| 1 | A bill to be entitled |
| 2 | An act relating to wellness or health improvement |
| 3 | programs; amending ss. 626.9541 and 641.3903, F.S.; |
| 4 | authorizing insurers and health maintenance organizations |
| 5 | to offer a voluntary wellness or health improvement |
| 6 | program and to encourage or reward participation in the |
| 7 | program by offering rewards or incentives to members; |
| 8 | authorizing insurers and health maintenance organizations |
| 9 | to require plan members not participating in the wellness |
| 10 | or health improvement programs to provide verification |
| 11 | that their medical condition warrants nonparticipation in |
| 12 | order for the nonparticipants to receive rewards or |
| 13 | incentives; requiring that the reward or incentive be |
| 14 | disclosed in the policy or certificate; providing that the |
| 15 | act does not prohibit insurers or health maintenance |
| 16 | organizations from offering other incentives or rewards |
| 17 | for adherence to a wellness or health improvement program; |
| 18 | providing an effective date. |
| 19 |
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| 20 | Be It Enacted by the Legislature of the State of Florida: |
| 21 |
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| 22 | Section 1. Subsection (4) is added to section 626.9541, |
| 23 | Florida Statutes, to read: |
| 24 | 626.9541 Unfair methods of competition and unfair or |
| 25 | deceptive acts or practices defined.- |
| 26 | (4) PARTICIPATION IN A WELLNESS OR HEALTH IMPROVEMENT |
| 27 | PROGRAM.- |
| 28 | (a) Authorization to offer rewards or incentives for |
| 29 | participation.-An insurer issuing a group or individual health |
| 30 | benefit plan may offer a voluntary wellness or health |
| 31 | improvement program and may encourage or reward participation in |
| 32 | the program by authorizing rewards or incentives, including, but |
| 33 | not limited to, merchandise, gift cards, debit cards, premium |
| 34 | discounts, contributions to a member's health savings account, |
| 35 | or modifications to copayment, deductible, or coinsurance |
| 36 | amounts. Any advertisement of the program is not subject to the |
| 37 | limitations set forth in paragraph (1)(m). |
| 38 | (b) Verification of medical condition by nonparticipants |
| 39 | due to medical condition.-An insurer may require a member of a |
| 40 | health benefit plan to provide verification, such as an |
| 41 | affirming statement from the member's physician, that the |
| 42 | member's medical condition makes it unreasonably difficult or |
| 43 | inadvisable to participate in the wellness or health improvement |
| 44 | program in order for that nonparticipant to receive the reward |
| 45 | or incentive. |
| 46 | (c) Disclosure requirement.-A reward or incentive offered |
| 47 | under this subsection shall be disclosed in the policy or |
| 48 | certificate. |
| 49 | (d) Other incentives.-This subsection does not prohibit |
| 50 | insurers from offering other incentives or rewards for adherence |
| 51 | to a wellness or health improvement program if otherwise |
| 52 | authorized by state or federal law. |
| 53 | Section 2. Subsection (15) is added to section 641.3903, |
| 54 | Florida Statutes, to read: |
| 55 | 641.3903 Unfair methods of competition and unfair or |
| 56 | deceptive acts or practices defined.-The following are defined |
| 57 | as unfair methods of competition and unfair or deceptive acts or |
| 58 | practices: |
| 59 | (15) PARTICIPATION IN A WELLNESS OR HEALTH IMPROVEMENT |
| 60 | PROGRAM.- |
| 61 | (a) Authorization to offer rewards or incentives for |
| 62 | participation.-A health maintenance organization issuing a group |
| 63 | or individual health benefit plan may offer a voluntary wellness |
| 64 | or health improvement program and may encourage or reward |
| 65 | participation in the program by authorizing rewards or |
| 66 | incentives, including, but not limited to, merchandise, gift |
| 67 | cards, debit cards, premium discounts, contributions to a |
| 68 | member's health savings account, or modifications to copayment, |
| 69 | deductible, or coinsurance amounts. |
| 70 | (b) Verification of medical condition by nonparticipants |
| 71 | due to medical condition.-A health maintenance organization may |
| 72 | require a member of a health benefit plan to provide |
| 73 | verification, such as an affirming statement from the member's |
| 74 | physician, that the member's medical condition makes it |
| 75 | unreasonably difficult or inadvisable to participate in the |
| 76 | wellness or health improvement program in order for that |
| 77 | nonparticipant to receive the reward or incentive. |
| 78 | (c) Disclosure requirement.-A reward or incentive offered |
| 79 | under this subsection shall be disclosed in the policy or |
| 80 | certificate. |
| 81 | (d) Other incentives.-This subsection does not prohibit |
| 82 | health maintenance organizations from offering other incentives |
| 83 | or rewards for adherence to a wellness or health improvement |
| 84 | program if otherwise authorized by state or federal law. |
| 85 | Section 3. This act shall take effect July 1, 2011. |