Illinois General Assembly - Full Text of Public Act 099-0421
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Public Act 099-0421


 

Public Act 0421 99TH GENERAL ASSEMBLY

  
  
  

 


 
Public Act 099-0421
 
SB1764 EnrolledLRB099 09375 MLM 29581 b

    AN ACT concerning insurance.
 
    Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
 
    Section 5. The Illinois Insurance Code is amended by
changing Section 356m as follows:
 
    (215 ILCS 5/356m)  (from Ch. 73, par. 968m)
    Sec. 356m. Infertility coverage.
    (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 the effective date
of this amendatory Act of 1991 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. 89-669, eff. 1-1-97.)

Effective Date: 1/1/2016