NY Ins L § 3239 (2021)
2021 New York Laws ISC - Insurance Article 32 - Insurance Contracts - Life, Accident and Health, Annuities 3239 - Wellness Programs.

§  3239.  Wellness programs. (a) An insurer licensed to write accident and health  insurance,  a  corporation  organized  pursuant  to  article forty-three of this chapter, a health maintenance organization certified pursuant  to article forty-four of the public health law and a municipal cooperative health benefits plan may establish  a  wellness  program  in conjunction  with  its issuance of a group accident and health insurance policy or group subscriber contract. A "wellness program" is  a  program designed  to promote health and prevent disease that may contain rewards and incentives for participation. Participation in the wellness  program shall  be available to similarly-situated members of the group and shall be voluntary on the part of  the  member.  The  terms  of  the  wellness program shall be set forth in the policy or contract.  (b)  A  wellness  program  may  include,  but  is  not limited to, the following programs or services:  (1) the use of a health risk assessment tool;  (2) a smoking cessation program;  (3) a weight management program;  (4) a stress and/or hypertension management program;  (5) a worker injury prevention program;  (6) a nutrition education program;  (7) health or fitness incentive programs;  (8) a coordinated weight management, nutrition, stress management  and physical  fitness  program  to  combat  the  high incidence of adult and childhood obesity, asthma and other chronic respiratory conditions;  (9) a substance or alcohol abuse cessation program; and  (10) a program to manage and cope with chronic pain.  (c)(1)  A  wellness  program  may  use  rewards  and  incentives   for participation  provided  that where the group health insurance policy or subscriber contract is required to be community-rated, the  rewards  and incentives  shall  not  include a discounted premium rate or a rebate or refund of premium.  (2) Permissible rewards and incentives may include:  (A) full or partial reimbursement of  the  cost  of  participating  in smoking cessation, weight management, stress and/or hypertension, worker injury  prevention,  nutrition  education,  substance  or  alcohol abuse cessation, or chronic pain management and coping programs;  (B) full or partial reimbursement of  the  cost  of  membership  in  a health club or fitness center;  (C) the waiver or reduction of copayments, coinsurance and deductibles for  preventive  services  covered  under the group policy or subscriber contract;  (D) monetary rewards in the form of gift cards or  gift  certificates, so  long  as the recipient of the reward is encouraged to use the reward for a product or a service that promotes good health,  such  as  healthy cook books, over the counter vitamins or exercise equipment;  (E)  full  or  partial reimbursement of the cost of participating in a stress management program or activity; and  (F) full or partial reimbursement of the cost of  participating  in  a health or fitness program.  (3)  Where  the  reward  involves a group member's meeting a specified standard based on a health condition, the wellness program must meet the requirements of 45 CFR Part 146.  (4) A reward or incentive which involves a discounted premium rate  or a  rebate or refund of premium shall be based on actuarial demonstration that the wellness program can reasonably be expected to  result  in  the overall good health and well being of the group.