S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4329
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                             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:
 
   Section 1. Section 3239 of the insurance law, as added by chapter  592
 of  the  laws  of 2008 and subsections (b) and (c) as amended by chapter
 180 of the laws of 2016, is amended to read as follows:
   § 3239. Wellness programs. (a)  An  insurer  licensed  to  write  LIFE
 INSURANCE MAY ESTABLISH A WELLNESS PROGRAM IN CONJUNCTION WITH ITS ISSU-
 ANCE  OF  LIFE INSURANCE POLICIES AND AN INSURER LICENSED TO WRITE acci-
 dent 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], LONGEVITY AND/OR prevent disease that
 may contain rewards and incentives for participation.  Participation  in
 the wellness program shall be available to similarly-situated members of
 the  group  OR TO ALL INSUREDS WITHIN THE SAME CLASS and shall be volun-
 tary on the part of the member OR INSURED.   The terms of  the  wellness
 program shall be set forth in the policy or contract.
   (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;
 
              

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD08784-01-1

 S. 4329                             2
 
   (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) a substance or alcohol abuse cessation program; [and]
   (10) a program to manage and cope with chronic pain; AND
   (11) A PREVENTATIVE CARE OR CHRONIC DISEASE MANAGEMENT PROGRAM.
   (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.
   (2) Permissible rewards and incentives may include:
   (A)  full  or  partial  reimbursement  of the cost of participating in
 smoking cessation, weight management, stress and/or hypertension, worker
 injury prevention,  nutrition  education,  substance  or  alcohol  abuse
 cessation,   PREVENTIVE   CARE   PROGRAMS,  CHRONIC  DISEASE  MANAGEMENT
 PROGRAMS, 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 HEALTH INSURANCE policy
 or subscriber contract;
   (C-1) A PREMIUM REFUND, DISCOUNT OR POLICY VALUE CREDIT UNDER  A  LIFE
 INSURANCE POLICY;
   (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] VOUCHERS OR
 DISCOUNTS ON PRODUCTS OR SERVICES THAT ARE INTENDED TO INCENT BEHAVIORAL
 CHANGES THAT IMPROVE THE HEALTH OR REDUCE  THE  RISK  OF  DEATH  OF  THE
 INSURED;
   (E)  full  or  partial reimbursement of the cost of participating in a
 stress management program or  activity,  INCLUDING  PARTICIPATION  IN  A
 MEDITATION,   MINDFULNESS,  SLEEP  IMPROVEMENT  OR  SIMILAR  PROGRAM  OR
 SERVICE; [and]
   (F) full or partial reimbursement of the cost of  participating  in  a
 health or fitness program;
   (G)  FULL  OR  PARTIAL  REIMBURSEMENT  OF THE COST OF A DEVICE AND ANY
 ASSOCIATED SUBSCRIPTION MEMBERSHIP THAT CAN BE USED  TO  TRACK  PHYSICAL
 ACTIVITY  AND/OR  BIOMETRIC  DATA, SUCH AS HEART RATE, BODY COMPOSITION,
 TONE OF VOICE, SLEEP OR SIMILAR INFORMATION TO INCENT BEHAVIORAL CHANGES
 THAT IMPROVE THE HEALTH OR REDUCE THE RISK OF DEATH OF THE INSURED; AND
   (H) FULL OR PARTIAL REIMBURSEMENT OF BIOMETRIC SCREENINGS.
   (3) Where the reward involves a group  member's  meeting  a  specified
 standard  based  on  a  health  condition,  the wellness program UNDER A
 HEALTH INSURANCE POLICY 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 UNDER A HEALTH INSURANCE POLICY shall be
 based on actuarial demonstration that the wellness program  can  reason-
 ably  be expected to result in the overall good health and well being of
 the group. A REWARD OR INCENTIVE WHICH  INVOLVES  A  DISCOUNTED  PREMIUM
 RATE  OR REBATE OR REFUND OF PREMIUM UNDER A LIFE INSURANCE POLICY SHALL
 BE SUPPORTED BY DATA AND RESEARCH THAT SUCH INCENTIVES,  IN  THE  AGGRE-
 GATE,  ARE  DIRECTED  TO SHARING THE BENEFIT OF IMPROVING MORTALITY RISK
 EXPERIENCE.
   § 2. This act shall take effect immediately.