Illinois General Assembly - Full Text of HB3709
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Full Text of HB3709  102nd General Assembly


Rep. Margaret Croke

Filed: 3/18/2021





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2    AMENDMENT NO. ______. Amend House Bill 3709 by replacing
3everything after the enacting clause with the following:
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 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,



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1zygote intrafallopian tube transfer, and low tubal ovum
3    (b) The coverage required under subsection (a) is subject
4to the following conditions:
5        (1) Coverage for procedures for in vitro
6    fertilization, gamete intrafallopian tube transfer, or
7    zygote intrafallopian tube transfer shall be required only
8    if:
9            (A) the covered individual has been unable to
10        attain a viable pregnancy, maintain a viable
11        pregnancy, or sustain a successful pregnancy through
12        reasonable, less costly medically appropriate
13        infertility treatments for which coverage is available
14        under the policy, plan, or contract;
15            (B) the covered individual has not undergone 4
16        completed oocyte retrievals, except that if a live
17        birth follows a completed oocyte retrieval, then 2
18        more completed oocyte retrievals shall be covered; and
19            (C) the procedures are performed at medical
20        facilities that conform to the American College of
21        Obstetric and Gynecology guidelines for in vitro
22        fertilization clinics or to the American Fertility
23        Society minimal standards for programs of in vitro
24        fertilization.
25        (2) The procedures required to be covered under this
26    Section are not required to be contained in any policy or



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1    plan issued to or by a religious institution or
2    organization or to or by an entity sponsored by a
3    religious institution or organization that finds the
4    procedures required to be covered under this Section to
5    violate its religious and moral teachings and beliefs.
6    (c) As used in For purpose of this Section, "infertility"
7means a disease, condition, or status characterized by: the
8inability to conceive after one year of unprotected sexual
9intercourse, the inability to conceive after one year of
10attempts to produce conception, the inability to conceive
11after an individual is diagnosed with a condition affecting
12fertility, or the inability to sustain a successful pregnancy.
13        (1) a failure to establish a pregnancy or to carry a
14    pregnancy to live birth after 12 months of regular,
15    unprotected sexual intercourse if the woman is 35 years of
16    age or younger, or after 6 months of regular, unprotected
17    sexual intercourse if the woman is over 35 years of age;
18    conceiving but having a miscarriage does not restart the
19    12-month or 6-month term for determining infertility;
20        (2) a person's inability to reproduce either as a
21    single individual or with a partner without medical
22    intervention; or
23        (3) a licensed physician's findings based on a
24    patient's medical, sexual, and reproductive history, age,
25    physical findings, or diagnostic testing.
26    (d) A policy, contract, or certificate may not impose any



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1exclusions, limitations, or other restrictions on coverage of
2fertility medications that are different from those imposed on
3any other prescription medications, nor may it impose any
4exclusions, limitations, or other restrictions on coverage of
5any fertility services based on a covered individual's
6participation in fertility services provided by or to a third
7party, nor may it impose deductibles, copayments, coinsurance,
8benefit maximums, waiting periods, or any other limitations on
9coverage for the diagnosis of infertility, treatment for
10infertility, and standard fertility preservation services,
11except as provided in this Section, that are different from
12those imposed upon benefits for services not related to
14(Source: P.A. 99-421, eff. 1-1-16.)".