Assembly Bill A4696

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   4696
 
                        2025-2026 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             February 4, 2025
                                ___________
 
 Introduced by M. of A. HUNTER -- read once and referred 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 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

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD05810-01-5
 A. 4696                             2
              

 
 contract for services of any kind,  or  any  valuable  consideration  or
 inducement whatever 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  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
 A. 4696                             3

 THAT IS  SUBJECT  TO  GUARANTEED  ISSUANCE  REQUIREMENTS  SET  FORTH  IN
 SUBSECTION  (T)  OF  SECTION  THREE  THOUSAND TWO HUNDRED TWENTY-ONE AND
 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.