State Codes and Statutes
Statutes > New-york > Isc > Article-32 > 3239§ 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.
