HB548: Group health insurance policies; provide a discount to employers who institute wellness programs.

Be it enacted by the General Assembly of Virginia:

1. That ? 38.2-4319 of the Code of Virginia is amended and reenacted and that the Code of Virginia is amended by adding a section numbered 38.2-3540.2 as follows:

? 38.2-3540.2. Employee wellness program.

Each group accident and sickness insurance policy and health care plan may provide a premium discount [ of up to five percent ] to every employer instituting and maintaining an employee wellness program satisfying such criteria as each insurer may establish. An employer instituting and maintaining an employee wellness program in accordance with the insurer's criteria may require that any employee wishing to enroll in such program undergo a health assessment as a condition of enrollment.

? 38.2-4319. Statutory construction and relationship to other laws.

A. No provisions of this title except this chapter and, insofar as they are not inconsistent with this chapter, ?? 38.2-100, 38.2-136, 38.2-200, 38.2-203, 38.2-209 through 38.2-213, 38.2-216, 38.2-218 through 38.2-225, 38.2-229, 38.2-232, 38.2-305, 38.2-316, 38.2-322, 38.2-400, 38.2-402 through 38.2-413, 38.2-500 through 38.2-515, 38.2-600 through 38.2-620, Chapter 9 (? 38.2-900 et seq.), ?? 38.2-1016.1 through 38.2-1023, 38.2-1057, Article 2 (? 38.2-1306.2 et seq.), ? 38.2-1306.1, ? 38.2-1315.1, Articles 3.1 (? 38.2-1316.1 et seq.), 4 (? 38.2-1317 et seq.) and 5 (? 38.2-1322 et seq.) of Chapter 13, Articles 1 (? 38.2-1400 et seq.) and 2 (? 38.2-1412 et seq.) of Chapter 14, ?? 38.2-1800 through 38.2-1836, 38.2-3401, 38.2-3405, 38.2-3405.1, 38.2-3407.2 through 38.2-3407.6:1, 38.2-3407.9 through 38.2-3407.16, 38.2-3411.2, 38.2-3411.3, 38.2-3411.4, 38.2-3412.1:01, 38.2-3414.1, 38.2-3418.1 through 38.2-3418.15, 38.2-3419.1, 38.2-3430.1 through 38.2-3437, 38.2-3500, subdivision 13 of ? 38.2-3503, subdivision 8 of ? 38.2-3504, ?? 38.2-3514.1, 38.2-3514.2, 38.2-3522.1 through 38.2-3523.4, 38.2-3525, 38.2-3540.1, 38.2-3540.2, 38.2-3541.1, 38.2-3542, 38.2-3543.2, Article 5 (? 38.2-3551 et seq.) of Chapter 35, Chapter 52 (? 38.2-5200 et seq.), Chapter 55 (? 38.2-5500 et seq.), Chapter 58 (? 38.2-5800 et seq.) and ? 38.2-5903 of this title shall be applicable to any health maintenance organization granted a license under this chapter. This chapter shall not apply to an insurer or health services plan licensed and regulated in conformance with the insurance laws or Chapter 42 (? 38.2-4200 et seq.) of this title except with respect to the activities of its health maintenance organization.

B. For plans administered by the Department of Medical Assistance Services that provide benefits pursuant to Title XIX or Title XXI of the Social Security Act, as amended, no provisions of this title except this chapter and, insofar as they are not inconsistent with this chapter, ?? 38.2-100, 38.2-136, 38.2-200, 38.2-203, 38.2-209 through 38.2-213, 38.2-216, 38.2-218 through 38.2-225, 38.2-229, 38.2-232, 38.2-322, 38.2-400, 38.2-402 through 38.2-413, 38.2-500 through 38.2-515, 38.2-600 through 38.2-620, Chapter 9 (? 38.2-900 et seq.), ?? 38.2-1016.1 through 38.2-1023, 38.2-1057, ? 38.2-1306.1, Article 2 (? 38.2-1306.2 et seq.), ? 38.2-1315.1, Articles 3.1 (? 38.2-1316.1 et seq.), 4 (? 38.2-1317 et seq.) and 5 (? 38.2-1322 et seq.) of Chapter 13, Articles 1 (? 38.2-1400 et seq.) and 2 (? 38.2-1412 et seq.) of Chapter 14, ?? 38.2-3401, 38.2-3405, 38.2-3407.2 through 38.2-3407.5, 38.2-3407.6 and 38.2-3407.6:1, 38.2-3407.9, 38.2-3407.9:01, and 38.2-3407.9:02, subdivisions 1, 2, and 3 of subsection F of ? 38.2-3407.10, 38.2-3407.11, 38.2-3407.11:3, 38.2-3407.13, 38.2-3407.13:1, and 38.2-3407.14, 38.2-3411.2, 38.2-3418.1, 38.2-3418.2, 38.2-3419.1, 38.2-3430.1 through 38.2-3437, 38.2-3500, subdivision 13 of ? 38.2-3503, subdivision 8 of ? 38.2-3504, ?? 38.2-3514.1, 38.2-3514.2, 38.2-3522.1 through 38.2-3523.4, 38.2-3525, 38.2-3540.1, 38.2-3540.2, 38.2-3542, 38.2-3543.2, Chapter 52 (? 38.2-5200 et seq.), Chapter 55 (? 38.2-5500 et seq.), Chapter 58 (? 38.2-5800 et seq.) and ? 38.2-5903 shall be applicable to any health maintenance organization granted a license under this chapter. This chapter shall not apply to an insurer or health services plan licensed and regulated in conformance with the insurance laws or Chapter 42 (? 38.2-4200 et seq.) of this title except with respect to the activities of its health maintenance organization.

C. Solicitation of enrollees by a licensed health maintenance organization or by its representatives shall not be construed to violate any provisions of law relating to solicitation or advertising by health professionals.

D. A licensed health maintenance organization shall not be deemed to be engaged in the unlawful practice of medicine. All health care providers associated with a health maintenance organization shall be subject to all provisions of law.

E. Notwithstanding the definition of an eligible employee as set forth in ? 38.2-3431, a health maintenance organization providing health care plans pursuant to ? 38.2-3431 shall not be required to offer coverage to or accept applications from an employee who does not reside within the health maintenance organization's service area.

F. For purposes of applying this section, "insurer" when used in a section cited in subsections A and B of this section shall be construed to mean and include "health maintenance organizations" unless the section cited clearly applies to health maintenance organizations without such construction.