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SB-0849, As Passed House, September 13, 2006

SUBSTITUTE FOR

SENATE BILL NO. 849

A bill to amend 1980 PA 350, entitled

"The nonprofit health care corporation reform act,"

(MCL 550.1101 to 550.1704) by adding section 414b.

THE PEOPLE OF THE STATE OF MICHIGAN ENACT:

Sec. 414b. (1) A health care corporation 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

members' health behaviors as determined by assessments of agreed-

upon health status indicators between the employer and the health

care corporation. Any rebate or premium provided by the health care

corporation is presumed to be appropriate unless credible data

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

health care corporation shall make available to employers all

wellness coverage plans that it markets to employers in this state.

(2) A health care corporation may offer nongroup 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 health care corporation. The

member 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 member and the health care corporation. Any rebate of

premium provided by the health care corporation is presumed to be

appropriate unless credible data demonstrate otherwise, but shall

not exceed 10% of paid premiums. A health care corporation shall

make available to individuals all wellness coverage plans that it

markets to individuals in this state.

(3) A health care corporation is 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