Bill Text: IL HB4112 | 2023-2024 | 103rd General Assembly | Engrossed

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Bill Title: Amends the Illinois Insurance Code. Provides that 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 on or after January 1, 2025 unless the policy contains coverage for the diagnosis and treatment of infertility. Requires such coverage to include procedures necessary to screen or diagnose a fertilized egg before implantation. Provides that coverage for in vitro fertilization, gamete intrafallopian tube transfer, or zygote intrafallopian tube transfer shall be required only if the procedures: (1) are considered medically appropriate based on clinical guidelines or standards developed by the American Society for Reproductive Medicine, the American College of Obstetricians and Gynecologists, or the Society for Assisted Reproductive Technology; and (2) are performed at medical facilities or clinics that conform to the American College of Obstetricians and Gynecologists guidelines for in vitro fertilization or the American Society for Reproductive Medicine minimum standards for practices offering assisted reproductive technologies. Makes changes in the Counties Code, the Illinois Municipal Code, the School Code, the Limited Health Service Organization Act, the Voluntary Health Services Plans Act, and the Illinois Public Aid Code to provide that infertility insurance must be included in health insurance coverage for employees. Effective immediately.

Spectrum: Strong Partisan Bill (Democrat 35-3)

Status: (Introduced) 2024-05-16 - Added Co-Sponsor Rep. Debbie Meyers-Martin [HB4112 Detail]

Download: Illinois-2023-HB4112-Engrossed.html

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HB4112 Engrossed LRB103 33223 LNS 63031 b
AN ACT concerning regulation.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. The State Employees Group Insurance Act of 1971
is amended by changing Section 6.11B as follows:
(5 ILCS 375/6.11B)
Sec. 6.11B. Infertility coverage.
(a) Beginning on January 1, 2024, the State Employees
Group Insurance Program shall provide 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. The coverage required
shall include procedures necessary to screen or diagnose a
fertilized egg before implantation, including, but not limited
to, preimplantation genetic diagnosis, preimplantation genetic
screening, and prenatal genetic diagnosis.
(b) Beginning on January 1, 2024, coverage under this
Section for procedures for in vitro fertilization, gamete
intrafallopian tube transfer, or zygote intrafallopian tube
transfer shall be required only if the procedures:
(1) are considered medically appropriate based on

HB4112 Engrossed - 2 - LRB103 33223 LNS 63031 b
clinical guidelines or standards developed by the American
Society for Reproductive Medicine, the American College of
Obstetricians and Gynecologists, or the Society for
Assisted Reproductive Technology; and
(2) are performed at medical facilities or clinics
that conform to the American College of Obstetricians and
Gynecologists guidelines for in vitro fertilization or the
American Society for Reproductive Medicine minimum
standards for practices offering assisted reproductive
technologies.
(c) As used in this Section, "infertility" means a
disease, condition, or status characterized by:
(1) a failure to establish a pregnancy or to carry a
pregnancy to live birth after 12 months of regular,
unprotected sexual intercourse if the woman is 35 years of
age or younger, or after 6 months of regular, unprotected
sexual intercourse if the woman is over 35 years of age;
conceiving but having a miscarriage does not restart the
12-month or 6-month term for determining infertility;
(2) a person's inability to reproduce either as a
single individual or with a partner without medical
intervention; or
(3) a licensed physician's findings based on a
patient's medical, sexual, and reproductive history, age,
physical findings, or diagnostic testing.
(d) The State Employees Group Insurance Program may not

HB4112 Engrossed - 3 - LRB103 33223 LNS 63031 b
impose any exclusions, limitations, or other restrictions on
coverage of fertility medications that are different from
those imposed on any other prescription medications, nor may
it impose any exclusions, limitations, or other restrictions
on coverage of any fertility services based on a covered
individual's participation in fertility services provided by
or to a third party, nor may it impose deductibles,
copayments, coinsurance, benefit maximums, waiting periods, or
any other limitations on coverage for the diagnosis of
infertility, treatment for infertility, and standard fertility
preservation services, except as provided in this Section,
that are different from those imposed upon benefits for
services not related to infertility.
(e) This Section applies only to coverage provided on or
after January 1, 2024 and before July 1, 2026.
(f) This Section is repealed on July 1, 2026.
(Source: P.A. 103-8, eff. 1-1-24.)
Section 10. The Counties Code is amended by changing
Section 5-1069.3 as follows:
(55 ILCS 5/5-1069.3)
Sec. 5-1069.3. Required health benefits. If a county,
including a home rule county, is a self-insurer for purposes
of providing health insurance coverage for its employees, the
coverage shall include coverage for the post-mastectomy care

