S T A T E O F N E W Y O R K
________________________________________________________________________
5929
2019-2020 Regular Sessions
I N S E N A T E
May 16, 2019
___________
Introduced by Sen. BRESLIN -- read twice and ordered printed, and when
printed to be committed to the Committee on Insurance
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 a new
subsection (g) is added to read as follows:
(c) Except as permitted by section three thousand two hundred thirty-
nine of this chapter or [subsection] SUBSECTIONS (f) AND (G) of this
section, no such life insurance company and no such savings and insur-
ance bank and no officer, agent, solicitor or representative thereof 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 accident 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 limited 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
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD11769-01-9
S. 5929 2
services of any kind, or any valuable consideration or inducement what-
ever which is not specified in such policy or contract.
(G) (1) NOTWITHSTANDING SUBSECTION (C) OF THIS SECTION, AN INSURER
LICENSED TO WRITE ACCIDENT AND HEALTH INSURANCE IN THIS STATE, A CORPO-
RATION 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 APPLY TO THE SUPERINTENDENT FOR APPROVAL TO
OFFER INCENTIVES OR REWARDS, NOT SPECIFIED IN THE POLICY, IF SUCH INCEN-
TIVES OR REWARDS OPERATE TO SUPPORT WELLNESS, PRIMARY AND PREVENTATIVE
CARE, POPULATION HEALTH, CARE COORDINATION, CASE MANAGEMENT, DISEASE
MANAGEMENT, MENTAL HEALTH AND SUBSTANCE USE DISORDER TREATMENT INITI-
ATIVES, EVIDENCED-BASED TREATMENT, OR QUALITY AND COST CONTAINMENT
INITIATIVES.
(2) PARTICIPATION IN THE OFFERING OF INCENTIVES OR REWARDS SHALL BE
VOLUNTARY AND OFFERED ON A NON-DISCRIMINATORY BASIS TO SIMILARLY SITU-
ATED MEMBERS, PROVIDED, HOWEVER, INCENTIVES MAY BE TARGETED AT DISCRETE
TARGET POPULATIONS INCLUDING, BUT NOT LIMITED TO, TARGET POPULATIONS
DETERMINED BASED ON AGE, SEX, GEOGRAPHIC LOCATION OR HEALTH STATUS.
(3) INCENTIVES OR REWARDS OFFERED UNDER THIS SUBSECTION MAY BE OFFERED
IN CONJUNCTION WITH NON-DISCRIMINATORY CONTESTS OR RAFFLES.
(4) WHERE EARNING AN INCENTIVE OR REWARD INVOLVES A MEMBER MEETING A
SPECIFIED STANDARD BASED ON A HEALTH CONDITION, SUCH INCENTIVE OR REWARD
PROGRAM SHALL MEET THE REQUIREMENTS OF 45 CPR PART 146.
(5) A FULL DESCRIPTION OF ANY INCENTIVE OR REWARD PROGRAM APPROVED BY
THE SUPERINTENDENT UNDER THIS SUBSECTION, ALONG WITH ANY RELATED INCEN-
TIVES AND REWARDS, SHALL BE PROVIDED TO ALL ELIGIBLE MEMBERS IN A FORMAT
APPROVED BY THE SUPERINTENDENT. SUCH PROGRAM AND ANY RELATED INCENTIVE
OR REWARD SHALL NOT NEED TO BE DESCRIBED IN THE POLICY, CONTRACT, OR
CERTIFICATE AND MAY BE OFFERED FOR AN ABBREVIATED PERIOD THAT DOES NOT
ALIGN WITH THE POLICY OR CONTRACT TERM, HOWEVER, SUCH INCENTIVE OR
REWARD PROGRAM SHALL BE ACTUARIALLY SUPPORTED BY APPROPRIATE PREMIUM
RATES.
§ 2. This act shall take effect immediately.