N.Y. Ins. Law § 3239

§ 3239. Wellness programs. (a) An insurer licensed to write life\ninsurance may establish a wellness program in conjunction with its\nissuance of life insurance policies and an insurer licensed to write\naccident and health insurance, a corporation organized pursuant to\narticle forty-three of this chapter, a health maintenance organization\ncertified pursuant to article forty-four of the public health law and a\nmunicipal cooperative health benefits plan may establish a wellness\nprogram in conjunction with its issuance of a group accident and health\ninsurance policy or group subscriber contract. A "wellness program" is a\nprogram designed to promote health, longevity or prevent disease that\nmay contain rewards and incentives for participation. Participation in\nthe wellness program shall be available to similarly-situated members of\nthe group or with regard to life insurance, to all insureds within the\nsame class in a manner that is not unfairly discriminatory and shall be\nvoluntary on the part of the member or insured. With regard to life\ninsurance, an insurer is prohibited from increasing premiums or charges\nstated in the policy as a result of participation or non-participation\nin the program. The terms of the wellness program shall be set forth in\nthe policy or contract.\n (b) A wellness program may include, but is not limited to, the\nfollowing programs or services:\n (1) the use of a health risk assessment tool;\n (2) a smoking cessation program;\n (3) a weight management program;\n (4) a stress and/or hypertension management program;\n (5) a worker injury prevention program;\n (6) a nutrition education program;\n (7) health or fitness incentive programs;\n (8) a coordinated weight management, nutrition, stress management and\nphysical fitness program to combat the high incidence of adult and\nchildhood obesity, asthma and other chronic respiratory conditions;\n (9) a substance or alcohol abuse cessation program;\n (10) a program to manage and cope with chronic pain;\n (11) a preventative care, screenings, or chronic disease management\nprogram; and\n (12) a meditation, sleep improvement or similar program or service.\n (c)(1) A wellness program may use rewards and incentives for\nparticipation provided that where the group health insurance policy or\nsubscriber contract is required to be community-rated, the rewards and\nincentives shall not include a discounted premium rate or a rebate or\nrefund of premium.\n (2) Permissible rewards and incentives may include:\n (A) full or partial reimbursement of the cost of participating in\nsmoking cessation, weight management, stress and/or hypertension, worker\ninjury prevention, nutrition education, substance or alcohol abuse\ncessation, preventative care programs, or screenings, chronic disease\nmanagement programs, or chronic pain management and coping programs;\n (B) full or partial reimbursement of the cost of membership in a\nhealth club or fitness center;\n (C) (1) the waiver or reduction of copayments, coinsurance and\ndeductibles for preventive services covered under the group health\ninsurance policy or subscriber contract;\n (2) a premium refund, discount, or policy value credit, or other\nincrease in benefits or decrease in charges under a life insurance\npolicy;\n (D) monetary rewards in the form of gift cards, gift certificates,\nvouchers or discounts on products or services that are intended to\nincent behavioral changes that improve the health or reduce the risk of\ndeath of the insured;\n (E) full or partial reimbursement of the cost of participating in a\nstress management program or activity, including participation in a\nmeditation, sleep improvement or similar program or service, provided\nthat such program or activity shall be based on data and research that\nthe program or service can be reasonably expected to result in overall\ngood health, well being, or improved mortality risk;\n (F) full or partial reimbursement of the cost of participating in a\nhealth or fitness program;\n (G) full or partial reimbursement of the cost of a wearable device and\nany associated subscription membership that can be used to track\nphysical activity or biometric data, and which incents behavioral\nchanges to improve the health or reduce the risk of death of the\ninsured; and\n (H) full or partial reimbursement of biometric screenings.\n (3) Where the reward involves a group member's meeting a specified\nstandard based on a health condition, the wellness program under a\nhealth insurance policy must meet the requirements of 45 CFR Part 146.\n (4) A reward or incentive which involves a discounted premium rate or\na rebate or refund of premium under a health insurance policy shall be\nbased on actuarial demonstration that the wellness program can\nreasonably be expected to result in the overall good health and well\nbeing of the group. A reward or incentive that involves a discounted\npremium rate or rebate or refund of premium under a life insurance\npolicy shall be actuarially supported by data and research that such\nincentives or rewards, in the aggregate, are directed to sharing the\nbenefit of improving expected mortality risk experience. Data collected\nin connection with a wellness program shall be subject to all state and\nfederal privacy and security laws.\n