102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB3874

 

Introduced 2/22/2021, by Rep. Janet Yang Rohr

 

SYNOPSIS AS INTRODUCED:
 
215 ILCS 5/356m  from Ch. 73, par. 968m
215 ILCS 5/356z.33

    Amends the Illinois Insurance Code. In provisions concerning infertility coverage and coverage for epinephrine injectors, provides that on or after the effective date of the amendatory Act, specified coverage shall be applicable to policies of insurance written in other states that insure an Illinois resident.


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FISCAL NOTE ACT MAY APPLY

 

 

A BILL FOR

 

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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 Sections 356m and 356z.33 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 the 99th General Assembly unless the policy
13contains coverage for the diagnosis and treatment of
14infertility including, but not limited to, in vitro
15fertilization, uterine embryo lavage, embryo transfer,
16artificial insemination, gamete intrafallopian tube transfer,
17zygote intrafallopian tube transfer, and low tubal ovum
18transfer.
19    (b) The coverage required under subsection (a) is subject
20to the following conditions:
21        (1) Coverage for procedures for in vitro
22    fertilization, gamete intrafallopian tube transfer, or
23    zygote intrafallopian tube transfer shall be required only

 

 

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1    if:
2            (A) the covered individual has been unable to
3        attain a viable pregnancy, maintain a viable
4        pregnancy, or sustain a successful pregnancy through
5        reasonable, less costly medically appropriate
6        infertility treatments for which coverage is available
7        under the policy, plan, or contract;
8            (B) the covered individual has not undergone 4
9        completed oocyte retrievals, except that if a live
10        birth follows a completed oocyte retrieval, then 2
11        more completed oocyte retrievals shall be covered; and
12            (C) the procedures are performed at medical
13        facilities that conform to the American College of
14        Obstetric and Gynecology guidelines for in vitro
15        fertilization clinics or to the American Fertility
16        Society minimal standards for programs of in vitro
17        fertilization.
18        (2) The procedures required to be covered under this
19    Section are not required to be contained in any policy or
20    plan issued to or by a religious institution or
21    organization or to or by an entity sponsored by a
22    religious institution or organization that finds the
23    procedures required to be covered under this Section to
24    violate its religious and moral teachings and beliefs.
25    (c) For purpose of this Section, "infertility" means the
26inability to conceive after one year of unprotected sexual

 

 

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1intercourse, the inability to conceive after one year of
2attempts to produce conception, the inability to conceive
3after an individual is diagnosed with a condition affecting
4fertility, or the inability to sustain a successful pregnancy.
5    (d) On or after the effective date of this amendatory Act
6of the 102nd General Assembly, coverage required under this
7Section shall be applicable to policies of insurance written
8in other states that insure an Illinois resident.
9(Source: P.A. 99-421, eff. 1-1-16.)
 
10    (215 ILCS 5/356z.33)
11    Sec. 356z.33. Coverage for epinephrine injectors.
12    (a) A group or individual policy of accident and health
13insurance or a managed care plan that is amended, delivered,
14issued, or renewed on or after January 1, 2020 (the effective
15date of Public Act 101-281) this amendatory Act of the 101st
16General Assembly shall provide coverage for medically
17necessary epinephrine injectors for persons 18 years of age or
18under. As used in this Section, "epinephrine injector" has the
19meaning given to that term in Section 5 of the Epinephrine
20Injector Act.
21    (b) On or after the effective date of this amendatory Act
22of the 102nd General Assembly, coverage required under this
23Section shall be applicable to policies of insurance written
24in other states that insure an Illinois resident.
25(Source: P.A. 101-281, eff. 1-1-20; revised 10-16-19.)