1. (a) Notwithstanding the provisions of the Insurance Code Chapter 1501, §541.056(a) and §544.052, and the provisions of Chapter 26, Subchapter A of this title (relating to Small Employer Health Insurance Portability and Availability Act Regulations), a group health benefit plan issuer or an accident and health insurance issuer may vary the amount of premium or contribution it requires similarly situated individuals to pay, and/or 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 or §21.4707 of this subchapter (relating to Wellness Programs With Participation as Sole Basis for Reward Eligibility and Wellness Programs With Reward Eligibility Based on Satisfying a Health Status Related Standard).
2. (b) Notwithstanding the provisions of the Insurance Code §541.056(a) and §544.052, an insurer issuing an accident and health insurance policy may vary the amount of premium or contribution it requires similarly situated individuals or individuals of the same class and of essentially the same hazard to pay, and/or 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 or §21.4707 of this subchapter.

Source Note:The provisions of this §21.4703 adopted to be effective March 31, 2009, 34 TexReg 2135.