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Who cares
Headline styles
Sponsors
3 Co-sponsors
History
- Referred to insurance
- Referred to insurance
Companion bill
The same bill in the other chamber. A bill becomes law when one version passes both houses and the governor signs it, so either number can carry it.
Authorizes health insurers to provide actuarially appropriate reductions in health insurance premiums for participation in a wellness program
In Assembly Committee · Insurance · Sponsor Rory Lancman
Full text
The text isn't available here yet. Check nysenate.gov.
Sponsor's memo
BILL NUMBER:S4609
Title of bill
An act to amend the insurance law and the public health law, in relation to making actuarially appropriate reductions in health insurance premiums in return for an enrollee's or insured's participation in a qualified wellness program
Purpose
To help curtail future health insurance premium increases, this bill authorizes health insurers and health maintenance organizations (HMOs) to offer an actuarially appropriate premium discount or other benefits or enhancements to covered persons that participate in a qualified wellness program. Such program must be approved by the Superintendent of Insurance.
Summary of provisions
Section 1: Amends Insurance Law section 3231 to permit insurers and HMOs that offer individual or small group insurance policies to offer an actuarially appropriate premium discount or other benefits or enhancements to those individuals that participate in a qualified wellness program. Such qualified wellness program must be approved by the Superintendent of Insurance. Further, such qualified Wellness program can be either a risk management system that identifies at-risk populations or any other systematic program or course of medical conduct which helps to promote physical and mental fitness, helps to prevent or mitigate acute or chronic sickness, disease or pain, or which minimizes adverse health consequences due to lifestyle. To ensure that the community rating laws are not affected, the insurer or HMO shall not require specific medical outcomes as a result of an insured's adherence to the approved wellness program.
Section 2: Amends Insurance Law section 4235(h) to permit insurers and HMOs that offer accident and health insurance (large group policies) to offer an actuarially appropriate premium discount or other benefits or enhancements to those persons that participate in a qualified wellness program approved by the Superintendent.
Section 3: Amends Insurance Law section 4317 to permit Article 43 insurers and HMOs that offer individual or small group contracts to offer, subject to the approval of the Superintendent, an actuarially appropriate premium discount or other enhancements to those persons that participate in a qualified wellness program.
Section 4. Amends Insurance Law section 4326 to permit insurers and HMOs that offer the subsidized "Healthy New York" policies to offer an actuarially appropriate premium discount or other enhancements to those persons that participate in a qualified wellness program.
Section 5. Amends Public Health Law section 4405 to provide for the same actuarially appropriate reduction in HMO health policies for those who participate in a qualified wellness program.
Existing law
Under current law, health insurers and HMOs are not allowed to offer an actuarially appropriate discount in premium rates to those persons that participate in a qualified wellness program.
Justification
Every year, health insurance rate payers are experiencing rapidly increasing premium rate increases. This increased cost of purchasing health insurance continues to force small and large businesses alike to drop health insurance coverage for their employees and their families. This bill provides a new avenue to help keep health insurance rates low. Further, it encourages persons, via a financial incentive, to participate in qualified wellness programs to enhance their physical and mental fitness and wellbeing.
We need to develop new and innovative ways to help to minimize future rate increases so that individuals will be able to afford the health care they need. Further, reducing or curtailing future health insurance premium increases will help to keep New York's businesses competitive with out of state firms.
Legislative history
New Bill.
Fiscal implications
None.
Local fiscal implications
None.
Effective date
180 days after it shall have become law.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.