Bill Text: NY A05302 | 2013-2014 | General Assembly | Amended
Bill Title: Authorizes health insurers and health maintenance organizations, subject to the approval of the superintendent of financial services, to provide actuarially appropriate reductions in health insurance premiums or other benefits or enhancements for an enrollee's or insured's participation in a qualified wellness program.
Spectrum: Moderate Partisan Bill (Democrat 34-4)
Status: (Introduced - Dead) 2014-06-03 - held for consideration in insurance [A05302 Detail]
Download: New_York-2013-A05302-Amended.html
S T A T E O F N E W Y O R K ________________________________________________________________________ 5302--B 2013-2014 Regular Sessions I N A S S E M B L Y February 22, 2013 ___________ Introduced by M. of A. GJONAJ, LAVINE, JAFFEE, BROOK-KRASNY, ROBERTS, STIRPE, BENEDETTO, COLTON, CRESPO, KEARNS, JACOBS, OTIS, ROBINSON, RAIA, STECK, LUPARDO -- Multi-Sponsored by -- M. of A. BRAUNSTEIN, CAMARA, GALEF, GOTTFRIED, P. LOPEZ, PEOPLES-STOKES, PERRY, RIVERA, ROSA, SEPULVEDA, SIMANOWITZ, SKARTADOS, SWEENEY, TITONE, WEISENBERG -- read once and referred to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Assembly Rule 3, sec. 2 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- again reported from said commit- tee with amendments, ordered reprinted as amended and recommitted to said committee 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: 1 Section 1. Section 3231 of the insurance law, as added by chapter 501 2 of the laws of 1992, is amended by adding a new subsection (c-1) to read 3 as follows: 4 (C-1) SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT, AN INSURER OR 5 HEALTH MAINTENANCE ORGANIZATION ISSUING AN INDIVIDUAL OR GROUP HEALTH 6 INSURANCE POLICY PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY 7 APPROPRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS 8 APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S 9 ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELL- 10 NESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK 11 POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT 12 WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE- 13 ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC 14 SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD06713-08-4 A. 5302--B 2 1 QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL 2 OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL 3 WELL-BEING OF ITS PARTICIPANTS: 4 (1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM- 5 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH 6 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES 7 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE 8 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI- 9 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER- 10 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS; 11 (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR- 12 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV- 13 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS 14 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS 15 ARTICLE; AND 16 (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS 17 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND 18 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE 19 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM. 20 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES 21 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE 22 INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC 23 OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE 24 APPROVED WELLNESS PROGRAM. 25 S 2. Subsections (a), (b) and (c) of section 3239 of the insurance 26 law, as added by chapter 592 of the laws of 2008, paragraphs 6 and 7 of 27 subsection (b) and subparagraphs (C) and (D) of paragraph 2 of 28 subsection (c) as amended, and paragraph 8 of subsection (b) and subpar- 29 agraphs (E) and (F) of paragraph 2 of subsection (c) as added by chapter 30 519 of the laws of 2013, are amended to read as follows: 31 (a) An insurer licensed to write accident and health insurance, a 32 corporation organized pursuant to article forty-three of this chapter, a 33 health maintenance organization certified pursuant to article forty-four 34 of the public health law and a municipal cooperative health benefits 35 plan may establish a wellness program in conjunction with its issuance 36 of a group accident and health insurance policy or group subscriber 37 contract. A "wellness program" is a program designed to promote health 38 and prevent disease that may contain rewards and incentives for partic- 39 ipation. Participation in the wellness program shall be available to 40 similarly-situated members of the group and shall be voluntary on the 41 part of the member. The SPECIFIC terms of the wellness program shall be 42 set forth in the policy or contract, OR IN A SEPARATE DOCUMENT PROVIDED 43 TO INSUREDS AND MEMBERS WHICH SHALL BE CONSISTENT WITH THE PROVISIONS OF 44 THIS SECTION. 