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Sponsors
1 Co-sponsor
History
- Referred to insurance
- Referred to insurance
Full text
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Sponsor's memo
BILL NUMBER:S1869
Title of bill
An act to amend the insurance law, in relation to making actuarially appropriate reductions in health insurance premiums in return for an enrollee's or insured's participation in a bona fide well- ness program; and to establish an advisory committee on wellness to report thereon
Purpose
To help curtail future health insurance premium increases, this legislation permits health insurers and health maintenance organ- izations (HMOs) to offer an actuarially appropriate premium discount to covered persons that participate in a bona fide wellness program that is approved by the Superintendent of Insurance.
Read the full memo (761 words)
Summary of provisions
§ 1- Amends § 3231 of the Insurance Law to permit insurers and HMOs that offer individual or small group insurance policies to offer an actuari- ally appropriate premium discount to those individuals that participate in a bona fide wellness program. A bona fide wellness program is one that is approved by the Superintendent of Insurance and which is either a risk management system that identifies at-risk populations or any other systematic program or course of medical conduct which helps to promote good health, helps to prevent or mitigate acute or chronic sick- ness or disease, 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.
§ 2- Amends subsection (h) of § 4235 of the Insurance Law to permit insurers and HMO's that offer accident and health insurance (large group policies) to offer an actuarially appropriate premium discount to those persons that participate in a bona fide wellness program approved by the Superintendent.
§ 3- Amends § 4317 of the Insurance Law to permit Article 43 insurers and HMO's that offer individual or small group contracts to offer, subject to the approval of the Superintendent, an actuarially appropri- ate premium discount to those persons that participate in a bona fide wellness program.
§ 4- Amends subsection (n) of § 4326 of the Insurance Law to permit insurers and HMO's that offer the new subsidized "Healthy New York" policies to offer an actuarially appropriate premium discount to those persons that participate in a wellness program.
§ 5- Creates a 15 member Blue Ribbon Advisory Committee on Wellness to be chaired by the Commissioner of Health and Superintendent of Insurance or their designees. This Committee shall look into and make recommenda- tions on developing a comprehensive wellness program that can be imple-
mented by New York State, local county health departments, hospitals, physicians, insurers, HMOs and other health care providers.
§ 6- Effective date.
Existing law
Currently, the Insurance Law does not authorize insurers and HMOs to offer an actuarially appropriate discount in premium rates to those persons that participate in a bona fide wellness program.
Justification
In the Hudson Valley and in other parts of this state, many health insurance rate payers are experiencing rate increases of between 10 to 20 percent. This significantly increased cost of health insurance may encourage small and large businesses to drop health insur- ance coverage for their employees and make the cost of health insurance even more prohibitive for those in the individual direct pay market.
New York State needs to develop more innovative ways to help to minimize future rate increases so that individuals will be able to obtain the health care they need. This bill establishes a blue ribbon advisory committee on wellness whose charge shall be to investigate and develop innovative ways to alter how health care is provided and financed so as to encourage general good health and well-being of this state's citi- zens. Encouraging a more systematic approach to increasing the good health of the state's population will not only enhance quality of life, it will also help to reduce health care costs and hence premiums charged to individuals and large & small employers. In addition, reducing or curtailing subsequent health insurance premium increases will assist New York's businesses to remain competitive in this world market and keep down the cost of doing business in this state.
This legislation is not an insurance mandate bill in that it merely permits, it does not require, insurers and HMOs to develop or implement Wellness programs for its insureds. It is hoped that some of the well- ness programs may be developed in conjunction with the Advisory Commit- tee.
Legislative history
2011-2012: A.3133/S.3991 2009-2010: A.2867/S.651; 2007-2008: A.2357/S.204; 2005-2006: A.3683/S.413; 2003-2004: A.3344/S.1223, 2001-2002: A.5851/S.2186.
Fiscal implications
None.
Effective date
This act shall take effect immediately.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.