(215 ILCS 5/356m)
(from Ch. 73, par. 968m)
(a) No group policy of accident and health insurance providing coverage
for more than 25 employees that provides pregnancy related benefits may be
issued, amended, delivered, or
renewed in this State after the effective date of this amendatory Act of the 99th General Assembly unless the policy contains coverage for the diagnosis and treatment of
infertility including, but not limited to, in vitro fertilization, uterine
embryo lavage, embryo transfer, artificial insemination, gamete
intrafallopian tube transfer, zygote intrafallopian tube transfer, and low
tubal ovum transfer.
(b) The coverage required under subsection (a) is subject to the following conditions:
(1) Coverage for procedures for in vitro
fertilization, gamete intrafallopian tube transfer, or zygote intrafallopian tube transfer shall be required only if:
(A) the covered individual has been unable to
attain a viable pregnancy, maintain a viable pregnancy, or sustain a successful pregnancy through reasonable, less costly medically appropriate infertility treatments for which coverage is available under the policy, plan, or contract;
(B) the covered individual has not undergone 4
completed oocyte retrievals, except that if a live birth follows a completed oocyte retrieval, then 2 more completed oocyte retrievals shall be covered; and
(C) the procedures are performed at medical
facilities that conform to the American College of Obstetric and Gynecology guidelines for in vitro fertilization clinics or to the American Fertility Society minimal standards for programs of in vitro fertilization.
(2) The procedures required to be covered under this
Section are not required to be contained in any policy or plan issued to or by a religious institution or organization or to or by an entity sponsored by a religious institution or organization that finds the procedures required to be covered under this Section to violate its religious and moral teachings and beliefs.
(c) For purpose of this Section, "infertility" means the inability to
conceive after one year of unprotected sexual intercourse, the inability to conceive after one year of attempts to produce conception, the inability to conceive after an individual is diagnosed with a condition affecting fertility, or the inability
to sustain a successful pregnancy.
(Source: P.A. 99-421, eff. 1-1-16