S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   8019
 
                             I N  S E N A T E
 
                              January 5, 2024
                                ___________
 
 Introduced  by  Sen. BRESLIN -- read twice and ordered printed, and when
   printed to be committed to the Committee on Rules
 
 AN ACT to amend the insurance law, in relation to wellness programs; and
   to amend a chapter of the laws of  2023  amending  the  insurance  law
   relating  to authorizing life insurers to establish wellness programs,
   as proposed in legislative bills numbers S. 5890-A and A.  2853-B,  in
   relation to the effectiveness thereof
 
   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 3239 of the insurance law, as amended by a  chapter
 of  the  laws of 2023 amending the insurance law relating to authorizing
 life insurers to establish wellness programs, as proposed in legislative
 bills numbers S. 5890-A and A. 2853-B, is amended to read as follows:
   § 3239. Wellness programs. (a)  An  insurer  licensed  to  write  life
 insurance may establish a wellness program in conjunction with its issu-
 ance  of  life insurance policies and an insurer licensed to write acci-
 dent and health insurance, a corporation organized pursuant  to  article
 forty-three of this chapter, a health maintenance organization certified
 pursuant  to article forty-four of the public health law and a municipal
 cooperative health benefits plan may establish  a  wellness  program  in
 conjunction  with  its issuance of a group accident and health insurance
 policy or group subscriber contract. A "wellness program" is  a  program
 designed  to  promote  health,  longevity  or  prevent  disease that may
 contain rewards and incentives for participation.  A "WELLNESS  PROGRAM"
 SHALL  NOT  INCLUDE  LIMITED BENEFITS HEALTH INSURANCE. Participation in
 the wellness program shall be available to similarly-situated members of
 the group or with regard to  life insurance, to all insureds within  the
 same  class  [in a manner that is not unfairly discriminatory] AND EQUAL
 EXPECTATION OF LIFE and shall be voluntary on the part of the member  or
 insured.    With regard to life insurance, an insurer is prohibited from
 increasing premiums or charges stated in  the  policy  as  a  result  of
 participation  or  non-participation  in  the  program. The terms of the
 wellness program shall be set forth in the policy  or  contract.    WITH
 REGARD  TO A WELLNESS PROGRAM ESTABLISHED IN CONNECTION WITH LIFE INSUR-
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD07895-06-4
 S. 8019                             2
 
 ANCE, AN INSURER SHALL PROVIDE A PROMINENT DISCLOSURE TO AN APPLICANT AT
 OR PRIOR TO THE TIME OF APPLICATION  THAT  THE  PROGRAM  IS  NOT  HEALTH
 INSURANCE  AND  PARTICIPANTS SHOULD NOT VIEW THE PROGRAM AS A SUBSTITUTE
 FOR THE PURCHASE OF HEALTH INSURANCE.
   (b) A wellness program may include, but is not limited to, the follow-
 ing programs or services:
   (1) the use of a health risk assessment tool;
   (2) a smoking cessation program;
   (3) a weight management program;
   (4) a stress and/or hypertension management program;
   (5) a worker injury prevention program;
   (6) a nutrition education program;
   (7) health or fitness incentive programs;
   (8)  a coordinated weight management, nutrition, stress management and
 physical fitness program to combat  the  high  incidence  of  adult  and
 childhood obesity, asthma and other chronic respiratory conditions;
   (9) a substance or alcohol abuse cessation program;
   (10) a program to manage and cope with chronic pain;
   (11)  a  [preventative] PREVENTIVE care PROGRAM, screenings (INCLUDING
 BIOMETRIC SCREENINGS), or chronic disease management program; and
   (12) a STRESS MANAGEMENT PROGRAM, INCLUDING PARTICIPATION IN  A  medi-
 tation[,] OR sleep improvement [or similar] program [or service].
   (c)(1)  A  wellness program may use rewards and incentives for partic-
 ipation provided  that  where  the  group  health  insurance  policy  or
 subscriber  contract  is required to be community-rated, the rewards and
 incentives shall not include a discounted premium rate or  a  rebate  or
 refund of premium.
   (2) Permissible rewards and incentives may include:
   (A)  full  or  partial  reimbursement  of the cost of participating in
 smoking cessation, weight management, stress and/or hypertension, worker
 injury prevention,  nutrition  education,  substance  or  alcohol  abuse
 cessation,  [preventative]  PREVENTIVE  care  programs, [or] screenings,
 chronic disease management programs,  or  chronic  pain  management  and
 coping programs;
   (B)  full  or  partial  reimbursement  of  the cost of membership in a
 health club or fitness center;
   (C) (1) the waiver or reduction of copayments, coinsurance and deduct-
 ibles for preventive services covered under the group  health  insurance
 policy or subscriber contract;
   (2)  a  premium  refund,  discount,  or  policy value credit, or other
 increase in benefits or decrease in charges under a life insurance poli-
 cy;
   (D) monetary rewards in the form of  gift  cards,  gift  certificates,
 vouchers  or  discounts  on  products  or services [that are intended to
 incent behavioral changes that improve the health or reduce the risk  of
 death of the insured] IN RETURN FOR ENGAGING IN HEALTHY BEHAVIORS;
   (E)  full  or  partial reimbursement of the cost of participating in a
 stress management program or  activity,  including  participation  in  a
 meditation[,]  OR  sleep  improvement [or similar] program [or service],
 provided that such program or  activity  shall  be  based  on  data  and
 research  that  the  program  or  service  can be reasonably expected to
 result in overall good health, well being, or improved mortality risk;
   (F) full or partial reimbursement of the cost of  participating  in  a
 health or fitness program; AND
   (G) full or partial reimbursement of the cost of a wearable device and
 any associated subscription membership [that can be used] to track phys-
 S. 8019                             3
 