45 (b) A wellness program may include, but is not limited to, the follow- 46 ing programs or services: 47 (1) the use of a health risk assessment tool; 48 (2) a smoking cessation program; 49 (3) a weight management program; 50 (4) a stress AND/OR HYPERTENSION management program; 51 (5) a worker injury prevention program; 52 (6) a nutrition education program; 53 (7) health or fitness incentive programs; [and] 54 (8) a coordinated weight management, nutrition, stress management and 55 physical fitness program to combat the high incidence of adult and 56 childhood obesity, asthma and other chronic respiratory conditions[.]; A. 5302--B 3 1 (9) ASSISTANCE, FINANCIAL OR OTHERWISE, PROVIDED TO AN EMPLOYER FOR 2 HEALTH PROMOTION AND DISEASE PREVENTION; 3 (10) INCENTIVES FOR INSUREDS OR MEMBERS TO ACCESS PREVENTIVE SERVICES, 4 SUCH AS MAMMOGRAPHY SCREENING; 5 (11) A SUBSTANCE OR ALCOHOL ABUSE CESSATION PROGRAM; AND 6 (12) A PROGRAM TO MANAGE AND COPE WITH CHRONIC PAIN. 7 (c)(1) A wellness program may use rewards and incentives for partic- 8 ipation provided that where the group health insurance policy or 9 subscriber contract is required to be community-rated, the rewards and 10 incentives shall not include a discounted premium rate or a rebate or 11 refund of premium, EXCEPT AS PROVIDED IN SECTION THREE THOUSAND TWO 12 HUNDRED THIRTY-ONE OF THIS ARTICLE, OR SECTION FOUR THOUSAND TWO HUNDRED 13 THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED SEVENTEEN OR FOUR THOUSAND 14 THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, OR SECTION FORTY-FOUR HUNDRED 15 FIVE OF THE PUBLIC HEALTH LAW. 16 (2) Permissible rewards and incentives MAY include: 17 (A) full or partial reimbursement of the cost of participating in 18 smoking cessation [or], weight management, STRESS AND/OR HYPERTENSION, 19 WORKER INJURY PREVENTION, NUTRITION EDUCATION, SUBSTANCE OR ALCOHOL 20 ABUSE CESSATION, OR CHRONIC PAIN MANAGEMENT AND COPING programs; 21 (B) full or partial reimbursement of the cost of membership in a 22 health club or fitness center; 23 (C) the waiver or reduction of copayments, coinsurance and deductibles 24 for preventive services covered under the group policy or subscriber 25 contract; 26 (D) monetary rewards in the form of gift cards or gift certificates, 27 so long as the recipient of the reward is encouraged to use the reward 28 for a product or a service that promotes good health, such as healthy 29 cook books, over the counter vitamins or exercise equipment; 30 (E) full or partial reimbursement of the cost of participating in a 31 stress management program or activity; and 32 (F) full or partial reimbursement of the cost of participating in a 33 health or fitness program. 34 (3) Where the reward involves a group member's meeting a specified 35 standard based on a health condition, the wellness program must meet the 36 requirements of 45 CFR Part 146. 37 (4) A reward or incentive which involves a discounted premium rate or 38 a rebate or refund of premium shall be based on actuarial demonstration 39 that the wellness program can reasonably be expected to result in the 40 overall good health and well being of the group AS PROVIDED IN SECTION 41 THREE THOUSAND TWO HUNDRED THIRTY-ONE OF THIS ARTICLE, SECTIONS FOUR 42 THOUSAND TWO HUNDRED THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED SEVENTEEN 43 AND FOUR THOUSAND THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, AND SECTION 44 FORTY-FOUR HUNDRED FIVE OF THE PUBLIC HEALTH LAW. 45 S 3. Subsection (h) of section 4235 of the insurance law is amended by 46 adding a new paragraph 5 to read as follows: 47 (5) EACH INSURER DOING BUSINESS IN THIS STATE, WHEN FILING WITH THE 48 SUPERINTENDENT ITS SCHEDULES OF PREMIUM RATES, RULES AND CLASSIFICATION 49 OF RISKS FOR USE IN CONNECTION WITH THE ISSUANCE OF ITS POLICIES OF 50 GROUP ACCIDENT, GROUP HEALTH OR GROUP ACCIDENT AND HEALTH INSURANCE, MAY 51 PROVIDE FOR AN ACTUARIALLY APPROPRIATE REDUCTION IN PREMIUM RATES OR 52 OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOUR- 53 AGE AN ENROLLEE'S OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELL- 54 NESS PROGRAM. A QUALIFIED WELLNESS PROGRAM CAN BE A RISK MANAGEMENT 55 SYSTEM THAT IDENTIFIES AT-RISK POPULATIONS OR ANY OTHER SYSTEMATIC 56 PROGRAM OR COURSE OF MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND A. 5302--B 4 1 MENTAL FITNESS, HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE THE 2 CONDITIONS OF ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINI- 3 MIZES ADVERSE HEALTH CONSEQUENCES DUE TO LIFESTYLE. SUCH A WELLNESS 4 PROGRAM MAY HAVE SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE 5 PHYSICAL HEALTH AND MENTAL WELL-BEING OF ITS PARTICIPANTS: 6 (A) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM- 7 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH 8 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES 9 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE 10 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI- 11 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER- 12 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS; 13 (B) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR- 14 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV- 15 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS 16 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS 17 CHAPTER; 18 (C) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS 19 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND 20 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE 21 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM. 22 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES 23 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE 24 INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC 25 OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE 26 APPROVED WELLNESS PROGRAM. 