I 

111TH CONGRESS 

1ST SESSION H. R. 3472 

To provide for health insurance coverage premium discounts for healthy 

behavior and improvements toward healthy behavior. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 31, 2009 

Mrs. DAHLKEMPER introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committees 

on Ways and Means and Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such 

provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To provide for health insurance coverage premium discounts 

for healthy behavior and improvements toward healthy 

behavior. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. PREMIUM DISCOUNTS FOR HEALTHY LIVING. 

4 (a) IN GENERAL.—Notwithstanding any other provi5 sion of law, for plan years beginning on or after January 

6 1, 2010, a group health plan, and a health insurance 

7 issuer offering group health insurance coverage in the 

8 group market or health insurance coverage in the indiVerDate Nov 24 2008 00:27 Aug 04, 2009 Jkt 079200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3472.IH H3472

tjames on DSKG8SOYB1PROD with BILLS
2 

•HR 3472 IH

1 vidual market, shall provide premium discounts for 

2 healthy behavior and improvements toward healthy behav3 ior as determined under this section. 

4 (b) DETERMINATION OF PREMIUM DISCOUNTS.— 

5 (1) IN GENERAL.—Not later than 1 year after 

6 the date of the enactment of this Act, the Secretary 

7 of Health and Human Services, acting through the 

8 Director of the Centers for Disease Control and Pre9 vention, shall conclude a rulemaking procedure to 

10 determine the appropriate premium discount appli11 cable to each healthy behavior and each improve12 ment toward healthy behavior. Such discounts shall 

13 be consistent with the regulations applicable to 

14 wellness programs issued under the Health Insur15 ance Portability and Accountability Act of 1996. 

16 (2) LIMITATION.—Such discounts shall not, in 

17 the aggregate, exceed 20 percent with respect to any 

18 individual. 

19 (c) HEALTHY BEHAVIOR.—For purposes of this sec20 tion, the following are healthy behaviors: 

21 (1) Not smoking. 

22 (2) Low blood pressure (but within the normal 

23 range). 

24 (3) Body mass index (BMI) in the normal 

25 range. 


tjames on DSKG8SOYB1PROD with BILLS
3 

•HR 3472 IH

1 (4) Low low-density lipoprotein (LDL) levels. 

2 (5) High high-density lipoprotein (HDL) levels. 

3 (6) Appropriate hemoglobin AIC levels. 

4 (d) IMPROVEMENTS TOWARDS HEALTHY BEHAV5 IOR.—For purposes of this section, the following are im6 provements towards healthy behavior: 

7 (1) Quitting smoking. 

8 (2) Reducing blood pressure, but not below the 

9 normal range. 

10 (3) Lowering body mass index (BMI), but not 

11 below the normal range. 

12 (4) Lowering low-density lipoprotein (LDL) lev13 els. 

14 (5) Increasing high-density lipoprotein (HDL) 

15 levels. 

16 (6) Lowering hemoglobin AIC levels, but not 

17 below the normal range. 

18 (e) CERTIFICATION.—In order to be taken into ac19 count under this section, any healthy behavior or improve20 ment towards healthy behavior must be supported by med21 ical test result information which is certified by a licensed 

22 physician, and the individual to whom it relates, as being 

23 complete, accurate and current. In the case of any know24 ingly false certification under this subsection, the SecVerDate Nov 24 2008 00:27 Aug 04, 2009 Jkt 079200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3472.IH H3472

tjames on DSKG8SOYB1PROD with BILLS
4 

•HR 3472 IH

1 retary of Health and Human Services shall impose a civil 

2 monetary penalty not in excess of $1,000. 

3 (f) APPLICATION TO ERISA, PHSA, AND IRC.—The 

4 provisions of this section shall apply with respect to a 

5 group health plan as if included under title XXVII of the 

6 Public Health Service Act, under title VII of the Employee 

7 Retirement Income Security Act of 1974, and under sub8 chapter B of chapter 100 of the Internal Revenue Code 

9 of 1986, and shall apply with respect to health insurance 

10 coverage offered in the individual market as if included 

11 under title XXVII of the Public Health Service Act. 

Æ 


tjames on DSKG8SOYB1PROD with BILLS