STATE OF NEW YORK
________________________________________________________________________
6466--B
Cal. No. 283
IN SENATE
January 13, 2016
___________
Introduced by Sens. KLEIN, CARLUCCI, SAVINO, VALESKY -- read twice and
ordered printed, and when printed to be committed to the Committee on
Health -- reported favorably from said committee, ordered to first and
second report, ordered to a third reading, amended and ordered
reprinted, retaining its place in the order of third reading -- passed
by Senate and delivered to the Assembly, recalled, vote reconsidered,
restored to third reading, amended and ordered reprinted, retaining
its place in the order of third reading
AN ACT to amend the insurance law, in relation to expanding the kinds of
qualified wellness programs that can be offered to enrollees
The People of the State of New York, represented in Senate and Assem-
bly, do enact as follows:
1 Section 1. Subsections (b) and (c) of section 3239 of the insurance
2 law, as added by chapter 592 of the laws of 2008, paragraphs 6 and 7 of
3 subsection (b) and subparagraphs (C) and (D) of paragraph 2 of
4 subsection (c) as amended, and paragraph 8 of subsection (b) and subpar-
5 agraphs (E) and (F) of paragraph 2 of subsection (c) as added by chapter
6 519 of the laws of 2013, are amended to read as follows:
7 (b) A wellness program may include, but is not limited to, the follow-
8 ing programs or services:
9 (1) the use of a health risk assessment tool;
10 (2) a smoking cessation program;
11 (3) a weight management program;
12 (4) a stress and/or hypertension management program;
13 (5) a worker injury prevention program;
14 (6) a nutrition education program;
15 (7) health or fitness incentive programs; [and]
16 (8) a coordinated weight management, nutrition, stress management and
17 physical fitness program to combat the high incidence of adult and
18 childhood obesity, asthma and other chronic respiratory conditions[.];
19 (9) a substance or alcohol abuse cessation program; and
20 (10) a program to manage and cope with chronic pain.
21 (c)(1) A wellness program may use rewards and incentives for partic-
22 ipation provided that where the group health insurance policy or
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD13293-05-6
S. 6466--B 2
1 subscriber contract is required to be community-rated, the rewards and
2 incentives shall not include a discounted premium rate or a rebate or
3 refund of premium.
4 (2) Permissible rewards and incentives may include:
5 (A) full or partial reimbursement of the cost of participating in
6 smoking cessation [or], weight management, stress and/or hypertension,
7 worker injury prevention, nutrition education, substance or alcohol
8 abuse cessation, or chronic pain management and coping programs;
9 (B) full or partial reimbursement of the cost of membership in a
10 health club or fitness center;
11 (C) the waiver or reduction of copayments, coinsurance and deductibles
12 for preventive services covered under the group policy or subscriber
13 contract;
14 (D) monetary rewards in the form of gift cards or gift certificates,
15 so long as the recipient of the reward is encouraged to use the reward
16 for a product or a service that promotes good health, such as healthy
17 cook books, over the counter vitamins or exercise equipment;
18 (E) full or partial reimbursement of the cost of participating in a
19 stress management program or activity; and
20 (F) full or partial reimbursement of the cost of participating in a
21 health or fitness program.
22 (3) Where the reward involves a group member's meeting a specified
23 standard based on a health condition, the wellness program must meet the
24 requirements of 45 CFR Part 146.
25 (4) A reward or incentive which involves a discounted premium rate or
26 a rebate or refund of premium shall be based on actuarial demonstration
27 that the wellness program can reasonably be expected to result in the
28 overall good health and well being of the group.
29 § 2. This act shall take effect on the one hundred eightieth day after
30 it shall have become a law; provided that, effective immediately any
31 rules and regulations necessary to implement the provisions of this act
32 on its effective date are authorized and directed to be added, amended
33 and/or repealed on or before such date.