CS/CS/HB 445

1	A bill to be entitled
2	An act relating to wellness or health improvement
3	programs; amending s. 626.9541, F.S.; authorizing insurers
4	to offer a voluntary wellness or health improvement
5	program and to encourage or reward participation in the
6	program by offering rewards or incentives to health
7	benefit plan members; authorizing insurers to require plan
8	members not participating in the wellness or health
9	improvement programs to provide verification that their
10	medical condition warrants nonparticipation in order for
11	the nonparticipants to receive rewards or incentives;
12	requiring that the reward or incentive be disclosed in the
13	policy or certificate; amending s. 641.3903, F.S.;
14	providing for a wellness or health improvement program;
15	providing authorization to offer certain rewards or
16	incentives for participation; authorizing verification of
17	a nonparticipant's medical condition; requiring that the
18	reward or incentive be disclosed in the policy or
19	certificate; providing an effective date.
20
21	Be It Enacted by the Legislature of the State of Florida:
22
23	Section 1.  Subsection (4) is added to section 626.9541,
24	Florida Statutes, to read:
25	626.9541  Unfair methods of competition and unfair or
26	deceptive acts or practices defined.-
27	(4)  WELLNESS OR HEALTH IMPROVEMENT PROGRAMS.-
28	(a)  Authorization to offer rewards or incentives for
29	participation.-An insurer issuing a group or individual health
30	benefit plan may offer a voluntary wellness or health
31	improvement program and may encourage or reward participation in
32	the program by authorizing rewards or incentives, including, but
33	not limited to, merchandise, gift cards, debit cards, premium
34	discounts or rebates, contributions to a member's health savings
35	account, or modifications to copayment, deductible, or
36	coinsurance amounts. Any advertisement of the program is not
37	subject to the limitations set forth in paragraph (1)(m).
38	(b)  Verification of medical condition by nonparticipants.-
39	An insurer may require a health benefit plan member to provide
40	verification, such as an affirming statement from the member's
41	physician, that the member's medical condition makes it
42	unreasonably difficult or inadvisable to participate in the
43	wellness or health improvement program in order for that
44	nonparticipant to receive the reward or incentive.
45	(c)  Disclosure requirement.-Any reward or incentive
46	offered under this subsection shall be disclosed in the policy
47	or certificate.
48	(d)  Other incentives.-This subsection does not prohibit
49	insurers from offering other incentives or rewards for adherence
50	to a wellness or health improvement program if otherwise
51	authorized by state or federal law.
52	Section 2.  Subsection (15) is added to section 641.3903,
53	Florida Statutes, to read:
54	641.3903  Unfair methods of competition and unfair or
55	deceptive acts or practices defined.-The following are defined
56	as unfair methods of competition and unfair or deceptive acts or
57	practices:
58	(15)  EXCEPTION FOR WELLNESS OR HEALTH IMPROVEMENT
59	PROGRAMS.-
60	(a)  Authorization to offer rewards or incentives for
61	participation.-A health maintenance organization issuing a group
62	or individual health benefit plan may offer a voluntary wellness
63	or health improvement program and may encourage or reward
64	participation in the program by authorizing rewards or
65	incentives, including, but not limited to, merchandise, gift
66	cards, debit cards, premium discounts or rebates, contributions
67	to a member's health savings account, or modifications to
68	copayment, deductible, or coinsurance amounts.
69	(b)  Verification of medical condition by nonparticipants.-
70	A health maintenance organization may require a health benefit
71	plan member to provide verification, such as an affirming
72	statement from the member's physician, that the member's medical
73	condition makes it unreasonably difficult or inadvisable to
74	participate in the wellness or health improvement program.
75	(c)  Disclosure required for legality.-A reward or
76	incentive offered under this subsection is not a violation of
77	this section if the program is disclosed in the contract or
78	certificate.
79	(d)  Other incentives.-This subsection does not prohibit a
80	health maintenance organization from offering other incentives
81	or rewards for adherence to a wellness or health improvement
82	program if otherwise authorized by state or federal law.
83	Section 3.  This act shall take effect July 1, 2011.

CODING: Words stricken are deletions; words underlined are additions.