27 S 4. Section 4317 of the insurance law is amended by adding a new 28 subsection (c-1) to read as follows: 29 (C-1) SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT, AN INSURER OR 30 HEALTH MAINTENANCE ORGANIZATION ISSUING AN INDIVIDUAL OR GROUP HEALTH 31 INSURANCE CONTRACT PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARI- 32 ALLY APPROPRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR 33 ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S 34 OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A 35 QUALIFIED WELLNESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTI- 36 FIES AT-RISK POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF 37 MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, 38 HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF 39 ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE 40 HEALTH CONSEQUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE 41 SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND 42 MENTAL WELL-BEING OF ITS PARTICIPANTS: 43 (1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM- 44 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH 45 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES 46 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE 47 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI- 48 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER- 49 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS; 50 (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR- 51 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV- 52 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS 53 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS 54 CHAPTER; AND 55 (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS 56 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND A. 5302--B 5 1 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE 2 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM. 3 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES 4 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE 5 INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC 6 OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE 7 APPROVED WELLNESS PROGRAM. 8 S 5. Subsection (m) of section 4326 of the insurance law is amended by 9 adding a new paragraph 4 to read as follows: 10 (4) APPROVAL OF THE SUPERINTENDENT, AN INSURER OR HEALTH MAINTENANCE 11 ORGANIZATION ISSUING A CONTRACT FOR QUALIFYING SMALL EMPLOYERS OR INDI- 12 VIDUALS PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY APPRO- 13 PRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS 14 APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S 15 ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELL- 16 NESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK 17 POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT 18 WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE- 19 ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC 20 SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE- 21 QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL 22 OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL 23 WELL-BEING OF ITS PARTICIPANTS: 24 (1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM- 25 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH 26 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES 27 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE 28 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI- 29 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER- 30 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS; 31 (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR- 32 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV- 33 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS 34 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS 35 CHAPTER; AND 36 (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS 37 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND 38 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE 39 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM. 40 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES 41 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE 42 INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC 43 OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE 44 APPROVED WELLNESS PROGRAM. 45 S 6. Section 4405 of the public health law is amended by adding a new 46 subdivision 5-a to read as follows: 47 5-A. SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT OF FINANCIAL 48 SERVICES, THE POSSIBLE PROVIDING OF AN ACTUARIALLY APPROPRIATE REDUCTION 49 IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE 50 SUPERINTENDENT OF FINANCIAL SERVICES TO ENCOURAGE AN ENROLLEE'S ACTIVE 51 PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELLNESS 52 PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK POPU- 53 LATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT 54 WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE- 55 ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC 56 SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE- A. 5302--B 6 1 QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL 2 OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL 3 WELL-BEING OF ITS PARTICIPANTS: 4 (1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM- 5 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH 6 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES 7 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE 8 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI- 9 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER- 10 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS; 11 (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR- 12 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV- 13 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS 14 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THE 15 INSURANCE LAW; AND 16 (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS 17 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND 18 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE 19 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM. 20 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES 21 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE 22 HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC OUTCOMES AS A 23 RESULT OF AN ENROLLEE'S ADHERENCE TO THE APPROVED WELLNESS PROGRAM; 24 S 7. This act shall take effect on the one hundred eightieth day after 25 it shall have become a law; provided that, effective immediately any 26 rules and regulations necessary to implement the provisions of this act 27 on its effective date are authorized and directed to be added, amended 28 and/or repealed on or before such date.