HB4112 Engrossed - 4 - LRB103 33223 LNS 63031 b
benefits required to be covered by a policy of accident and
health insurance under Section 356t and the coverage required
under Sections 356g, 356g.5, 356g.5-1, 356m, 356q, 356u, 356w,
356x, 356z.4, 356z.4a, 356z.6, 356z.8, 356z.9, 356z.10,
356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22, 356z.25,
356z.26, 356z.29, 356z.30a, 356z.32, 356z.33, 356z.36,
356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.48, 356z.51,
356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, and
356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70
of the Illinois Insurance Code. The coverage shall comply with
Sections 155.22a, 355b, 356z.19, and 370c of the Illinois
Insurance Code. The Department of Insurance shall enforce the
requirements of this Section. The requirement that health
benefits be covered as provided in this Section is an
exclusive power and function of the State and is a denial and
limitation under Article VII, Section 6, subsection (h) of the
Illinois Constitution. A home rule county to which this
Section applies must comply with every provision of this
Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;

HB4112 Engrossed - 5 - LRB103 33223 LNS 63031 b
102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
103-535, eff. 8-11-23; 103-551, eff. 8-11-23; revised
8-29-23.)
Section 15. The Illinois Municipal Code is amended by
changing Section 10-4-2.3 as follows:
(65 ILCS 5/10-4-2.3)
Sec. 10-4-2.3. Required health benefits. If a
municipality, including a home rule municipality, is a
self-insurer for purposes of providing health insurance
coverage for its employees, the coverage shall include
coverage for the post-mastectomy care benefits required to be
covered by a policy of accident and health insurance under
Section 356t and the coverage required under Sections 356g,
356g.5, 356g.5-1, 356m, 356q, 356u, 356w, 356x, 356z.4,
356z.4a, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
356z.13, 356z.14, 356z.15, 356z.22, 356z.25, 356z.26, 356z.29,
356z.30a, 356z.32, 356z.33, 356z.36, 356z.40, 356z.41,
356z.45, 356z.46, 356z.47, 356z.48, 356z.51, 356z.53, 356z.54,
356z.56, 356z.57, 356z.59, 356z.60, and 356z.61, and 356z.62,

HB4112 Engrossed - 6 - LRB103 33223 LNS 63031 b
356z.64, 356z.67, 356z.68, and 356z.70 of the Illinois
Insurance Code. The coverage shall comply with Sections
155.22a, 355b, 356z.19, and 370c of the Illinois Insurance
Code. The Department of Insurance shall enforce the
requirements of this Section. The requirement that health
benefits be covered as provided in this is an exclusive power
and function of the State and is a denial and limitation under
Article VII, Section 6, subsection (h) of the Illinois
Constitution. A home rule municipality to which this Section
applies must comply with every provision of this Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-443, eff.
1-1-22; 102-642, eff. 1-1-22; 102-665, eff. 10-8-21; 102-731,
eff. 1-1-23; 102-804, eff. 1-1-23; 102-813, eff. 5-13-22;
102-816, eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff.
1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
103-535, eff. 8-11-23; 103-551, eff. 8-11-23; revised
8-29-23.)

HB4112 Engrossed - 7 - LRB103 33223 LNS 63031 b
Section 20. The School Code is amended by changing Section
10-22.3f as follows:
(105 ILCS 5/10-22.3f)
Sec. 10-22.3f. Required health benefits. Insurance
protection and benefits for employees shall provide the
post-mastectomy care benefits required to be covered by a
policy of accident and health insurance under Section 356t and
the coverage required under Sections 356g, 356g.5, 356g.5-1,
356m, 356q, 356u, 356w, 356x, 356z.4, 356z.4a, 356z.6, 356z.8,
356z.9, 356z.11, 356z.12, 356z.13, 356z.14, 356z.15, 356z.22,
356z.25, 356z.26, 356z.29, 356z.30a, 356z.32, 356z.33,
356z.36, 356z.40, 356z.41, 356z.45, 356z.46, 356z.47, 356z.51,
356z.53, 356z.54, 356z.56, 356z.57, 356z.59, 356z.60, and
356z.61, and 356z.62, 356z.64, 356z.67, 356z.68, and 356z.70
of the Illinois Insurance Code. Insurance policies shall
comply with Section 356z.19 of the Illinois Insurance Code.
The coverage shall comply with Sections 155.22a, 355b, and
370c of the Illinois Insurance Code. The Department of
Insurance shall enforce the requirements of this Section.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.

