Florida Senate - 2011                        COMMITTEE AMENDMENT
       Bill No. SB 1522
       
       
       
       
       
       
                                Barcode 922012                          
       
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                  Comm: RCS            .                                
                  03/22/2011           .                                
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       The Committee on Health Regulation (Gaetz) recommended the
       following:
       
    1         Senate Amendment (with title amendment)
    2  
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (4) is added to section 626.9541,
    6  Florida Statutes, to read:
    7         626.9541 Unfair methods of competition and unfair or
    8  deceptive acts or practices defined.—
    9         (4) WELLNESS OR HEALTH IMPROVEMENT PROGRAMS.—
   10         (a) Authorization to offer rewards or incentives for
   11  participation.—An insurer issuing a group or individual health
   12  benefit plan may offer a voluntary wellness or health
   13  improvement program and may encourage or reward participation in
   14  the program by authorizing rewards or incentives, including, but
   15  not limited to, merchandise, gift cards, debit cards, premium
   16  discounts or rebates, contributions to a member’s health savings
   17  account, or modifications to copayment, deductible, or
   18  coinsurance amounts. Any advertisement of the program is not
   19  subject to the limitations set forth in paragraph (1)(m).
   20         (b) Verification of medical condition by nonparticipants
   21  due to medical condition.—An insurer may require a health
   22  benefit plan member to provide verification, such as an
   23  affirming statement from the member’s physician, that the
   24  member’s medical condition makes it unreasonably difficult or
   25  inadvisable to participate in the wellness or health improvement
   26  program in order for that nonparticipant to receive the reward
   27  or incentive.
   28         (c) Disclosure requirement.A reward or incentive offered
   29  under this subsection shall be disclosed in the policy or
   30  certificate.
   31         (d) Other incentives.—This subsection does not prohibit
   32  insurers from offering other incentives or rewards for adherence
   33  to a wellness or health improvement program if otherwise
   34  authorized by state or federal law.
   35         Section 2. Section 627.6402, Florida Statutes, is amended
   36  to read:
   37         627.6402 Insurance rebates or rewards for healthy
   38  lifestyles.—
   39         (1) Any rate, rating schedule, or rating manual for an
   40  individual health insurance policy filed with the office may
   41  provide for an appropriate rebate of premiums paid in the last
   42  year when the individual covered by such plan is enrolled in and
   43  maintains participation in any health wellness, maintenance, or
   44  improvement program approved by the health plan. The rebate may
   45  be based on premiums paid in the last calendar year or the last
   46  policy year. The individual must provide evidence of
   47  demonstrative maintenance or improvement of the individual’s
   48  health status as determined by assessments of agreed-upon health
   49  status indicators between the individual and the health insurer,
   50  including, but not limited to, reduction in weight, body mass
   51  index, and smoking cessation. Any rebate provided by the health
   52  insurer is presumed to be appropriate unless credible data
   53  demonstrates otherwise, or unless such rebate program requires
   54  the insured to incur costs to qualify for the rebate which equal
   55  or exceed the value of the rebate, but in no event shall the
   56  rebate exceed 10 percent of paid premiums.
   57         (2) The premium rebate authorized by this section shall be
   58  effective for an insured on an annual basis, unless the
   59  individual fails to maintain or improve his or her health status
   60  while participating in an approved wellness program, or credible
   61  evidence demonstrates that the individual is not participating
   62  in the approved wellness program.
   63         (3) Rebates or rewards are permitted pursuant to s.
   64  626.9541(4).
   65         Section 3. Section 627.65626, Florida Statutes, is amended
   66  to read:
   67         627.65626 Insurance rebates or rewards for healthy
   68  lifestyles.—
   69         (1) Any rate, rating schedule, or rating manual for a
   70  health insurance policy that provides creditable coverage as
   71  defined in s. 627.6561(5) filed with the office shall provide
   72  for an appropriate rebate of premiums paid in the last policy
   73  year, contract year, or calendar year when the majority of
   74  members of a health plan have enrolled and maintained
   75  participation in any health wellness, maintenance, or
   76  improvement program offered by the group policyholder and health
   77  plan. The rebate may be based upon premiums paid in the last
   78  calendar year or policy year. The group must provide evidence of
   79  demonstrative maintenance or improvement of the enrollees’
   80  health status as determined by assessments of agreed-upon health
   81  status indicators between the policyholder and the health
   82  insurer, including, but not limited to, reduction in weight,
   83  body mass index, and smoking cessation. The group or health
   84  insurer may contract with a third-party administrator to
   85  assemble and report the health status required in this
   86  subsection between the policyholder and the health insurer. Any
   87  rebate provided by the health insurer is presumed to be
   88  appropriate unless credible data demonstrates otherwise, or
   89  unless the rebate program requires the insured to incur costs to
   90  qualify for the rebate which equal or exceed the value of the
   91  rebate, but the rebate may not exceed 10 percent of paid
   92  premiums.
   93         (2) The premium rebate authorized by this section shall be
   94  effective for an insured on an annual basis unless the number of
   95  participating members on the policy renewal anniversary becomes
   96  less than the majority of the members eligible for participation
   97  in the wellness program.
   98         (3) Rebates or rewards are permitted pursuant to s.
   99  626.9541(4).
  100         Section 4. Subsection (40) of section 641.31, Florida
  101  Statutes, is amended to read:
  102         641.31 Health maintenance contracts.—
  103         (40) A health maintenance organization that issues
