CS/CS/HB 445

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