I 
111TH CONGRESS 
1ST SESSION H. R. 3688 
To encourage programs of health promotion or disease prevention. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 1, 2009 
Mr. ARCURI (for himself, Mr. BUYER, Mr. CASTLE, Mr. POLIS of Colorado, 
Mr. DONNELLY of Indiana, and Mr. DEAL of Georgia) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committees on Education and Labor and 
Ways and Means, 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 encourage programs of health promotion or disease 
prevention. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. PROGRAMS OF HEALTH PROMOTION OR DIS-
EASE PREVENTION. 
(a) IN GENERAL.—Nothing in the Employee Retire-
ment Income Security Act of 1974, the Internal Revenue 
Code of 1986, or the Public Health Service Act shall be 
applied, administered, or interpreted to prevent any pro-
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vider or issuer of health insurance (including any em-
ployer) from establishing premium discounts or rebates, 
or modifying copayments or deductibles, in the case of in-
dividuals who adhere to, or participate in, a program of 
health promotion or disease prevention which meets the 
requirements of subsection (b). 
(b) PROGRAMS OF HEALTH PROMOTION OR DISEASE 
PREVENTION TO WHICH SECTION APPLIES.— 
(1) GENERAL PROVISIONS.— 
(A) GENERAL
RULE.—For purposes of 
subsection (a), a program of health promotion 
or disease prevention (referred to in this sub-
section as a ‘‘wellness program’’) shall be a pro-
gram that is designed to promote health or pre-
vent disease that meets the applicable require-
ments of this subsection. 
(B) NO CONDITIONS BASED ON HEALTH 
STATUS FACTOR.—If none of the conditions for 
obtaining a premium discount or rebate or 
other reward for participation in a wellness pro-
gram is based on an individual satisfying a 
standard that is related to a health status fac-
tor, such wellness program shall not violate this 
section if participation in the program is made 
available to all similarly situated individuals 
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and the requirements of paragraph (2) are com-
plied with. 
(C) CONDITIONS BASED ON HEALTH STA-
TUS FACTOR.—If any of the conditions for ob-
taining a premium discount or rebate or other 
reward for participation in a wellness program 
is based on an individual satisfying a standard 
that is related to a health status factor, such 
wellness program shall not violate this section if 
the requirements of paragraph (3) are complied 
with. 
(2) WELLNESS
PROGRAMS
NOT
SUBJECT
TO 
REQUIREMENTS.—If none of the conditions for ob-
taining a premium discount or rebate or other re-
ward under a wellness program as described in para-
graph (1)(B) are based on an individual satisfying 
a standard that is related to a health status factor 
(or if such a wellness program does not provide such 
a reward), the wellness program shall not violate 
this section if participation in the program is made 
available to all similarly situated individuals. The 
following programs shall not have to comply with the 
requirements of paragraph (3) if participation in the 
program is made available to all similarly situated 
individuals: 
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(A) A program that reimburses all or part 
of the cost for memberships in a fitness center. 
(B) A diagnostic testing program that pro-
vides a reward for participation and does not 
base any part of the reward on outcomes. 
(C) A program that encourages preventive 
care related to a health condition through the 
waiver of the copayment or deductible require-
ment under an individual or group health plan 
for the costs of certain items or services related 
to a health condition (such as prenatal care or 
well-baby visits). 
(D) A program that reimburses individuals 
for the costs of smoking cessation programs 
without regard to whether the individual quits 
smoking. 
(E) A program that provides a reward to 
individuals for attending a periodic health edu-
cation seminar. 
(3) WELLNESS
PROGRAMS
SUBJECT
TO
RE-
QUIREMENTS.—If any of the conditions for obtaining 
a premium discount, rebate, or reward under a 
wellness program as described in paragraph (1)(C) 
is based on an individual satisfying a standard that 
is related to a health status factor, the wellness pro-
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gram shall not violate this section if the following re-
quirements are complied with: 
(A) The reward for the wellness program, 
together with the reward for other wellness pro-
grams with respect to the plan that requires 
satisfaction of a standard related to a health 
status factor, shall not exceed 30 percent of the 
cost of employee-only coverage under the plan. 
If, in addition to employees or individuals, any 
class of dependents (such as spouses or spouses 
and dependent children) may participate fully 
in the wellness program, such reward shall not 
exceed 30 percent of the cost of the coverage in 
which an employee or individual and any de-
pendents are enrolled. For purposes of this 
paragraph, the cost of coverage shall be deter-
mined based on the total amount of employer 
and employee contributions for the benefit 
package under which the employee is (or the 
employee and any dependents are) receiving 
coverage. A reward may be in the form of a dis-
count or rebate of a premium or contribution a 
waiver of all or part of a cost-sharing mecha-
nism (such as deductibles, copayments, or coin-
surance), the absence of a surcharge, or the 
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