Bill Text: NY A05302 | 2013-2014 | General Assembly | Amended
NOTE: There are more recent revisions of this legislation. Read Latest Draft
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
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--A
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 -- Multi-Sponsored by -- M. of A.
BRAUNSTEIN, GALEF, GOTTFRIED, RIVERA, ROSA, SIMANOWITZ, STECK, SWEE-
NEY, WEISENBERG -- read once and referred to the Committee on Insur-
ance -- 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
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-
15 QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
16 OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL
17 WELL-BEING OF ITS PARTICIPANTS:
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06713-06-4
A. 5302--A 2
1 (1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
2 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
3 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
4 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
5 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
6 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
7 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
8 (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
9 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
10 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
11 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
12 ARTICLE; AND
13 (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
14 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
15 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
16 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
17 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
18 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
19 INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
20 OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
21 APPROVED WELLNESS PROGRAM.
22 S 2. Subsections (b) and (c) of section 3239 of the insurance law, as
23 added by chapter 592 of the laws of 2008, paragraphs 6 and 7 of
24 subsection (b) and subparagraph (C) and (D) of paragraph 2 of subsection
25 (c) as amended, and paragraph 8 of subsection (b) and subparagraph (E)
26 and (F) of paragraph 2 of subsection (c) as added by chapter 519 of the
27 laws of 2013, are amended to read as follows:
28 (b) A wellness program may include, but is not limited to, the follow-
29 ing programs or services:
30 (1) the use of a health risk assessment tool;
31 (2) a smoking cessation program;
32 (3) a weight management program;
33 (4) a stress AND/OR HYPERTENSION management program;
34 (5) a worker injury prevention program;
35 (6) a nutrition education program;
36 (7) health or fitness incentive programs; [and]
37 (8) a coordinated weight management, nutrition, stress management and
38 physical fitness program to combat the high incidence of adult and
39 childhood obesity, asthma and other chronic respiratory conditions[.];
40 (9) A SUBSTANCE OR ALCOHOL ABUSE CESSATION PROGRAM; AND
41 (10) A PROGRAM TO MANAGE AND COPE WITH CHRONIC PAIN.
42 (c)(1) A wellness program may use rewards and incentives for partic-
43 ipation provided that where the group health insurance policy or
44 subscriber contract is required to be community-rated, the rewards and
45 incentives shall not include a discounted premium rate or a rebate or
46 refund of premium, EXCEPT AS PROVIDED IN SECTION THREE THOUSAND TWO
47 HUNDRED THIRTY-ONE OF THIS ARTICLE, OR SECTION FOUR THOUSAND TWO HUNDRED
48 THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED SEVENTEEN OR FOUR THOUSAND
49 THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, OR SECTION FORTY-FOUR HUNDRED
50 FIVE OF THE PUBLIC HEALTH LAW.
51 (2) Permissible rewards and incentives MAY include:
52 (A) full or partial reimbursement of the cost of participating in
53 smoking cessation [or], weight management, STRESS AND/OR HYPERTENSION,
54 WORKER INJURY PREVENTION, NUTRITION EDUCATION, SUBSTANCE OR ALCOHOL
55 ABUSE CESSATION, OR CHRONIC PAIN MANAGEMENT AND COPING programs;
A. 5302--A 3
1 (B) full or partial reimbursement of the cost of membership in a
2 health club or fitness center;
3 (C) the waiver or reduction of copayments, coinsurance and deductibles
4 for preventive services covered under the group policy or subscriber
5 contract;
6 (D) monetary rewards in the form of gift cards or gift certificates,
7 so long as the recipient of the reward is encouraged to use the reward
8 for a product or a service that promotes good health, such as healthy
9 cook books, over the counter vitamins or exercise equipment;
10 (E) full or partial reimbursement of the cost of participating in a
11 stress management program or activity; and
12 (F) full or partial reimbursement of the cost of participating in a
13 health or fitness program.
14 (3) Where the reward involves a group member's meeting a specified
15 standard based on a health condition, the wellness program must meet the
16 requirements of 45 CFR Part 146.
