Bill Text: NC H1968 | 2010 | Regular Session | Amended
Bill Title: State Health Plan/ Repeal BMI Penalty
Spectrum: Strong Partisan Bill (Republican 28-2)
Status: (Introduced - Dead) 2010-05-26 - Ref to the Com on Health, if favorable, Insurance, if favorable, Appropriations [H1968 Detail]
Download: North_Carolina-2010-H1968-Amended.html
GENERAL ASSEMBLY OF NORTH CAROLINA
SESSION 2009
H 1
HOUSE BILL 1968
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Short Title: State Health Plan/ Repeal BMI Penalty. |
(Public) |
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Sponsors: |
Representatives Dollar, Blackwell, Folwell, Hurley (Primary Sponsors); Blackwood, Brown, Burris‑Floyd, Cleveland, Current, Frye, Gillespie, Guice, Gulley, Harrison, Heagarty, Hilton, Iler, Ingle, Langdon, Lewis, McCormick, McGee, Moore, Randleman, Sager, Setzer, Stam, Steen, Stevens, and Wiley. |
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Referred to: |
Health, if favorable, Insurance, if favorable, Appropriations. |
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May 26, 2010
A BILL TO BE ENTITLED
AN ACT to Repeal the Body Mass Index (BMI) penalty from the North Carolina State Health Plan for Teachers and State Employees.
The General Assembly of North Carolina enacts:
SECTION 1. Section 2(b) of S.L. 2009‑16, as amended by S.L. 2009‑571, reads as rewritten:
"SECTION 2.(b) Implement Comprehensive Wellness
Initiative.
(1) Program development. – The Plan shall develop a Comprehensive
Wellness Initiative that includes a focus on smoking cessation and weight
management and that is designed to be implemented effective July 1,
2010, for smoking cessation and July 1, 2011, for weight management. July
1, 2010. Benefit levels shall be determined by the Plan based upon tobacco use
or the inability of the member to meet national, evidence‑based healthy
weight clinical guidelines. use. For purposes of the Comprehensive
Wellness Initiative, "member" includes all State Health Plan primary
subscribers and their covered dependents. The Plan shall develop a process
whereby a Plan member may appeal the Plan's basis for action it takes due to
the member's failure or refusal to comply with the Plan's smoking cessation or
weight management requirements.
(2) Smoking cessation. – Effective July 1, 2010, all members of the Plan who do not have Medicare as their primary coverage shall be enrolled in the Basic Plan under the Plan's PPO unless the subscriber can attest that the subscriber or any qualifying dependent does not smoke or otherwise use tobacco products. The Plan shall develop a mechanism for verifying that the member does not smoke or use other tobacco products. Tobacco use will be reassessed annually at the time of Plan enrollment. All subscribers who have attested that neither they nor their dependents use tobacco, or whose physician certifies in writing that the member is participating in a smoking cessation program, shall have the choice of remaining in the Basic Plan option or enrolling in the Standard Plan option. For purposes of the smoking cessation initiative, "member" includes all members covered under the Plan. As used in this section, "smoking cessation program" means active participation in a Plan‑approved cessation program to include counseling or use of tobacco cessation medications.
(3) Weight management. – Effective July 1,
2011, all members of the Plan who do not have Medicare as their primary
coverage shall be enrolled in the Basic Plan under the Plan's PPO Plan unless
the subscriber attests that the weight and height ratio of the member is within
a range determined by the Plan based on evidence‑based healthy weight
clinical guidelines, or unless the member's physician certifies in writing that
the member has a medical condition that prevents the attainment of the
specified weight range or that the member is actively participating in a Plan‑approved
weight management program. In either case, the member shall have the option to
enroll in the Basic or Standard Plan.
Not later than October 1, 2009, the Executive Administrator shall inform Plan members of the healthy lifestyle initiatives, requirements for compliance, and consequences of noncompliance. The Executive Administrator shall provide to members education and training to assist members in complying with healthy lifestyle initiatives. The Executive Administrator may implement incentive initiatives to further encourage member achievement in smoking cessation, weight management, and other integrated health management programs.
The Executive Administrator shall report to the Committee on
Employee Hospital and Medical Benefits recommendations the Plan may have for
additional sanctions that may be imposed when the Executive Administrator finds
that a member intentionally makes a false statement on a Plan document. The
five‑year cessation of coverage requirement of G.S. 135‑45.2(j)
does not apply to the smoking cessation and weight management provisions
provision of this subsection."
SECTION 2. This act is effective when it becomes law.
