New York A 7177: Authorizes health insurers to provide actuarially appropriate reductions in health insurance premiums for participation in a wellness program

Bill Text

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A07177 Summary:

BILL NOA07177 

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SAME ASNo Same As

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SPONSORBichotte Hermelyn

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COSPNSR

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MLTSPNSR

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Amd §§3231, 3239, 4235, 4317 & 4326, Ins L; amd §4405, Pub Health L

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Authorizes health insurers and health maintenance organizations, subject to the approval of the superintendent of financial services, to provide actuarially appropriate reductions in health insurance premiums or other benefits or enhancements for an enrollee's or insured's participation in a qualified wellness program.

Go to top A07177 Actions:

BILL NOA07177 

&nbsp

03/21/2025referred to insurance

01/07/2026referred to insurance

Go to topA07177 Committee&nbspVotes:

Go to topA07177 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topA07177 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 7177

 2025-2026 Regular Sessions

 IN ASSEMBLY

 March 21, 2025
 ___________

 Introduced by M. of A. BICHOTTE HERMELYN -- read once and referred to
 the Committee on Insurance

 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

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 Section 1. Section 3231 of the insurance law, as added by chapter 501
 2 of the laws of 1992, is amended by adding a new subsection (c-1) to read
 3 as follows:
 4 (c-1) Subject to the approval of the superintendent, an insurer or
 5 health maintenance organization issuing an individual or group health
 6 insurance policy pursuant to this section may provide for an actuarially
 7 appropriate reduction in premium rates or other benefits or enhancements
 8 approved by the superintendent to encourage an enrollee's or insured's
 9 active participation in a qualified wellness program. A qualified well-
 10 ness program can be a risk management system that identifies at-risk
 11 populations or any other systematic program or course of medical conduct
 12 which helps to promote physical and mental fitness, health and well-be-
 13 ing, helps to prevent or mitigate the conditions of acute or chronic
 14 sickness, disease or pain, or which minimizes adverse health conse-
 15 quences due to lifestyle. Such a wellness program may have some or all
 16 of the following elements to advance the physical health and mental
 17 well-being of its participants:
 18 (1) an education program to increase the awareness of and dissem-
 19 ination of information about pursuing healthier lifestyles, and which
 20 warns about risks of pursuing environmental or behavioral activities
 21 that are detrimental to human health. In addition, information on the
 22 availability of health screening tests to assist in the early identifi-

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD11010-01-5

 A. 7177 2

 1 cation and treatment of diseases such as cancer, heart disease, hyper-
 2 tension, diabetes, asthma, obesity or other adverse health afflictions;
 3 (2) a program that encourages behavioral practices that either encour-
 4 age healthy living activities or discourage unhealthy living activities.
 5 Such activities or practices may include wellness programs, as provided
 6 under section three thousand two hundred thirty-nine of this article;
 7 and
 8 (3) the monitoring of the progress of each covered person to track
 9 such person's adherence to such wellness program and to provide assist-
 10 ance and moral support to such covered person to assist them to attain
 11 the goals of the covered person's wellness program.
 12 Such wellness program shall demonstrate actuarially that it encourages
 13 the general good health and well-being of the covered population. The
 14 insurer or health maintenance organization shall not require specific
 15 outcomes as a result of an enrollee's or insured's adherence to the
 16 approved wellness program.
 17 § 2. Subsections (a), (b) and (c) of section 3239 of the insurance
 18 law, as amended by chapter 3 of the laws of 2024, are amended to read as
 19 follows:
 20 (a) An insurer licensed to