17 (4) A reward or incentive which involves a discounted premium rate or
18 a rebate or refund of premium shall be based on actuarial demonstration
19 that the wellness program can reasonably be expected to result in the
20 overall good health and well being of the group AS PROVIDED IN SECTION
21 THREE THOUSAND TWO HUNDRED THIRTY-ONE OF THIS ARTICLE, SECTIONS FOUR
22 THOUSAND TWO HUNDRED THIRTY-FIVE, FOUR THOUSAND THREE HUNDRED SEVENTEEN
23 AND FOUR THOUSAND THREE HUNDRED TWENTY-SIX OF THIS CHAPTER, AND SECTION
24 FORTY-FOUR HUNDRED FIVE OF THE PUBLIC HEALTH LAW.
25 S 3. Subsection (h) of section 4235 of the insurance law is amended by
26 adding a new paragraph 5 to read as follows:
27 (5) EACH INSURER DOING BUSINESS IN THIS STATE, WHEN FILING WITH THE
28 SUPERINTENDENT ITS SCHEDULES OF PREMIUM RATES, RULES AND CLASSIFICATION
29 OF RISKS FOR USE IN CONNECTION WITH THE ISSUANCE OF ITS POLICIES OF
30 GROUP ACCIDENT, GROUP HEALTH OR GROUP ACCIDENT AND HEALTH INSURANCE, MAY
31 PROVIDE FOR AN ACTUARIALLY APPROPRIATE REDUCTION IN PREMIUM RATES OR
32 OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOUR-
33 AGE AN ENROLLEE'S OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELL-
34 NESS PROGRAM. A QUALIFIED WELLNESS PROGRAM CAN BE A RISK MANAGEMENT
35 SYSTEM THAT IDENTIFIES AT-RISK POPULATIONS OR ANY OTHER SYSTEMATIC
36 PROGRAM OR COURSE OF MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND
37 MENTAL FITNESS, HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE THE
38 CONDITIONS OF ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINI-
39 MIZES ADVERSE HEALTH CONSEQUENCES DUE TO LIFESTYLE. SUCH A WELLNESS
40 PROGRAM MAY HAVE SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE
41 PHYSICAL HEALTH AND MENTAL WELL-BEING OF ITS PARTICIPANTS:
42 (A) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
43 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
44 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
45 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
46 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
47 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
48 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
49 (B) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
50 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
51 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
52 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
53 CHAPTER;
54 (C) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
55 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
A. 5302--A 4
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 4. Section 4317 of the insurance law is amended by adding a new
9 subsection (c-1) to read as follows:
10 (C-1) SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT, AN INSURER OR
11 HEALTH MAINTENANCE ORGANIZATION ISSUING AN INDIVIDUAL OR GROUP HEALTH
12 INSURANCE CONTRACT PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARI-
13 ALLY APPROPRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR
14 ENHANCEMENTS APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S
15 OR INSURED'S ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A
16 QUALIFIED WELLNESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTI-
17 FIES AT-RISK POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF
18 MEDICAL CONDUCT WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS,
19 HEALTH AND WELL-BEING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF
20 ACUTE OR CHRONIC SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE
21 HEALTH CONSEQUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE
22 SOME OR ALL OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND
23 MENTAL 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 5. Subsection (m) of section 4326 of the insurance law is amended by
46 adding a new paragraph 4 to read as follows:
