SB-0848, As Passed House, September 13, 2006

SUBSTITUTE FOR

SENATE BILL NO. 848

     A bill to amend 1956 PA 218, entitled

"The insurance code of 1956,"

(MCL 500.100 to 500.8302) by adding section 3426.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

     Sec. 3426. (1) Each insurer providing a group expense-incurred

hospital, medical, or surgical certificate delivered, issued for

delivery, or renewed in this state and each health maintenance

organization may offer group wellness coverage. Wellness coverage

may provide for an appropriate rebate or reduction in premiums or

for reduced copayments, coinsurance, or deductibles, or a

combination of these incentives, for participation in any health

behavior wellness, maintenance, or improvement program offered by

the employer. The employer shall provide evidence of demonstrative

maintenance or improvement of the insureds' or enrollees' health

behaviors as determined by assessments of agreed-upon health status

indicators between the employer and the health insurer or health

maintenance organization. Any rebate of premium provided by the

health insurer or health maintenance organization is presumed to be

appropriate unless credible data demonstrate otherwise, but shall

not exceed 10% of paid premiums. Each insurer and each health

maintenance organization shall make available to employers all

wellness coverage plans that the insurer or health maintenance

organization markets to employers in this state.

     (2) Each insurer providing an individual or family expense-

incurred hospital, medical, or surgical policy delivered, issued

for delivery, or renewed in this state and each health maintenance

organization may offer individual and family wellness coverage.

Wellness coverage may provide for an appropriate rebate or

reduction in premiums or for reduced copayments, coinsurance, or

deductibles, or a combination of these incentives, for

participation in any health behavior wellness, maintenance, or

improvement program approved by the insurer or health maintenance

organization. The insured or enrollee shall provide evidence of

demonstrative maintenance or improvement of the individual's or

family's health behaviors as determined by assessments of agreed-

upon health status indicators between the insured or enrollee and

the health insurer or health maintenance organization. Any rebate

of premium provided by the health insurer or health maintenance

organization is presumed to be appropriate unless credible data

demonstrate otherwise, but shall not exceed 10% of paid premiums.

Each insurer and each health maintenance organization shall make

available to individuals and families all wellness coverage plans

that the insurer or health maintenance organization markets to

individuals and families in this state.

     (3) An insurer and a health maintenance organization are not

required to continue any health behavior wellness, maintenance, or

improvement program or to continue any incentive associated with a

health behavior wellness, maintenance, or improvement program.

     Enacting section 1. This amendatory act takes effect January

1, 2007.

     Enacting section 2. It is only the intent of this amendatory

act to promote the availability of health behavior wellness,

maintenance, and improvement programs.