S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  9867--A
 
                           I N  A S S E M B L Y
 
                             February 20, 2020
                                ___________
 
 Introduced by M. of A. HUNTER -- read once and referred to the Committee
   on  Insurance -- committee discharged, bill amended, ordered reprinted
   as amended and recommitted to said committee
 
 AN ACT to amend the insurance law, in relation to the offering of reward
   or incentive programs to eligible members
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subsection  (c)  of section 4224 of the insurance law, as
 amended by chapter 496 of the laws of  2013,  is  amended  and  two  new
 subsections (g) and (h) are added to read as follows:
   (c)  Except as permitted by section three thousand two hundred thirty-
 nine of this chapter or [subsection] SUBSECTIONS (f),  (G)  AND  (H)  of
 this  section,  no  such  life insurance company and no such savings and
 insurance bank and no officer, agent, solicitor or representative there-
 of and no such insurer doing in this state the business of accident  and
 health  insurance  and  no  officer,  agent, solicitor or representative
 thereof, and no licensed insurance  broker  and  no  employee  or  other
 representative of any such insurer, agent or broker, shall pay, allow or
 give,  or  offer  to  pay,  allow or give, directly or indirectly, as an
 inducement to any person to insure, or shall give, sell or purchase,  or
 offer  to  give, sell or purchase, as such inducement, or interdependent
 with any policy of life insurance or annuity contract or policy of acci-
 dent and health insurance, any stocks, bonds, or  other  securities,  or
 any  dividends or profits accruing or to accrue thereon, or any valuable
 consideration or inducement whatever not specified  in  such  policy  or
 contract other than any valuable consideration, including but not limit-
 ed to merchandise or periodical subscriptions, not exceeding twenty-five
 dollars  in  value; nor shall any person in this state knowingly receive
 as such inducement, any rebate of premium or policy fee or  any  special
 favor  or  advantage in the dividends or other benefits to accrue on any
 such policy or contract, or knowingly receive  any  paid  employment  or
 contract  for  services  of  any  kind, or any valuable consideration or
 inducement whatever which is not specified in such policy or contract.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD15293-02-0

