Bill Text: IL HB3874 | 2021-2022 | 102nd General Assembly | Introduced
Bill Title: 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.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2021-04-02 - Added Co-Sponsor Rep. Thomas M. Bennett [HB3874 Detail]
Download: Illinois-2021-HB3874-Introduced.html
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| 1 | AN ACT concerning regulation.
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| 2 | Be it enacted by the People of the State of Illinois,
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| 3 | represented in the General Assembly:
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| 4 | Section 5. The Illinois Insurance Code is amended by | ||||||||||||||||||||||||||
| 5 | changing Sections 356m and 356z.33 as follows:
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| 6 | (215 ILCS 5/356m) (from Ch. 73, par. 968m)
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| 7 | Sec. 356m. Infertility coverage.
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| 8 | (a) No group policy of accident and health insurance | ||||||||||||||||||||||||||
| 9 | providing coverage
for more than 25 employees that provides | ||||||||||||||||||||||||||
| 10 | pregnancy related benefits may be
issued, amended, delivered, | ||||||||||||||||||||||||||
| 11 | or
renewed in this State after the effective date of this | ||||||||||||||||||||||||||
| 12 | amendatory Act of the 99th General Assembly unless the policy | ||||||||||||||||||||||||||
| 13 | contains coverage for the diagnosis and treatment of
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| 14 | infertility including, but not limited to, in vitro | ||||||||||||||||||||||||||
| 15 | fertilization, uterine
embryo lavage, embryo transfer, | ||||||||||||||||||||||||||
| 16 | artificial insemination, gamete
intrafallopian tube transfer, | ||||||||||||||||||||||||||
| 17 | zygote intrafallopian tube transfer, and low
tubal ovum | ||||||||||||||||||||||||||
| 18 | transfer.
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| 19 | (b) The coverage required under subsection (a) is subject | ||||||||||||||||||||||||||
| 20 | to the following conditions:
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| 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:
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| 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
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| 6 | infertility treatments for which coverage is available | ||||||
| 7 | under the policy,
plan, or contract;
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| 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
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| 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
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| 15 | fertilization clinics or to the American Fertility | ||||||
| 16 | Society minimal
standards for programs of in vitro | ||||||
| 17 | fertilization.
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| 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.
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| 25 | (c) For purpose of this Section, "infertility" means the | ||||||
| 26 | inability to
conceive after one year of unprotected sexual | ||||||
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| 1 | intercourse, the inability to conceive after one year of | ||||||
| 2 | attempts to produce conception, the inability to conceive | ||||||
| 3 | after an individual is diagnosed with a condition affecting | ||||||
| 4 | fertility, or the inability
to sustain a successful pregnancy.
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| 5 | (d) On or after the effective date of this amendatory Act | ||||||
| 6 | of the 102nd General Assembly, coverage required under this | ||||||
| 7 | Section shall be applicable to policies of insurance written | ||||||
| 8 | in other states that insure an Illinois resident. | ||||||
| 9 | (Source: P.A. 99-421, eff. 1-1-16.)
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| 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 | ||||||
| 13 | insurance or a managed care plan that is amended, delivered, | ||||||
| 14 | issued, or renewed on or after January 1, 2020 (the effective | ||||||
| 15 | date of Public Act 101-281) this amendatory Act of the 101st | ||||||
| 16 | General Assembly shall provide coverage for medically | ||||||
| 17 | necessary epinephrine injectors for persons 18 years of age or | ||||||
| 18 | under. As used in this Section, "epinephrine injector" has the | ||||||
| 19 | meaning given to that term in Section 5 of the Epinephrine | ||||||
| 20 | Injector Act.
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| 21 | (b) On or after the effective date of this amendatory Act | ||||||
| 22 | of the 102nd General Assembly, coverage required under this | ||||||
| 23 | Section shall be applicable to policies of insurance written | ||||||
| 24 | in other states that insure an Illinois resident. | ||||||
| 25 | (Source: P.A. 101-281, eff. 1-1-20; revised 10-16-19.)
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