO,  KEARNS,  OTIS,  ROBINSON,  RAIA,
  SKOUFIS,  STECK,  LUPARDO,  McDONALD, GOTTFRIED, HOOPER -- Multi-Spon-
  sored by -- M. of A.  BRAUNSTEIN,  BRENNAN,  CAMARA,  GALEF,  HEASTIE,
  LOPEZ,  LUPINACCI, McLAUGHLIN, PEOPLES-STOKES, PERRY, RIVERA, SEPULVE-
  DA, SIMANOWITZ, SKARTADOS, TITONE, WRIGHT -- read once and referred to
  the Committee on Insurance

AN ACT to amend the insurance law and the public health law, in relation
  to making  actuarially  appropriate  reductions  in  health  insurance
  premiums  in  return for an enrollee's or insured's participation in a
  qualified wellness program

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Section 3231 of the insurance law, as added by chapter 501
of the laws of 1992, is amended by adding a new subsection (c-1) to read
as follows:
  (C-1) SUBJECT TO THE APPROVAL OF THE  SUPERINTENDENT,  AN  INSURER  OR
HEALTH  MAINTENANCE  ORGANIZATION  ISSUING AN INDIVIDUAL OR GROUP HEALTH
INSURANCE POLICY PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY
APPROPRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS
APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S  OR  INSURED'S
ACTIVE  PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELL-
NESS PROGRAM CAN BE A RISK MANAGEMENT  SYSTEM  THAT  IDENTIFIES  AT-RISK
POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH  HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE-
ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS  OF  ACUTE  OR  CHRONIC
SICKNESS,  DISEASE  OR  PAIN,  OR  WHICH MINIMIZES ADVERSE HEALTH CONSE-
QUENCES DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY HAVE SOME OR  ALL
OF  THE  FOLLOWING  ELEMENTS  TO  ADVANCE THE PHYSICAL HEALTH AND MENTAL
WELL-BEING OF ITS PARTICIPANTS:

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD03890-01-5

              

A. 4238                             2

  (1) AN EDUCATION PROGRAM TO INCREASE  THE  AWARENESS  OF  AND  DISSEM-
INATION  OF  INFORMATION  ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING  ENVIRONMENTAL  OR  BEHAVIORAL  ACTIVITIES
THAT  ARE  DETRIMENTAL  TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGE HEALTHY LIVING ACTIVITIES OR DISCOURAGE UNHEALTHY LIVING ACTIVITIES.
SUCH  ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS PROVIDED
UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE  OF  THIS  ARTICLE;
AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR  HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN  THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE  GENERAL  GOOD  HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL  NOT  REQUIRE  SPECIFIC
OUTCOMES  AS  A  RESULT  OF  AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
APPROVED WELLNESS PROGRAM.
  S 2. Subsections (a), (b) and (c) of section  3239  of  the  insurance
law,  as added by chapter 592 of the laws of 2008, paragraphs 6 and 7 of
subsection  (b)  and  subparagraphs  (C)  and  (D)  of  paragraph  2  of
subsection (c) as amended, and paragraph 8 of subsection (b) and subpar-
agraphs (E) and (F) of paragraph 2 of subsection (c) as added by chapter
519 of the laws of 2013, are amended to read as follows:
  (a)  An  insurer  licensed  to  write accident and health insurance, a
corporation organized pursuant to article forty-three of this chapter, a
health maintenance organization certified pursuant to article forty-four
of the public health law and a  municipal  cooperative  health  benefits
plan  may  establish a wellness program in conjunction with its issuance
of a group accident and health  insurance  policy  or  group  subscriber
contract.  A  "wellness program" is a program designed to promote health
and prevent disease that may contain rewards and incentives for  partic-
ipation.  Participation  in  the  wellness program shall be available to
similarly-situated members of the group and shall be  voluntary  on  the
part  of the member. The SPECIFIC terms of the wellness program shall be
set forth in the policy or contract, OR IN A SEPARATE DOCUMENT  PROVIDED
TO INSUREDS AND MEMBERS WHICH SHALL BE CONSISTENT WITH THE PROVISIONS OF
THIS SECTION.
  (b) A wellness program may include, but is not limited to, the follow-
ing programs or services:
  (1) the use of a health risk assessment tool;
  (2) a smoking cessation program;
  (3) a weight management program;
  (4) a stress AND/OR HYPERTENSION management program;
  (5) a worker injury prevention program;
  (6) a nutrition education program;
  (7) health or fitness incentive programs; [and]
  (8)  a coordinated weight management, nutrition, stress management and
physical fitness program to combat  the  high  incidence  of  adult  and
childhood obesity, asthma and other chronic respiratory conditions[.];
  (9)  ASSISTANCE,  FINANCIAL  OR OTHERWISE, PROVIDED TO AN EMPLOYER FOR
HEALTH PROMOTION AND DISEASE PREVENTION;