 A. 9867--A                          2
 
   (G) (1) NOTWITHSTANDING SUBSECTION (C) OF  THIS  SECTION,  AN  INSURER
 LICENSED  TO  WRITE  ACCIDENT  AND  HEALTH  INSURANCE IN THIS STATE OR A
 CORPORATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAPTER OR
 A HEALTH MAINTENANCE ORGANIZATION CERTIFIED PURSUANT TO  ARTICLE  FORTY-
 FOUR  OF  THE PUBLIC HEALTH LAW MAY OFFER AN INCENTIVE OR REWARD PROGRAM
 TO SUPPORT WELLNESS, PRIMARY AND PREVENTATIVE CARE,  POPULATION  HEALTH,
 CARE  COORDINATION,  CASE  MANAGEMENT, DISEASE MANAGEMENT, MENTAL HEALTH
 AND SUBSTANCE USE DISORDER TREATMENT INITIATIVES, EVIDENCED-BASED TREAT-
 MENT, OR QUALITY AND COST CONTAINMENT INITIATIVES.   WITH THE  EXCEPTION
 OF  INCENTIVES  OR  REWARDS  RELATED  TO  WELLNESS  PROGRAMS GOVERNED BY
 SECTION THREE THOUSAND TWO HUNDRED  THIRTY-NINE  OF  THIS  CHAPTER,  THE
 TOTAL VALUE OF SUCH INCENTIVES MAY NOT EXCEED AN AGGREGATE AVERAGE VALUE
 TO THE INSURED OF SIX HUNDRED DOLLARS PER YEAR.
   (2)  WELLNESS  PROGRAMS OFFERED PURSUANT TO SECTION THREE THOUSAND TWO
 HUNDRED THIRTY-NINE OF THIS CHAPTER AND  INCENTIVE  OR  REWARD  PROGRAMS
 OFFERED  PURSUANT  TO  THIS SUBSECTION MAY (I) TARGET POPULATIONS DETER-
 MINED BASED ON AGE, SEX, OR HEALTH STATUS; (II) BE OFFERED FOR A LIMITED
 PERIOD OR DURATION THAT DOES NOT ALIGN WITH THE POLICY OR CONTRACT  TERM
 AND  MAY  INCLUDE  A  SWEEPSTAKES,  RAFFLE  OR  CONTEST; AND (III) OFFER
 REWARDS OR INCENTIVES THAT DO NOT  INVOLVE  A  TANGIBLE  BENEFIT  TO  BE
 AVAILABLE TO ALL ENROLLEES OR A DIRECT BENEFIT TO THE ENROLLEE.
   (H)(1)  THIS SUBSECTION SHALL APPLY ONLY WITH RESPECT TO A GROUP ACCI-
 DENT AND HEALTH INSURANCE POLICY ISSUED BY AN INSURER LICENSED TO  WRITE
 ACCIDENT  AND  HEALTH INSURANCE IN THIS STATE OR A GROUP CONTRACT ISSUED
 BY A CORPORATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF THIS CHAP-
 TER, EXCLUDING COMMUNITY-RATED POLICIES  OR  CONTRACTS  SUBJECT  TO  THE
 REQUIREMENTS  OF  SECTION  THREE THOUSAND TWO HUNDRED THIRTY-ONE OR FOUR
 THOUSAND THREE HUNDRED SEVENTEEN OF THIS CHAPTER.
   (2)  NOTWITHSTANDING  SUBSECTION  (C)  OF  THIS  SECTION,  NO  INSURER
 LICENSED  TO  WRITE  ACCIDENT  AND  HEALTH  INSURANCE IN THIS STATE OR A
 CORPORATION ORGANIZED PURSUANT TO ARTICLE FORTY-THREE OF  THIS  CHAPTER,
 OR  OFFICER, AGENT, SOLICITOR OR REPRESENTATIVE THEREOF SHALL BE CONSID-
 ERED TO BE OFFERING AN IMPERMISSIBLE INDUCEMENT OR REBATE IF IT  ADJUSTS
 ITS  PREMIUMS  TO  REFLECT  PAYMENT  OF  A  COMMISSION WITHIN A RANGE OF
 COMMISSION OPTIONS FILED WITH THE SUPERINTENDENT IN ITS PREMIUM RATE  OR
 RATE  MANUAL.  NOR SHALL A PRODUCER OR ANY OTHER PERSON BE CONSIDERED TO
 BE IN VIOLATION OF THIS SECTION FOR ACCEPTING OR PAYING A  PREMIUM  RATE
 THAT  REFLECTS  A COMMISSION WITHIN A PERMISSIBLE RANGE SET FORTH IN THE
 PREMIUM RATE OR RATE MANUAL FILED WITH THE SUPERINTENDENT.
   (3) AN INSURER OR  CORPORATION  MAY  INCLUDE  A  RANGE  OF  COMMISSION
 OPTIONS IN THE PREMIUM RATE OR RATE MANUAL FILED WITH THE SUPERINTENDENT
 TO  PERMIT  ADJUSTMENT  OF  PREMIUMS  TO REFLECT THE COST OF COMMISSIONS
 WITHIN THE FILED RANGES. WITHIN THE FILED RANGE, THE APPLICABLE  COMMIS-
 SION MAY REFLECT AN AMOUNT AGREED UPON BY AND BETWEEN A POLICY HOLDER OR
 CONTRACT  HOLDER  AND  THE INSURER OR CORPORATION OR PRODUCER ENGAGED IN
 THE SALE.  THE APPLICABLE COMMISSION MAY VARY BY GROUP AND A SINGLE-CASE
 FILING MAY BE SUBMITTED  TO  THE  SUPERINTENDENT  IF  NEEDED  TO  OBTAIN
 APPROVAL  OF  A  DISTINCT  COMMISSION  ARRANGEMENT. THE REQUIREMENTS SET
 FORTH IN SECTION TWO THOUSAND ONE HUNDRED NINETEEN OF THIS CHAPTER SHALL
 NOT APPLY WHERE THE PREMIUM AND COMMISSION IS COLLECTED BY  THE  INSURER
 OR CORPORATION AND CONSISTENT WITH AMOUNTS SET FORTH IN THE PREMIUM RATE
 OR RATE MANUAL APPROVED BY THE SUPERINTENDENT.
   (4)  IF  A RANGE OF COMMISSION OPTIONS IS INCLUDED IN THE PREMIUM RATE
 OR RATE MANUAL FILED WITH THE SUPERINTENDENT FOR A  POLICY  OR  CONTRACT
 THAT  IS  SUBJECT  TO  GUARANTEED  ISSUANCE  REQUIREMENTS  SET  FORTH IN
 SUBSECTION (T) OF SECTION THREE  THOUSAND  TWO  HUNDRED  TWENTY-ONE  AND

 A. 9867--A                          3
 
 SUBSECTION (N) OF SECTION FOUR THOUSAND THREE HUNDRED FIVE OF THIS CHAP-
 TER,  THEN  THE FULL RANGE OF COMMISSION OPTIONS INCLUDED IN THE PREMIUM
 RATE OR RATE MANUAL FILED WITH THE SUPERINTENDENT MUST BE MADE AVAILABLE
 TO ALL SIMILARLY SITUATED GROUPS SEEKING TO PURCHASE THE COVERAGE.
   § 2. This act shall take effect immediately.