96TH GENERAL ASSEMBLY
State of Illinois
2009 and 2010
HB4331

 

Introduced 2/27/2009, by Rep. Deborah Mell

 

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

    Amends the Illinois Insurance Code. Provides that no group policy of accident and health insurance providing coverage for more than 25 employees that provides pregnancy related benefits shall contain a provision that covers the diagnosis and treatment of infertility only if the individual was covered under the policy for at least one year. Deletes a definition for "infertility".


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A BILL FOR

 

HB4331 LRB096 08444 RPM 18561 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:

 

 

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1             (A) the covered individual has been unable to
2         attain or sustain a successful pregnancy through
3         reasonable, less costly medically appropriate
4         infertility treatments for which coverage is available
5         under the policy, plan, or contract;
6             (B) the covered individual has not undergone 4
7         completed oocyte retrievals, except that if a live
8         birth follows a completed oocyte retrieval, then 2 more
9         completed oocyte retrievals shall be covered; and
10             (C) the procedures are performed at medical
11         facilities that conform to the American College of
12         Obstetric and Gynecology guidelines for in vitro
13         fertilization clinics or to the American Fertility
14         Society minimal standards for programs of in vitro
15         fertilization.
16         (2) The procedures required to be covered under this
17     Section are not required to be contained in any policy or
18     plan issued to or by a religious institution or
19     organization or to or by an entity sponsored by a religious
20     institution or organization that finds the procedures
21     required to be covered under this Section to violate its
22     religious and moral teachings and beliefs.
23     (c) No group policy of accident and health insurance
24 providing coverage for more than 25 employees that provides
25 pregnancy related benefits shall contain a provision that
26 covers the diagnosis and treatment of infertility only if the

 

 

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1 individual was covered under the policy for at least one year.
2 For purpose of this Section, "infertility" means the inability
3 to conceive after one year of unprotected sexual intercourse or
4 the inability to sustain a successful pregnancy.
5 (Source: P.A. 89-669, eff. 1-1-97.)