Sen. Dan Kotowski
Filed: 4/8/2008
 
 

 




 

 		












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AMENDMENT TO SENATE BILL 2486




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


 
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    "(215 ILCS 5/356z.11 new)

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    Sec. 356z.11. Wellness coverage.
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    (a) A group or individual policy of accident and health 
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insurance or managed care plan amended, delivered, issued, or 
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renewed after the effective date of this amendatory Act of the 
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95th General Assembly that provides coverage for hospital or 
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medical treatment on an expense incurred basis may offer a 
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reasonably designed program for wellness coverage that allows 
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for a reward, a health spending account contribution, a 
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reduction in premiums or reduced medical, prescription drug, or 
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equipment copayments, coinsurance, or deductibles, or a 
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combination of these incentives, for participation in any 
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health behavior wellness, maintenance, or improvement program 
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approved or offered by the insurer or managed care plan. The 
 


 






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insured or enrollee may be required to provide evidence of 
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participation in a program, demonstrative compliance with 
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treatment recommendations, or improvement of the individual's 
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or dependent's health behaviors as determined by the health 
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insurer or managed care plan.
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    (b) For purposes of this Section, "wellness coverage" means 
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health care coverage with the primary purpose to engage and 
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motivate the insured or enrollee through: incentives; 
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provision of health education, counseling, and self-management 
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skills; identification of modifiable health risks; and other 
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activities to influence health behavior changes. 
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    (c) Incentives as outlined in this Section are specific and 
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unique to the offering of wellness coverage and have no 
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application to any other required or optional health care 
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benefit. 
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    (d) Such wellness coverage shall satisfy the requirements 
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for an exception from the general prohibition against 
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discrimination based on a health factor under the federal 
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Health Insurance Portability and Accountability Act of 1996 
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(P.L. 104-191; 110 Stat. 1936), including any federal 
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regulations that are adopted pursuant to that Act. 
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    (e) A reward, health spending account contribution, or 
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reduction established under this Section does not violate 
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Section 151 of this Code.".