 ical activity or biometric data, and which incents behavioral changes to
 improve [the] health or [reduce the risk of death of the insured; and
   (H)  full  or partial reimbursement of biometric screenings] MORTALITY
 RISK.
   (3) Where the reward involves a group  member's  meeting  a  specified
 standard  based  on  a  health  condition,  the wellness program under a
 health insurance policy [must] SHALL meet the  requirements  of  45  CFR
 Part 146.
   (4)  A  reward or incentive [which] THAT involves a discounted premium
 rate or a rebate or refund of premium  under  [a]  ACCIDENT  AND  health
 insurance  [policy]  POLICIES  shall be based on actuarial demonstration
 that the wellness program can reasonably be expected to  result  in  the
 overall  good health and well being of the group. A [reward or incentive
 that involves a discounted premium rate or rebate or refund of]  premium
 REFUND,  DISCOUNT, OR POLICY VALUE CREDIT, OR OTHER INCREASE IN BENEFITS
 OR DECREASE IN CHARGES under [a] life insurance [policy shall be actuar-
 ially supported by data and research that such incentives or rewards, in
 the aggregate, are directed to sharing the benefit of improving expected
 mortality risk] POLICIES IN CONNECTION WITH A WELLNESS PROGRAM SHALL  BE
 BASED  ON  SOUND  ACTUARIAL  PRINCIPLES  RELATED TO ACTUAL OR REASONABLY
 ANTICIPATED experience.  [Data collected]
   (D) FAIR COLLECTION AND USE OF  PERSONAL  INFORMATION.  (1)  NONPUBLIC
 PERSONAL  INFORMATION,  INCLUDING  HEALTH  DATA, AN INSURER COLLECTS AND
 SHARES in connection with a wellness program shall  be  subject  to  all
 state  and federal privacy and security laws AND REGULATIONS PROMULGATED
 THEREUNDER, INCLUDING 11 NYCRR 420.
   (2) WELLNESS PROGRAM PARTICIPANTS SHALL HAVE THE  RIGHT  TO  OBTAIN  A
 COPY OF THEIR WELLNESS PROGRAM INFORMATION AND AN OPPORTUNITY TO CORRECT
 ANY INACCURACIES.
   (3)  AN INSURER MAY CONTRACT WITH A THIRD PARTY FOR PURPOSES OF ADMIN-
 ISTERING OR OPERATING  A  WELLNESS  PROGRAM  ON  SUCH  INSURER'S  BEHALF
 PROVIDED  THAT  THE  INSURER MAINTAINS A SYSTEM OF SUPERVISION TO ENSURE
 COMPLIANCE WITH THIS SECTION, INCLUDING PROCEDURES TO  TAKE  APPROPRIATE
 CORRECTIVE  ACTION  FOR  ANY  PARTICIPANT  HARMED BY A VIOLATION OF THIS
 SECTION BY THE INSURER DIRECTLY OR BY ANY  THIRD  PARTY  WITH  WHOM  THE
 INSURER CONTRACTS.
   § 2. Section 2 of a chapter of the laws of 2023 amending the insurance
 law   relating  to  authorizing  life  insurers  to  establish  wellness
 programs, as proposed in legislative bills  numbers  S.  5890-A  and  A.
 2853-B, is amended to read as follows:
   §  2.  This act shall take effect immediately AND SHALL APPLY TO POLI-
 CIES ISSUED, RENEWED, MODIFIED, OR AMENDED ON OR  AFTER  SUCH  EFFECTIVE
 DATE.
   §  3.  This act shall take effect immediately; provided, however, that
 section one of this act shall take effect on the same date  and  in  the
 same  manner as a chapter of the laws of 2023 amending the insurance law
 relating to authorizing life  insurers to establish  wellness  programs,
 as  proposed in legislative bills numbers S. 5890-A and A. 2853-B, takes
 effect.