Bill Text: NY A02853 | 2023-2024 | General Assembly | Amended
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
STATE OF NEW YORK ________________________________________________________________________ 2853--B 2023-2024 Regular Sessions IN ASSEMBLY January 27, 2023 ___________ Introduced by M. of A. MEEKS, CLARK, LUPARDO, STECK, WEPRIN, McDONALD, BUTTENSCHON -- read once and referred to the Committee on Insurance -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- again reported from said committee with amendments, ordered reprinted as amended and recommitted to said committee 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. LBD07895-05-3A. 2853--B 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 the41reward for a product or a service that promotes good health, such as42healthy 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-A. 2853--B 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.