A. 4238                             3

  (10) INCENTIVES FOR INSUREDS OR MEMBERS TO ACCESS PREVENTIVE SERVICES,
SUCH AS MAMMOGRAPHY SCREENING;
  (11) A SUBSTANCE OR ALCOHOL ABUSE CESSATION PROGRAM; AND
  (12) A PROGRAM TO MANAGE AND COPE WITH CHRONIC PAIN.
  (c)(1)  A  wellness program may use rewards and incentives for partic-
ipation provided  that  where  the  group  health  insurance  policy  or
subscriber  contract  is required to be community-rated, the rewards and
incentives shall not include a discounted premium rate or  a  rebate  or
refund  of  premium,  EXCEPT  AS  PROVIDED IN SECTION THREE THOUSAND TWO
HUNDRED THIRTY-ONE OF THIS ARTICLE, OR SECTION FOUR THOUSAND TWO HUNDRED
THIRTY-FIVE, FOUR THOUSAND THREE  HUNDRED  SEVENTEEN  OR  FOUR  THOUSAND
THREE  HUNDRED TWENTY-SIX OF THIS CHAPTER, OR SECTION FORTY-FOUR HUNDRED
FIVE OF THE PUBLIC HEALTH LAW.
  (2) Permissible rewards and incentives MAY include:
  (A) full or partial reimbursement of  the  cost  of  participating  in
smoking  cessation  [or], weight management, STRESS AND/OR HYPERTENSION,
WORKER INJURY PREVENTION,  NUTRITION  EDUCATION,  SUBSTANCE  OR  ALCOHOL
ABUSE CESSATION, OR CHRONIC PAIN MANAGEMENT AND COPING programs;
  (B)  full  or  partial  reimbursement  of  the cost of membership in a
health club or fitness center;
  (C) the waiver or reduction of copayments, coinsurance and deductibles
for preventive services covered under the  group  policy  or  subscriber
contract;
  (D)  monetary  rewards in the form of gift cards or gift certificates,
so long as the recipient of the reward is encouraged to use  the  reward
for  a  product  or a service that promotes good health, such as healthy
cook books, over the counter vitamins or exercise equipment;
  (E) full or partial reimbursement of the cost of  participating  in  a
stress management program or activity; and
  (F)  full  or  partial reimbursement of the cost of participating in a
health or fitness program.
  (3) Where the reward involves a group  member's  meeting  a  specified
standard based on a health condition, the wellness program must meet the
requirements of 45 CFR Part 146.
  (4)  A reward or incentive which involves a discounted premium rate or
a rebate or refund of premium shall be based on actuarial  demonstration
that  the  wellness  program can reasonably be expected to result in the
overall good health and well being of the group AS PROVIDED  IN  SECTION
THREE  THOUSAND  TWO  HUNDRED  THIRTY-ONE OF THIS ARTICLE, SECTIONS FOUR
THOUSAND TWO HUNDRED THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED  SEVENTEEN
AND  FOUR THOUSAND THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, AND SECTION
FORTY-FOUR HUNDRED FIVE OF THE PUBLIC HEALTH LAW.
  S 3. Subsection (h) of section 4235 of the insurance law is amended by
adding a new paragraph 5 to read as follows:
  (5) EACH INSURER DOING BUSINESS IN THIS STATE, WHEN  FILING  WITH  THE
SUPERINTENDENT  ITS SCHEDULES OF PREMIUM RATES, RULES AND CLASSIFICATION
OF RISKS FOR USE IN CONNECTION WITH THE  ISSUANCE  OF  ITS  POLICIES  OF
GROUP ACCIDENT, GROUP HEALTH OR GROUP ACCIDENT AND HEALTH INSURANCE, MAY
PROVIDE  FOR  AN  ACTUARIALLY  APPROPRIATE REDUCTION IN PREMIUM RATES OR
OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOUR-
AGE AN ENROLLEE'S OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELL-
NESS PROGRAM. A QUALIFIED WELLNESS PROGRAM  CAN  BE  A  RISK  MANAGEMENT
SYSTEM  THAT  IDENTIFIES  AT-RISK  POPULATIONS  OR  ANY OTHER SYSTEMATIC
PROGRAM OR COURSE OF MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND
MENTAL FITNESS, HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE  THE
CONDITIONS OF ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINI-