  104  individual or group contracts may offer a reward or premium
  105  rebate pursuant to s. 656.9541(4) for a healthy lifestyle
  106  program.
  107         (a) Any group rate, rating schedule, or rating manual for a
  108  health maintenance organization policy, which provides
  109  creditable coverage as defined in s. 627.6561(5), filed with the
  110  office shall provide for an appropriate rebate of premiums paid
  111  in the last policy year, contract year, or calendar year when
  112  the majority of members of a health plan are enrolled in and
  113  have maintained participation in any health wellness,
  114  maintenance, or improvement program offered by the group
  115  contract holder. The group must provide evidence of
  116  demonstrative maintenance or improvement of his or her health
  117  status as determined by assessments of agreed-upon health status
  118  indicators between the group and the health insurer, including,
  119  but not limited to, reduction in weight, body mass index, and
  120  smoking cessation. Any rebate provided by the health maintenance
  121  organization is presumed to be appropriate unless credible data
  122  demonstrates otherwise, or unless the rebate program requires
  123  the insured to incur costs to qualify for the rebate which
  124  equals or exceeds the value of the rebate but the rebate may not
  125  exceed 10 percent of paid premiums.
  126         (b) The premium rebate authorized by this section shall be
  127  effective for a subscriber on an annual basis, unless the number
  128  of participating members on the contract renewal anniversary
  129  becomes fewer than the majority of the members eligible for
  130  participation in the wellness program.
  131         (c) A health maintenance organization that issues
  132  individual contracts may offer a premium rebate, as provided
  133  under this section, for a healthy lifestyle program.
  134         Section 5. Subsection (15) is added to section 641.3903,
  135  Florida Statutes, to read:
  136         641.3903 Unfair methods of competition and unfair or
  137  deceptive acts or practices defined.—The following are defined
  138  as unfair methods of competition and unfair or deceptive acts or
  139  practices:
  140         (15) EXCEPTION FOR WELLNESS OR HEALTH IMPROVEMENT
  141  PROGRAMS.—
  142         (a)Authorization to offer rewards or incentives for
  143  participation.—An organization issuing a group or individual
  144  health benefit plan may offer a voluntary wellness or health
  145  improvement program and may encourage or reward participation in
  146  the program by authorizing rewards or incentives, including, but
  147  not limited to, merchandise, gift cards, debit cards, premium
  148  discounts or rebates, contributions to a member’s health savings
  149  account, or modifications to copayment, deductible, or
  150  coinsurance amounts.
  151         (b) Verification of medical condition by nonparticipants.
  152  An organization may require a health benefit plan member to
  153  provide verification, such as an affirming statement from the
  154  member’s physician, that the member’s medical condition makes it
  155  unreasonably difficult or inadvisable to participate in the
  156  wellness or health improvement program. A reward or incentive
  157  offered under this subsection is not a violation of this section
  158  if the program is disclosed in the contract or certificate. This
  159  subsection does not prohibit an organization from offering other
  160  incentives or rewards for adherence to a wellness or health
  161  improvement program if otherwise authorized by state or federal
  162  law.
  163         Section 6. This act shall take effect July 1, 2011.
  164  
  165  ================= T I T L E  A M E N D M E N T ================
  166         And the title is amended as follows:
  167         Delete everything before the enacting clause
  168  and insert:
  169                        A bill to be entitled                      
  170         An act relating to wellness or health improvement
  171         programs; amending s. 626.9541, F.S.; authorizing
  172         insurers to offer a voluntary wellness or health
  173         improvement program and to encourage or reward
  174         participation in the program by offering rewards or
  175         incentives to health benefit plan members; authorizing
  176         insurers to require plan members not participating in
  177         the wellness or health improvement programs to provide
  178         verification that their medical condition warrants
  179         nonparticipation in order for the nonparticipants to
  180         receive rewards or incentives; requiring that the
  181         reward or incentive be disclosed in the policy or
  182         certificate; amending s. 627.6402, F.S.; authorizing
  183         insurers to offer rewards or incentives to health
  184         benefit plan members to encourage or reward
  185         participation in wellness or health improvement
  186         programs; authorizing insurers to require plan members
  187         not participating in programs to provide verification
  188         that their medical condition warrants
  189         nonparticipation; amending s. 627.65626, F.S.;
  190         authorizing group health insurers to offer rewards or
  191         incentives to health benefit plan members to encourage
  192         or reward participation in wellness or health
  193         improvement programs; authorizing insurers to require
  194         plan members not participating in programs to provide
  195         verification that their medical condition warrants
  196         nonparticipation; amending s. 641.31, F.S.; deleting
  197         provisions authorizing health maintenance
  198         organizations to offer rebates of premiums for
  199         participation in a wellness program; authorizing
  200         health maintenance organizations to offer rewards or
  201         incentives to members to encourage or reward
  202         participation in wellness or health improvement
  203         programs; authorizing the health maintenance
  204         organization to require plan members not participating
  205         in programs to provide verification that their medical
  206         condition warrants nonparticipation; amending s.
  207         641.3903, F.S.; providing for a wellness or health
  208         improvement program; providing authorization to offer
  209         certain rewards or incentives for participation;
  210         authorizing verification of a nonparticipant’s medical
  211         condition; providing an effective date.