1 | Representative Farkas offered the following: |
2 |
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3 | Amendment to Amendment (455143) |
4 | Remove lines 800 through 818 and insert: |
5 | in the last contract or calendar year when the majority of the |
6 | members of a health individual covered by such plan are is |
7 | enrolled in and maintain maintains participation in any health |
8 | wellness, maintenance, or improvement program offered by the |
9 | group contract holder and approved by the health plan. The group |
10 | individual must provide evidence of demonstrative maintenance or |
11 | improvement of his or her health status as determined by |
12 | assessments of agreed-upon health status indicators between the |
13 | group individual and the health insurer, including, but not |
14 | limited to, reduction in weight, body mass index, and smoking |
15 | cessation. Any rebate provided by the health maintenance |
16 | organization insurer is presumed to be appropriate unless |
17 | credible data demonstrates otherwise or unless such rebate |
18 | program requires the insured to incur costs to qualify for the |
19 | rebate that equal or exceed the value of the rebate, but in no |
20 | event shall the rebate not exceed 10 percent of paid premiums. |
21 | (b) The premium rebate authorized by this section shall be |
22 | effective for a subscriber an insured on an annual basis, unless |
23 | the number of participating members on the |