Texas Administrative Code
Title 28 - INSURANCE
Part 1 - TEXAS DEPARTMENT OF INSURANCE
Chapter 21 - TRADE PRACTICES
Subchapter MM - WELLNESS PROGRAMS
Section 21.4706 - Wellness Programs With Participation as Sole Basis for Reward Eligibility

Universal Citation: 28 TX Admin Code § 21.4706

Current through Reg. 50, No. 13; March 28, 2025

(a) A wellness program that contains no condition for obtaining a reward premised on an individual satisfying a standard associated with a health factor does not violate this subchapter so long as the status-related program is made available to all individuals eligible for coverage under the plan.

(b) Wellness programs meeting the description of this section would include the following program types:

(1) a program that reimburses all or part of the cost for membership in a fitness center;

(2) a diagnostic testing program that provides a reward for participation and does not base any part of the reward on testing outcomes;

(3) a program that encourages preventive care through the waiver of the copayment or deductible requirement under a group health plan or individual policy for the costs of a particular preventive care item or items;

(4) a program that reimburses covered individuals for the costs of smoking cessation programs without regard to whether the individual quits smoking; or

(5) a program that provides a reward to covered individuals for attending a monthly health education seminar.

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