A. 4238                             4

MIZES  ADVERSE  HEALTH  CONSEQUENCES DUE TO LIFESTYLE.   SUCH A WELLNESS
PROGRAM MAY HAVE SOME OR ALL OF THE FOLLOWING ELEMENTS  TO  ADVANCE  THE
PHYSICAL HEALTH AND MENTAL WELL-BEING OF ITS PARTICIPANTS:
  (A)  AN  EDUCATION  PROGRAM  TO  INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER  LIFESTYLES,  AND  WHICH
WARNS  ABOUT  RISKS  OF  PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION,  INFORMATION  ON  THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (B) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGE HEALTHY LIVING ACTIVITIES OR DISCOURAGE UNHEALTHY LIVING ACTIVITIES.
SUCH  ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS PROVIDED
UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS CHAPTER;
  (C) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE  AND
MORAL  SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE  COVERED  POPULATION.  THE
INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S  OR  INSURED'S  ADHERENCE  TO  THE
APPROVED WELLNESS PROGRAM.
  S  4.  Section  4317  of  the insurance law is amended by adding a new
subsection (c-1) to read as follows:
  (C-1) SUBJECT TO THE APPROVAL OF THE  SUPERINTENDENT,  AN  INSURER  OR
HEALTH  MAINTENANCE  ORGANIZATION  ISSUING AN INDIVIDUAL OR GROUP HEALTH
INSURANCE CONTRACT PURSUANT TO THIS SECTION MAY PROVIDE FOR AN  ACTUARI-
ALLY  APPROPRIATE  REDUCTION  IN  PREMIUM  RATES  OR  OTHER  BENEFITS OR
ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOURAGE  AN  ENROLLEE'S
OR  INSURED'S  ACTIVE  PARTICIPATION  IN A QUALIFIED WELLNESS PROGRAM. A
QUALIFIED WELLNESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT  IDENTI-
FIES  AT-RISK  POPULATIONS  OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF
MEDICAL CONDUCT WHICH HELPS TO  PROMOTE  PHYSICAL  AND  MENTAL  FITNESS,
HEALTH  AND  WELL-BEING,  HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF
ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH  MINIMIZES  ADVERSE
HEALTH  CONSEQUENCES DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY HAVE
SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND
MENTAL WELL-BEING OF ITS PARTICIPANTS:
  (1) AN EDUCATION PROGRAM TO INCREASE  THE  AWARENESS  OF  AND  DISSEM-
INATION  OF  INFORMATION  ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
WARNS ABOUT RISKS OF PURSUING  ENVIRONMENTAL  OR  BEHAVIORAL  ACTIVITIES
THAT  ARE  DETRIMENTAL  TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY  IDENTIFI-
CATION  AND  TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGE HEALTHY LIVING ACTIVITIES OR DISCOURAGE UNHEALTHY LIVING ACTIVITIES.
SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS  PROVIDED
UNDER  SECTION  THREE  THOUSAND TWO HUNDRED THIRTY-NINE OF THIS CHAPTER;
AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE  AND
MORAL  SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.

