99TH GENERAL ASSEMBLY
State of Illinois
2015 and 2016
SB1764

 

Introduced 2/20/2015, by Sen. Don Harmon

 

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

    Amends the Illinois Insurance Code. Provides that insurers offering accident and health insurance to groups of more than 25 employees provide coverage for infertility treatments to covered individuals unable to attain a viable pregnancy or maintain a viable pregnancy (previously covered just those unable to sustain a successful pregnancy). Expands definition of infertility to include individuals unable to conceive after one year of attempting to produce conception and those unable to conceive after diagnosis with a condition affecting fertility.


LRB099 09375 MLM 29581 b

 

 

A BILL FOR

 

SB1764LRB099 09375 MLM 29581 b

1    AN ACT concerning insurance.
 
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 the 99th General Assembly the effective date
13of this amendatory Act of 1991 unless the policy contains
14coverage for the diagnosis and treatment of infertility
15including, but not limited to, in vitro fertilization, uterine
16embryo lavage, embryo transfer, artificial insemination,
17gamete intrafallopian tube transfer, zygote intrafallopian
18tube transfer, and low tubal ovum transfer.
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

 

 

SB1764- 2 -LRB099 09375 MLM 29581 b

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 more
11        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 religious
22    institution or organization that finds the procedures
23    required to be covered under this Section to violate its
24    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

 

 

SB1764- 3 -LRB099 09375 MLM 29581 b

1intercourse, the inability to conceive after one year of
2attempts to produce conception, the inability to conceive after
3an individual is diagnosed with a condition affecting
4fertility, or the inability to sustain a successful pregnancy.
5(Source: P.A. 89-669, eff. 1-1-97.)