Bill Text: NY A02853 | 2023-2024 | General Assembly | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: 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 or biometric data; provides for discounts on life insurance and on products or services intended to incent positive behavioral changes.

Spectrum: Partisan Bill (Democrat 7-0)

Status: (Introduced) 2023-05-30 - substituted by s5890a [A02853 Detail]

Download: New_York-2023-A02853-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                         2853--A

                               2023-2024 Regular Sessions

                   IN ASSEMBLY

                                    January 27, 2023
                                       ___________

        Introduced  by  M.  of  A. MEEKS, CLARK, LUPARDO, STECK -- read once and
          referred to the Committee on Insurance -- committee  discharged,  bill
          amended,  ordered reprinted as amended and recommitted to said commit-
          tee

        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
    21  in  the program. The terms of the wellness program shall be set forth in
    22  the policy or contract.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD07895-03-3
        A. 2853--A                          2

     1    (b) A wellness program may include, but is not limited to, the follow-
     2  ing programs or services:
     3    (1) the use of a health risk assessment tool;
     4    (2) a smoking cessation program;
     5    (3) a weight management program;
     6    (4) a stress and/or hypertension management program;
     7    (5) a worker injury prevention program;
     8    (6) a nutrition education program;
     9    (7) health or fitness incentive programs;
    10    (8)  a coordinated weight management, nutrition, stress management and
    11  physical fitness program to combat  the  high  incidence  of  adult  and
    12  childhood obesity, asthma and other chronic respiratory conditions;
    13    (9) a substance or alcohol abuse cessation program; [and]
    14    (10) a program to manage and cope with chronic pain;
    15    (11)  a  preventative  care, screenings, or chronic disease management
    16  program; and
    17    (12) a meditation, sleep improvement or similar program or service.
    18    (c)(1) A wellness program may use rewards and incentives  for  partic-
    19  ipation  provided  that  where  the  group  health  insurance  policy or
    20  subscriber contract is required to be community-rated, the  rewards  and
    21  incentives  shall  not  include a discounted premium rate or a rebate or
    22  refund of premium.
    23    (2) Permissible rewards and incentives may include:
    24    (A) full or partial reimbursement of  the  cost  of  participating  in
    25  smoking cessation, weight management, stress and/or hypertension, worker
    26  injury  prevention,  nutrition  education,  substance  or  alcohol abuse
    27  cessation, preventative care programs, or  screenings,  chronic  disease
    28  management programs, or chronic pain management and coping programs;
    29    (B)  full  or  partial  reimbursement  of  the cost of membership in a
    30  health club or fitness center;
    31    (C) (1) the waiver or reduction of copayments, coinsurance and deduct-
    32  ibles for preventive services covered under the group  health  insurance
    33  policy or subscriber contract;
    34    (2)  a  premium  refund,  discount or policy value credit under a life
    35  insurance policy;
    36    (D) monetary rewards in the form of  gift  cards  [or],  gift  certif-
    37  icates, [so long as the recipient of the reward is encouraged to use the
    38  reward  for  a  product  or a service that promotes good health, such as
    39  healthy cook books, over the counter  vitamins  or  exercise  equipment]
    40  vouchers  or  discounts  on  products  or  services that are intended to
    41  incent behavioral changes that improve the health or reduce the risk  of
    42  death of the insured;
    43    (E)  full  or  partial reimbursement of the cost of participating in a
    44  stress management program or  activity,  including  participation  in  a
    45  meditation,  sleep  improvement  or similar program or service, provided
    46  that such program or activity shall be based on data and  research  that
    47  the  program  or service can be reasonably expected to result in overall
    48  good health, well being, or improved mortality risk; [and]
    49    (F) full or partial reimbursement of the cost of  participating  in  a
    50  health or fitness program;
    51    (G) full or partial reimbursement of the cost of a wearable device and
    52  any  associated  subscription membership that can be used to track phys-
    53  ical activity or biometric data, and which incents behavioral changes to
    54  improve the health or reduce the risk of death of the insured; and
    55    (H) full or partial reimbursement of biometric screenings.
        A. 2853--A                          3

     1    (3) Where the reward involves a group  member's  meeting  a  specified
     2  standard  based  on  a  health  condition,  the wellness program under a
     3  health insurance policy must meet the requirements of 45 CFR Part 146.
     4    (4)  A reward or incentive which involves a discounted premium rate or
     5  a rebate or refund of premium under a health insurance policy  shall  be
     6  based  on  actuarial demonstration that the wellness program can reason-
     7  ably be expected to result in the overall good health and well being  of
     8  the group. A reward or incentive that involves a discounted premium rate
     9  or  rebate  or  refund of premium under a life insurance policy shall be
    10  actuarially supported by data  and  research  that  such  incentives  or
    11  rewards,  in  the  aggregate,  are  directed  to  sharing the benefit of
    12  improving  expected  mortality  risk  experience.    Data  collected  in
    13  connection  with  a  wellness  program shall be subject to all state and
    14  federal privacy and security laws.
    15    § 2. This act shall take effect immediately.