INS CD-WELLNESS COVERAGE House SponsorsRep. Frank J. Mautino-Robert W. Pritchard-William B. Black Senate Sponsors(Sen. Dan Kotowski) 1/13/2009HouseSession Sine Die 5 ILCS 375/6.11215 ILCS 5/356z.11 new215 ILCS 125/5-3from Ch. 111 1/2, par. 1411.2 Amends the State Employees Group Insurance Act of 1971, the Illinois Insurance Code, and the Health Maintenance Organization Act. Provides that a policy or plan that provides coverage for hospital or medical treatment on an expense incurred basis, may offer 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. Provides that "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. Makes other changes. Effective January 1, 2009.House Amendment No. 1 Changes language to provide that a group or individual policy of accident and health insurance or managed care plan amended, delivered, issued, or renewed after the effective date of the amendatory Act that provides coverage for hospital or medical treatment on an expense incurred basis may offer a reasonably designed program for wellness coverage that allows a reduction in premiums or other expenses (rather than including a reward or a health spending account contribution). Provides that individuals unable to participate in wellness program standards, due to an adverse health factor, shall not be penalized based upon their adverse health status. Defines the term "reasonably designed program". Provides that a plan offering wellness coverage must give participants the opportunity to qualify for offered incentives at least once a year. Provides that 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. Provides that plans may seek physician verification that health factors make it unreasonably difficult or medically inadvisable for the participant to satisfy the standards. Provides that the total incentive under a wellness program shall not exceed 20% of the cost of employee-only coverage. Provides that the cost of employee-only coverage includes both employer and employee contributions. Provides that for plans offering family coverage, the 20% limitation applies to cost of family coverage and applies to the entire family. Provides that there is no rulemaking authority under the amendatory Act, but that the Governor may suggest rules by filing them with the General Assembly and requesting that the General Assembly authorize such rulemaking by law, enact the suggested rules into law, or take other appropriate action in the General Assembly's discretion.House Amendment No. 2 Replaces everything after the enacting clause. Amends the State Employees Group Insurance Act of 1971, the Illinois Insurance Code, and the Health Maintenance Organization Act. Provides that a policy or plan 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 or other incentives for participation in any health behavior wellness, maintenance, or improvement program approved or offered by the insurer or managed care plan. Provides that "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. Provides that 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. Provides that there is no rulemaking authority under the amendatory Act, but that the Governor may suggest rules by filing them with the General Assembly and requesting that the General Assembly authorize such rulemaking by law, enact the suggested rules into law, or take other appropriate action in the General Assembly's discretion. Makes other changes. Effective January 1, 2009. 2/13/2008HouseFiled with the Clerk by Rep. Frank J. Mautino 2/13/2008HouseFirst Reading 2/13/2008HouseReferred to Rules Committee 2/25/2008HouseAssigned to Insurance Committee 3/5/2008HouseAdded Chief Co-Sponsor Rep. Robert W. Pritchard 3/11/2008HouseHouse Amendment No. 1 Filed with Clerk by Insurance Committee 3/11/2008HouseHouse Amendment No. 1 Adopted in Insurance Committee; by Voice Vote 3/11/2008HouseDo Pass as Amended / Short Debate Insurance Committee; 020-000-000 3/12/2008HousePlaced on Calendar 2nd Reading - Short Debate 3/13/2008HouseSecond Reading - Short Debate 3/13/2008HousePlaced on Calendar Order of 3rd Reading - Short Debate 4/1/2008HouseHouse Amendment No. 2 Filed with Clerk by Rep. Frank J. Mautino 4/1/2008HouseHouse Amendment No. 2 Referred to Rules Committee 4/2/2008HouseHouse Amendment No. 2 Recommends Be Adopted Rules Committee; 003-000-000 4/18/2008HouseFinal Action Deadline Extended-9(b) May 9, 2008 5/8/2008HouseAdded Chief Co-Sponsor Rep. William B. Black 5/8/2008HouseRecalled to Second Reading - Short Debate 5/8/2008HouseHouse Amendment No. 2 Adopted by Voice Vote 5/8/2008HousePlaced on Calendar Order of 3rd Reading - Short Debate 5/9/2008HouseFinal Action Deadline Extended-9(b) May 23, 2008 5/14/2008HouseThird Reading - Short Debate - Passed 113-000-000 5/15/2008SenateArrive in Senate 5/15/2008SenatePlaced on Calendar Order of First Reading May 20, 2008 5/20/2008SenateChief Senate Sponsor Sen. Dan Kotowski 5/21/2008SenateFirst Reading 5/21/2008SenateReferred to Rules 1/13/2009HouseSession Sine Die