98TH GENERAL ASSEMBLY
State of Illinois
2013 and 2014
HB3734

 

Introduced , by Rep. Robyn Gabel

 

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

    Amends the Illinois Insurance Code in the provision concerning infertility coverage. Provides that "infertility" includes iatrogenic infertility and conditions of an individual becoming infertile due to a disease.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

HB3734LRB098 14474 RPM 49191 b

1    AN ACT concerning regulation.
 
2    Be it enacted by the People of the State of Illinois,
3represented in the General Assembly:
 
4    Section 5. The Illinois Insurance Code is amended by
5changing 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
9providing coverage for more than 25 employees that provides
10pregnancy related benefits may be issued, amended, delivered,
11or renewed in this State after the effective date of this
12amendatory Act of 1991 unless the policy contains coverage for
13the diagnosis and treatment of infertility including, but not
14limited to, in vitro fertilization, uterine embryo lavage,
15embryo transfer, artificial insemination, gamete
16intrafallopian tube transfer, zygote intrafallopian tube
17transfer, and low tubal ovum transfer.
18    (b) The coverage required under subsection (a) is subject
19to 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) For purpose of this Section, "infertility" means the
24inability to conceive after one year of unprotected sexual
25intercourse or the inability to sustain a successful pregnancy.
26"Infertility" includes iatrogenic infertility and conditions

 

 

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1of an individual becoming infertile due to a disease.
2(Source: P.A. 89-669, eff. 1-1-97.)