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| 1 | AMENDMENT TO HOUSE BILL 3494
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| 2 | AMENDMENT NO. ______. Amend House Bill 3494 by replacing | ||||||
| 3 | everything after the enacting clause with the following:
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| 4 | "Section 5. The Illinois Insurance Code is amended by | ||||||
| 5 | changing Section 356m as follows:
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| 6 | (215 ILCS 5/356m) (from Ch. 73, par. 968m)
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| 7 | Sec. 356m. Infertility coverage.
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| 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
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| 16 | intrafallopian tube transfer, zygote intrafallopian tube | ||||||
| 17 | transfer, and low
tubal ovum transfer.
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| 18 | (b) The coverage required under subsection (a) is subject | ||||||
| 19 | to the following conditions:
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| 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:
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| 24 | (A) the covered individual has been unable to | ||||||
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| 1 | attain or sustain a
successful pregnancy through | ||||||
| 2 | reasonable, less costly medically appropriate
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| 3 | infertility treatments for which coverage is available | ||||||
| 4 | under the policy,
plan, or contract;
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| 5 | (B) the covered individual has not undergone 4 | ||||||
| 6 | completed oocyte
retrievals, except that if a live | ||||||
| 7 | birth follows a completed oocyte
retrieval, then 2 more | ||||||
| 8 | completed oocyte retrievals shall be covered; and
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| 9 | (C) the procedures are performed at medical | ||||||
| 10 | facilities that conform to
the American College of | ||||||
| 11 | Obstetric and Gynecology guidelines for in vitro
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| 12 | fertilization clinics or to the American Fertility | ||||||
| 13 | Society minimal
standards for programs of in vitro | ||||||
| 14 | fertilization.
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| 15 | (2) The procedures required to be covered under this | ||||||
| 16 | Section are not
required to be contained in any policy or | ||||||
| 17 | plan issued to or by a religious
institution or | ||||||
| 18 | organization or to or by an entity sponsored by a religious
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| 19 | institution or organization that finds the procedures | ||||||
| 20 | required to be
covered under this Section to violate its | ||||||
| 21 | religious
and moral teachings and beliefs.
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| 22 | (c) For purpose of this Section, "infertility" means
the | ||||||
| 23 | inability to
conceive after one year of unprotected sexual | ||||||
| 24 | intercourse,
or the inability
to sustain a successful | ||||||
| 25 | pregnancy, or a medical condition that causes conception or | ||||||
| 26 | gestation to be unlikely without fertility treatment.
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| 27 | (Source: P.A. 89-669, eff. 1-1-97.)
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| 28 | Section 99. Effective date. This Act takes effect upon | ||||||
| 29 | becoming law.".
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