A. 4238                             5

  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE GENERAL GOOD HEALTH AND WELL-BEING OF THE  COVERED  POPULATION.  THE
INSURER  OR  HEALTH  MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
OUTCOMES AS A RESULT OF AN ENROLLEE'S  OR  INSURED'S  ADHERENCE  TO  THE
APPROVED WELLNESS PROGRAM.
  S 5. Subsection (m) of section 4326 of the insurance law is amended by
adding a new paragraph 4 to read as follows:
  (4)  APPROVAL  OF THE SUPERINTENDENT, AN INSURER OR HEALTH MAINTENANCE
ORGANIZATION ISSUING A CONTRACT FOR QUALIFYING SMALL EMPLOYERS OR  INDI-
VIDUALS  PURSUANT  TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY APPRO-
PRIATE REDUCTION IN PREMIUM RATES  OR  OTHER  BENEFITS  OR  ENHANCEMENTS
APPROVED  BY  THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S
ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED  WELL-
NESS  PROGRAM  CAN  BE  A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK
POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND  WELL-BE-
ING,  HELPS  TO  PREVENT  OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
SICKNESS, DISEASE OR PAIN, OR  WHICH  MINIMIZES  ADVERSE  HEALTH  CONSE-
QUENCES  DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
OF THE FOLLOWING ELEMENTS TO ADVANCE  THE  PHYSICAL  HEALTH  AND  MENTAL
WELL-BEING OF ITS PARTICIPANTS:
  (1)  AN  EDUCATION  PROGRAM  TO  INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER  LIFESTYLES,  AND  WHICH
WARNS  ABOUT  RISKS  OF  PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION,  INFORMATION  ON  THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGE HEALTHY LIVING ACTIVITIES OR DISCOURAGE UNHEALTHY LIVING ACTIVITIES.
SUCH  ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS PROVIDED
UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE  OF  THIS  CHAPTER;
AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR  HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN  THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE  GENERAL  GOOD  HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL  NOT  REQUIRE  SPECIFIC
OUTCOMES  AS  A  RESULT  OF  AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
APPROVED WELLNESS PROGRAM.
  S 6. Section 4405 of the public health law is amended by adding a  new
subdivision 5-a to read as follows:
  5-A.  SUBJECT  TO  THE  APPROVAL  OF  THE  SUPERINTENDENT OF FINANCIAL
SERVICES, THE POSSIBLE PROVIDING OF AN ACTUARIALLY APPROPRIATE REDUCTION
IN PREMIUM RATES OR OTHER  BENEFITS  OR  ENHANCEMENTS  APPROVED  BY  THE
SUPERINTENDENT  OF  FINANCIAL SERVICES TO ENCOURAGE AN ENROLLEE'S ACTIVE
PARTICIPATION IN A QUALIFIED  WELLNESS  PROGRAM.  A  QUALIFIED  WELLNESS
PROGRAM  CAN  BE  A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK POPU-
LATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR  COURSE  OF  MEDICAL  CONDUCT
WHICH  HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE-
ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS  OF  ACUTE  OR  CHRONIC
SICKNESS,  DISEASE  OR  PAIN,  OR  WHICH MINIMIZES ADVERSE HEALTH CONSE-
QUENCES DUE TO LIFESTYLE.  SUCH A WELLNESS PROGRAM MAY HAVE SOME OR  ALL

A. 4238                             6

OF  THE  FOLLOWING  ELEMENTS  TO  ADVANCE THE PHYSICAL HEALTH AND MENTAL
WELL-BEING OF ITS PARTICIPANTS:
  (1)  AN  EDUCATION  PROGRAM  TO  INCREASE THE AWARENESS OF AND DISSEM-
INATION OF INFORMATION ABOUT PURSUING HEALTHIER  LIFESTYLES,  AND  WHICH
WARNS  ABOUT  RISKS  OF  PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION,  INFORMATION  ON  THE
AVAILABILITY  OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART  DISEASE,  HYPER-
TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
  (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
AGE HEALTHY LIVING ACTIVITIES OR DISCOURAGE UNHEALTHY LIVING ACTIVITIES.
SUCH  ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS PROVIDED
UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE  OF  THE  INSURANCE
LAW; AND
  (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
OR  HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN  THE
GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
  SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
THE  GENERAL  GOOD  HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC OUTCOMES AS A
RESULT OF AN ENROLLEE'S ADHERENCE TO THE APPROVED WELLNESS PROGRAM;
  S 7. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided  that,  effective  immediately  any
rules  and regulations necessary to implement the provisions of this act
on its effective date are authorized and directed to be  added,  amended
and/or repealed on or before such date.