HB4940ham001 95TH GENERAL ASSEMBLY

Insurance Committee

Filed: 3/11/2008

09500HB4940ham001 LRB095 17333 MJR 47971 a

AMENDMENT TO HOUSE BILL 4940

AMENDMENT NO. ______. Amend House Bill 4940 on page 2, by replacing lines 7 and 8 with the following: "a reasonably designed program for wellness coverage that allows for a reduction in premiums or reduced"; and

on page 2, line 14, by replacing "program," with "program. Individuals unable to participate in wellness program standards, due to an adverse health factor, shall not be penalized based upon their adverse health status."; and

on page 2, by deleting lines 15 through 18; and

on page 3, by replacing lines 3 through 5 with the following:

"(d) For purposes of this Section, "reasonably designed program" means a program of wellness coverage that (1) has a reasonable chance of improving health or preventing disease, (2) is not overly burdensome, (3) does not discriminate based upon factors of health, and (4) is not otherwise contrary to law.

(e) A plan offering wellness coverage must give participants the opportunity to qualify for offered incentives at least once a year.

(f) A plan offering wellness coverage must allow a reasonable alternative to any individual for whom it is unreasonably difficult, due to a medical condition, to satisfy otherwise applicable wellness program standards. Plans may seek physician verification that health factors make it unreasonably difficult or medically inadvisable for the participant to satisfy the standards.

(g) The total incentive under a wellness program shall not exceed 20% of the cost of employee-only coverage. The cost of employee-only coverage includes both employer and employee contributions. For plans offering family coverage, the 20% limitation applies to cost of family coverage and applies to the entire family.

(h) Notwithstanding any other rulemaking authority that may exist, neither the Governor nor any agency or agency head under the jurisdiction of the Governor has any authority to make or promulgate rules to implement or enforce the provisions of this amendatory Act of the 95th General Assembly. If, however, the Governor believes that rules are necessary to implement or enforce the provisions of this amendatory Act of the 95th General Assembly, the Governor may suggest rules to the General Assembly by filing them with the Clerk of the House and the Secretary of the Senate and by requesting that the General Assembly authorize such rulemaking by law, enact those suggested rules into law, or take any other appropriate action in the General Assembly's discretion. Nothing contained in this amendatory Act of the 95th General Assembly shall be interpreted to grant rulemaking authority under any other Illinois statute where such authority is not otherwise explicitly given. For the purposes of this amendatory Act of the 95th General Assembly, "rules" is given the meaning contained in Section 1-70 of the Illinois Administrative Procedure Act, and "agency" and "agency head" are given the meanings contained in Sections 1-20 and 1-25 of the Illinois Administrative Procedure Act to the extent that such definitions apply to agencies or agency heads under the jurisdiction of the Governor.".