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.
Disclaimer: These regulations may not be the most recent version. Texas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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