93RD GENERAL ASSEMBLY
State of Illinois
2003 and 2004
SB2423

 

Introduced 2/3/2004, by Ira I. Silverstein

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356m   from Ch. 73, par. 968m

    Amends the Illinois Insurance Code. In provisions requiring infertility coverage for procedures for in vitro fertilization, gamete intrafallopian tube transfer, or zygote intrafallopian tube transfer only if certain conditions exist, requires that the covered individual has not undergone 6 (now 4) completed oocyte retrievals.


LRB093 20769 SAS 46669 b

 

 

A BILL FOR

 

SB2423 LRB093 20769 SAS 46669 b

1     AN ACT concerning insurance.
 
2     Be it enacted by the People of the State of Illinois,
3 represented in the General Assembly:
 
4     Section 5. The Illinois Insurance Code is amended by
5 changing Section 356m as follows:
 
6     (215 ILCS 5/356m)  (from Ch. 73, par. 968m)
7     Sec. 356m. Infertility coverage.
8     (a) No group policy of accident and health insurance
9 providing coverage for more than 25 employees that provides
10 pregnancy related benefits may be issued, amended, delivered,
11 or renewed in this State after the effective date of this
12 amendatory Act of 1991 unless the policy contains coverage for
13 the diagnosis and treatment of infertility including, but not
14 limited to, in vitro fertilization, uterine embryo lavage,
15 embryo transfer, artificial insemination, gamete
16 intrafallopian tube transfer, zygote intrafallopian tube
17 transfer, and low tubal ovum transfer.
18     (b) The coverage required under subsection (a) is subject
19 to the following conditions:
20         (1) Coverage for procedures for in vitro
21     fertilization, gamete intrafallopian tube transfer, or
22     zygote intrafallopian tube transfer shall be required only
23     if:
24             (A) the covered individual has been unable to
25         attain or sustain a successful pregnancy through
26         reasonable, less costly medically appropriate
27         infertility treatments for which coverage is available
28         under the policy, plan, or contract;
29             (B) the covered individual has not undergone 6 4
30         completed oocyte retrievals, except that if a live
31         birth follows a completed oocyte retrieval, then 2 more
32         completed oocyte retrievals shall be covered; and

 

 

SB2423 - 2 - LRB093 20769 SAS 46669 b

1             (C) the procedures are performed at medical
2         facilities that conform to the American College of
3         Obstetric and Gynecology guidelines for in vitro
4         fertilization clinics or to the American Fertility
5         Society minimal standards for programs of in vitro
6         fertilization.
7         (2) The procedures required to be covered under this
8     Section are not required to be contained in any policy or
9     plan issued to or by a religious institution or
10     organization or to or by an entity sponsored by a religious
11     institution or organization that finds the procedures
12     required to be covered under this Section to violate its
13     religious and moral teachings and beliefs.
14     (c) For purpose of this Section, "infertility" means the
15 inability to conceive after one year of unprotected sexual
16 intercourse or the inability to sustain a successful pregnancy.
17 (Source: P.A. 89-669, eff. 1-1-97.)