HB4112 Engrossed - 8 - LRB103 33223 LNS 63031 b
(Source: P.A. 102-30, eff. 1-1-22; 102-103, eff. 1-1-22;
102-203, eff. 1-1-22; 102-306, eff. 1-1-22; 102-642, eff.
1-1-22; 102-665, eff. 10-8-21; 102-731, eff. 1-1-23; 102-804,
eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
102-860, eff. 1-1-23; 102-1093, eff. 1-1-23; 102-1117, eff.
1-13-23; 103-84, eff. 1-1-24; 103-91, eff. 1-1-24; 103-420,
eff. 1-1-24; 103-445, eff. 1-1-24; 103-535, eff. 8-11-23;
103-551, eff. 8-11-23; revised 8-29-23.)
Section 25. 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 January 1, 2016 through
December 31, 2025 the effective date of this amendatory Act of
the 99th General Assembly 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) for

HB4112 Engrossed - 9 - LRB103 33223 LNS 63031 b
procedures for in vitro fertilization, gamete intrafallopian
tube transfer, or zygote intrafallopian tube transfer shall be
required only if: 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:
(1) (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;
(2) (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
(3) (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

HB4112 Engrossed - 10 - LRB103 33223 LNS 63031 b
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) No group policy of accident and health insurance that
provides pregnancy related benefits may be issued, amended,
delivered, or renewed in this State on or after January 1, 2026
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 and procedures necessary to screen or diagnose a
fertilized egg before implantation, including, but not limited
to, preimplantation genetic diagnosis, preimplantation genetic
screening, and prenatal genetic diagnosis. Coverage under this
subsection for the diagnosis and treatment of infertility
shall be required only if the procedures:
(1) are considered medically appropriate by the
patient's medical provider based on clinical guidelines or
standards developed by the American Society for
Reproductive Medicine, the American College of
Obstetricians and Gynecologists, or the Society for
Assisted Reproductive Technology; and
(2) are performed at medical facilities or clinics
that conform to the American College of Obstetricians and
Gynecologists guidelines for in vitro fertilization or the

HB4112 Engrossed - 11 - LRB103 33223 LNS 63031 b
American Society for Reproductive Medicine minimum
standards for practices offering assisted reproductive
technologies.
(d) (c) As used in this Section, "infertility" means a
disease, condition, or status characterized by:
(1) a failure to establish a pregnancy or to carry a
pregnancy to live birth after 12 months of regular,
unprotected sexual intercourse if the woman is 35 years of
age or younger, or after 6 months of regular, unprotected
sexual intercourse if the woman is over 35 years of age;
conceiving but having a miscarriage does not restart the
12-month or 6-month term for determining infertility;
(2) a person's inability to reproduce either as a
single individual or with a partner without medical
intervention; or
(3) a licensed physician's findings based on a
patient's medical, sexual, and reproductive history, age,
physical findings, or diagnostic testing.
(e) (d) A policy, contract, or certificate may not impose
any exclusions, limitations, or other restrictions on coverage
of fertility medications that are different from those imposed
on any other prescription medications, nor may it impose any
exclusions, limitations, or other restrictions on coverage of
any fertility services based on a covered individual's
participation in fertility services provided by or to a third
party, nor may it impose deductibles, copayments, coinsurance,

HB4112 Engrossed - 12 - LRB103 33223 LNS 63031 b
benefit maximums, waiting periods, or any other limitations on
coverage for the diagnosis of infertility, treatment for
infertility, and standard fertility preservation services,
except as provided in this Section, that are different from
those imposed upon benefits for services not related to
infertility.
(f) 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.
(Source: P.A. 102-170, eff. 1-1-22.)
Section 30. The Limited Health Service Organization Act is
amended by changing Section 4003 as follows:
(215 ILCS 130/4003) (from Ch. 73, par. 1504-3)
Sec. 4003. Illinois Insurance Code provisions. Limited
health service organizations shall be subject to the
provisions of Sections 133, 134, 136, 137, 139, 140, 141.1,
141.2, 141.3, 143, 143c, 147, 148, 149, 151, 152, 153, 154,
154.5, 154.6, 154.7, 154.8, 155.04, 155.37, 155.49, 355.2,
355.3, 355b, 356m, 356q, 356v, 356z.4, 356z.4a, 356z.10,
356z.21, 356z.22, 356z.25, 356z.26, 356z.29, 356z.30a,

