| (a) Wellness programs as set out in this subchapter
are excepted from the general prohibitions against discrimination
based on a health status-related factor for plan provisions that vary
benefits, including cost-sharing mechanisms, or the premium or contribution
for individuals eligible for plan coverage, in connection with participation
in such a wellness program.
(b) A wellness program must be reasonably designed
to promote disease prevention, wellness, and health. A program satisfies
this standard if it:
(1) has a reasonable probability of improving the health
of, or preventing disease in, participating individuals;
(2) is not overly burdensome;
(3) is not a subterfuge for otherwise prohibited discrimination
based on a health status-related factor; and
(4) is not highly suspect in the method chosen to promote
disease prevention, wellness, and health.
(c) A wellness program must comply, as applicable,
with Insurance Code §1701.061 and provisions of rules codified
in this title relating to Insurance Code §1701.061 and the administration
of noninsurance benefits.
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