Guam § 15707 - Refunds, Rebates, Deductibles and Other

§ 15707. Refunds, Rebates, Deductibles and Other

Wellness Incentives in Health Plans or Health Insurance

Policies.

(a) It shall not be unlawful for an insurer to offer or sell, or

for a broker, agent or solicitor on behalf of an insurer to offer or

sell, a health plan or health insurance policy which provides for a

refund or rebate of premium or deductible, a discounted co-

payment or other wellness incentive in a health plan or health

insurance policy, provided, that any such valuable consideration

or reward is specified in the plan or policy, and further provided,

that the plan or policy complies with the Final Rules for

Nondiscrimination and Wellness Programs promulgated under the

Health Insurance Portability and Accountability Act of 1996

(“HIPAA”), which provide an express exception to the general

rule prohibiting discrimination on a health factor if the reward is

based on participation in a wellness program of health promotion

or disease prevention.

(b) It shall not be unlawful for an insurer to pay a refund or

rebate of premium or refund a deductible to an insured or discount

a co-payment under a health plan or health insurance policy,

provided, that the amount of such payment complies with

limitations and restrictions set forth in HIPAA and the Final Rules

for Nondiscrimination and Wellness Programs promulgated under

HIPAA.

(c) It is unlawful for any insurer or general agent to appoint

an agent for the purpose of enabling such agent, or other person,

to obtain at a cost less than that specified in the policy any

insurance from such insurer.

(d) The provisions of this Section and the requirement of a

wellness program under the exception to the HIPAA’s general rule

against discrimination shall not be applicable to any health plan or

health insurance policy which does not discriminate against any

individual on any health factor or otherwise violate the general

rule. Refunds of premiums, deductibles (including pre-funded

deductibles) or co-payments which are uniformly applied to all

similarly situated insureds are not rewards based on a health

factor, and are therefore not in violation of the general rule.