HB4112 Engrossed - 13 - LRB103 33223 LNS 63031 b
356z.32, 356z.33, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53,
356z.54, 356z.57, 356z.59, 356z.61, 356z.64, 356z.67, 356z.68,
364.3, 368a, 401, 401.1, 402, 403, 403A, 408, 408.2, 409, 412,
444, and 444.1 and Articles IIA, VIII 1/2, XII, XII 1/2, XIII,
XIII 1/2, XXV, and XXVI of the Illinois Insurance Code.
Nothing in this Section shall require a limited health care
plan to cover any service that is not a limited health service.
For purposes of the Illinois Insurance Code, except for
Sections 444 and 444.1 and Articles XIII and XIII 1/2, limited
health service organizations in the following categories are
deemed to be domestic companies:
(1) a corporation under the laws of this State; or
(2) a corporation organized under the laws of another
state, 30% or more of the enrollees of which are residents
of this State, except a corporation subject to
substantially the same requirements in its state of
organization as is a domestic company under Article VIII
1/2 of the Illinois Insurance Code.
(Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;
102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-731, eff.
1-1-23; 102-775, eff. 5-13-22; 102-813, eff. 5-13-22; 102-816,
eff. 1-1-23; 102-860, eff. 1-1-23; 102-1093, eff. 1-1-23;
102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91, eff.
1-1-24; 103-420, eff. 1-1-24; 103-426, eff. 8-4-23; 103-445,
eff. 1-1-24; revised 8-29-23.)

HB4112 Engrossed - 14 - LRB103 33223 LNS 63031 b
Section 35. The Voluntary Health Services Plans Act is
amended by changing Section 10 as follows:
(215 ILCS 165/10) (from Ch. 32, par. 604)
Sec. 10. Application of Insurance Code provisions. Health
services plan corporations and all persons interested therein
or dealing therewith shall be subject to the provisions of
Articles IIA and XII 1/2 and Sections 3.1, 133, 136, 139, 140,
143, 143c, 149, 155.22a, 155.37, 354, 355.2, 355.3, 355b,
356g, 356g.5, 356g.5-1, 356m, 356q, 356r, 356t, 356u, 356v,
356w, 356x, 356y, 356z.1, 356z.2, 356z.3a, 356z.4, 356z.4a,
356z.5, 356z.6, 356z.8, 356z.9, 356z.10, 356z.11, 356z.12,
356z.13, 356z.14, 356z.15, 356z.18, 356z.19, 356z.21, 356z.22,
356z.25, 356z.26, 356z.29, 356z.30, 356z.30a, 356z.32,
356z.33, 356z.40, 356z.41, 356z.46, 356z.47, 356z.51, 356z.53,
356z.54, 356z.56, 356z.57, 356z.59, 356z.60, 356z.61, 356z.62,
356z.64, 356z.67, 356z.68, 364.01, 364.3, 367.2, 368a, 401,
401.1, 402, 403, 403A, 408, 408.2, and 412, and paragraphs (7)
and (15) of Section 367 of the Illinois Insurance Code.
Rulemaking authority to implement Public Act 95-1045, if
any, is conditioned on the rules being adopted in accordance
with all provisions of the Illinois Administrative Procedure
Act and all rules and procedures of the Joint Committee on
Administrative Rules; any purported rule not so adopted, for
whatever reason, is unauthorized.
(Source: P.A. 102-30, eff. 1-1-22; 102-203, eff. 1-1-22;

HB4112 Engrossed - 15 - LRB103 33223 LNS 63031 b
102-306, eff. 1-1-22; 102-642, eff. 1-1-22; 102-665, eff.
10-8-21; 102-731, eff. 1-1-23; 102-775, eff. 5-13-22; 102-804,
eff. 1-1-23; 102-813, eff. 5-13-22; 102-816, eff. 1-1-23;
102-860, eff. 1-1-23; 102-901, eff. 7-1-22; 102-1093, eff.
1-1-23; 102-1117, eff. 1-13-23; 103-84, eff. 1-1-24; 103-91,
eff. 1-1-24; 103-420, eff. 1-1-24; 103-445, eff. 1-1-24;
103-551, eff. 8-11-23; revised 8-29-23.)