SB2486sam002 95TH GENERAL ASSEMBLY

Sen. Dan Kotowski

Filed: 4/8/2008

09500SB2486sam002 LRB095 17334 RPM 48856 a

AMENDMENT TO SENATE BILL 2486

AMENDMENT NO. ______. Amend Senate Bill 2486 by replacing line 21 on page 1 through line 5 on page 3 with the following:

"(215 ILCS 5/356z.11 new)

Sec. 356z.11. Wellness coverage.

(a) A group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of this amendatory Act of the 95th General Assembly that provides coverage for hospital or medical treatment on an expense incurred basis may offer a reasonably designed program for wellness coverage that allows for a reward, a health spending account contribution, a reduction in premiums or reduced medical, prescription drug, or equipment copayments, coinsurance, or deductibles, or a combination of these incentives, for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan. The insured or enrollee may be required to provide evidence of participation in a program, demonstrative compliance with treatment recommendations, or improvement of the individual's or dependent's health behaviors as determined by the health insurer or managed care plan.

(b) For purposes of this Section, "wellness coverage" means health care coverage with the primary purpose to engage and motivate the insured or enrollee through: incentives; provision of health education, counseling, and self-management skills; identification of modifiable health risks; and other activities to influence health behavior changes.

(c) Incentives as outlined in this Section are specific and unique to the offering of wellness coverage and have no application to any other required or optional health care benefit.

(d) Such wellness coverage shall satisfy the requirements for an exception from the general prohibition against discrimination based on a health factor under the federal Health Insurance Portability and Accountability Act of 1996 (P.L. 104-191; 110 Stat. 1936), including any federal regulations that are adopted pursuant to that Act.

(e) A reward, health spending account contribution, or reduction established under this Section does not violate Section 151 of this Code.".