47 (4) APPROVAL OF THE SUPERINTENDENT, AN INSURER OR HEALTH MAINTENANCE
48 ORGANIZATION ISSUING A CONTRACT FOR QUALIFYING SMALL EMPLOYERS OR INDI-
49 VIDUALS PURSUANT TO THIS SECTION MAY PROVIDE FOR AN ACTUARIALLY APPRO-
50 PRIATE REDUCTION IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS
51 APPROVED BY THE SUPERINTENDENT TO ENCOURAGE AN ENROLLEE'S OR INSURED'S
52 ACTIVE PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELL-
53 NESS PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK
54 POPULATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
55 WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE-
56 ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
A. 5302--A 5
1 SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE-
2 QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
3 OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL
4 WELL-BEING OF ITS PARTICIPANTS:
5 (1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
6 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
7 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
8 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
9 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
10 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
11 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
12 (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
13 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
14 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
15 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THIS
16 CHAPTER; AND
17 (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
18 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
19 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
20 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
21 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
22 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
23 INSURER OR HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC
24 OUTCOMES AS A RESULT OF AN ENROLLEE'S OR INSURED'S ADHERENCE TO THE
25 APPROVED WELLNESS PROGRAM.
26 S 6. Section 4405 of the public health law is amended by adding a new
27 subdivision 5-a to read as follows:
28 5-A. SUBJECT TO THE APPROVAL OF THE SUPERINTENDENT OF FINANCIAL
29 SERVICES, THE POSSIBLE PROVIDING OF AN ACTUARIALLY APPROPRIATE REDUCTION
30 IN PREMIUM RATES OR OTHER BENEFITS OR ENHANCEMENTS APPROVED BY THE
31 SUPERINTENDENT OF FINANCIAL SERVICES TO ENCOURAGE AN ENROLLEE'S ACTIVE
32 PARTICIPATION IN A QUALIFIED WELLNESS PROGRAM. A QUALIFIED WELLNESS
33 PROGRAM CAN BE A RISK MANAGEMENT SYSTEM THAT IDENTIFIES AT-RISK POPU-
34 LATIONS OR ANY OTHER SYSTEMATIC PROGRAM OR COURSE OF MEDICAL CONDUCT
35 WHICH HELPS TO PROMOTE PHYSICAL AND MENTAL FITNESS, HEALTH AND WELL-BE-
36 ING, HELPS TO PREVENT OR MITIGATE THE CONDITIONS OF ACUTE OR CHRONIC
37 SICKNESS, DISEASE OR PAIN, OR WHICH MINIMIZES ADVERSE HEALTH CONSE-
38 QUENCES DUE TO LIFESTYLE. SUCH A WELLNESS PROGRAM MAY HAVE SOME OR ALL
39 OF THE FOLLOWING ELEMENTS TO ADVANCE THE PHYSICAL HEALTH AND MENTAL
40 WELL-BEING OF ITS PARTICIPANTS:
41 (1) AN EDUCATION PROGRAM TO INCREASE THE AWARENESS OF AND DISSEM-
42 INATION OF INFORMATION ABOUT PURSUING HEALTHIER LIFESTYLES, AND WHICH
43 WARNS ABOUT RISKS OF PURSUING ENVIRONMENTAL OR BEHAVIORAL ACTIVITIES
44 THAT ARE DETRIMENTAL TO HUMAN HEALTH. IN ADDITION, INFORMATION ON THE
45 AVAILABILITY OF HEALTH SCREENING TESTS TO ASSIST IN THE EARLY IDENTIFI-
46 CATION AND TREATMENT OF DISEASES SUCH AS CANCER, HEART DISEASE, HYPER-
47 TENSION, DIABETES, ASTHMA, OBESITY OR OTHER ADVERSE HEALTH AFFLICTIONS;
48 (2) A PROGRAM THAT ENCOURAGES BEHAVIORAL PRACTICES THAT EITHER ENCOUR-
49 AGES HEALTHY LIVING ACTIVITIES OR DISCOURAGES UNHEALTHY LIVING ACTIV-
50 ITIES. SUCH ACTIVITIES OR PRACTICES MAY INCLUDE WELLNESS PROGRAMS, AS
51 PROVIDED UNDER SECTION THREE THOUSAND TWO HUNDRED THIRTY-NINE OF THE
52 INSURANCE LAW; AND
53 (3) THE MONITORING OF THE PROGRESS OF EACH COVERED PERSON TO TRACK HIS
54 OR HER ADHERENCE TO SUCH WELLNESS PROGRAM AND TO PROVIDE ASSISTANCE AND
55 MORAL SUPPORT TO SUCH COVERED PERSON TO ASSIST HIM OR HER TO ATTAIN THE
56 GOALS OF THE COVERED PERSON'S WELLNESS PROGRAM.
A. 5302--A 6
1 SUCH WELLNESS PROGRAM SHALL DEMONSTRATE ACTUARIALLY THAT IT ENCOURAGES
2 THE GENERAL GOOD HEALTH AND WELL-BEING OF THE COVERED POPULATION. THE
3 HEALTH MAINTENANCE ORGANIZATION SHALL NOT REQUIRE SPECIFIC OUTCOMES AS A
4 RESULT OF AN ENROLLEE'S ADHERENCE TO THE APPROVED WELLNESS PROGRAM;
5 S 7. This act shall take effect on the one hundred eightieth day after
6 it shall have become a law; provided that, effective immediately any
7 rules and regulations necessary to implement the provisions of this act
8 on its effective date are authorized and directed to be added, amended
9 and/or repealed on or before such date.
