2010 New York Code
ISC - Insurance
Article 32 - (3201 - 3239) INSURANCE CONTRACTS - LIFE, ACCIDENT AND HEALTH, ANNUITIES
3239 - Wellness programs.

§  3239.  Wellness programs. (a) An insurer licensed to write accident
  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 and prevent disease that may contain rewards
  and incentives for participation. Participation in the wellness  program
  shall  be available to similarly-situated members of the group and shall
  be voluntary on the part of  the  member.  The  terms  of  the  wellness
  program shall be set forth in the policy or contract.
    (b)  A  wellness  program  may  include,  but  is  not limited to, the
  following 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 management program;
    (5) a worker injury prevention program;
    (6) a nutrition education program; and
    (7) health or fitness incentive programs.
    (c)(1)  A  wellness  program  may  use  rewards  and  incentives   for
  participation  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 include:
    (A) full or partial reimbursement of  the  cost  of  participating  in
  smoking cessation or weight management programs;
    (B)  full  or  partial  reimbursement  of  the cost of membership in a
  health club or fitness center;
    (C) the waiver or reduction of copayments, coinsurance and deductibles
  for preventive services covered under the  group  policy  or  subscriber
  contract; and
    (D)  monetary  rewards in the form of gift cards or gift certificates,
  so long as the recipient of the reward is encouraged to use  the  reward
  for  a  product  or a service that promotes good health, such as healthy
  cook books, over the counter vitamins or exercise equipment.
    (3) Where the reward involves a group  member's  meeting  a  specified
  standard based on a health condition, the wellness program must meet the
  requirements of 45 CFR Part 146.
    (4)  A reward or incentive which involves a discounted premium rate or
  a rebate or refund of premium 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.

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