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TITLE 28INSURANCE
PART 1TEXAS DEPARTMENT OF INSURANCE
CHAPTER 21TRADE PRACTICES
SUBCHAPTER MMWELLNESS PROGRAMS
RULE §21.4704Purposes

The purposes of this subchapter are to provide for the circumstances under which, and the constraints within which, a group health benefit plan issuer, an accident and health insurance issuer, or health maintenance organization may:

  (1) vary benefits, including cost-sharing mechanisms such as a deductible, copayment, or coinsurance, based on whether an individual has met the standards of a wellness program that satisfies the requirements of §§21.4706, 21.4707, or 21.4708 of this title; or

  (2) vary the amount of premium or contribution it requires similarly situated individuals to pay based on whether an individual has met the standards of a wellness program that satisfies the requirements of §§21.4706, 21.4707, or 21.4708 of this title.


Source Note: The provisions of this §21.4704 adopted to be effective March 31, 2009, 34 TexReg 2135; amended to be effective July 22, 2015, 40 TexReg 4693

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