Bill Text: IL SB1764 | 2015-2016 | 99th General Assembly | Chaptered
Bill Title: 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.
Spectrum: Partisan Bill (Democrat 5-0)
Status: (Passed) 2015-08-20 - Public Act . . . . . . . . . 99-0421 [SB1764 Detail]
Download: Illinois-2015-SB1764-Chaptered.html
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| Public Act 099-0421 | ||||
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AN ACT concerning insurance.
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Be it enacted by the People of the State of Illinois,
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represented in the General Assembly:
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Section 5. The Illinois Insurance Code is amended by | ||||
changing Section 356m as follows:
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(215 ILCS 5/356m) (from Ch. 73, par. 968m)
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Sec. 356m. Infertility coverage.
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(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 the effective date of this | ||||
amendatory Act of the 99th General Assembly the effective date | ||||
of this amendatory Act of
1991 unless the policy contains | ||||
coverage for the diagnosis and treatment of
infertility | ||||
including, but not limited to, in vitro fertilization, uterine
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embryo lavage, embryo transfer, artificial insemination, | ||||
gamete
intrafallopian tube transfer, zygote intrafallopian | ||||
tube transfer, and low
tubal ovum transfer.
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(b) The coverage required under subsection (a) is subject | ||||
to the following conditions:
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(1) Coverage for procedures for in vitro | ||||
fertilization, gamete
intrafallopian tube transfer, or | ||||
zygote intrafallopian tube transfer shall
be required only | ||||
if:
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(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
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infertility treatments for which coverage is available | ||
under the policy,
plan, or contract;
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(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
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(C) the procedures are performed at medical | ||
facilities that conform to
the American College of | ||
Obstetric and Gynecology guidelines for in vitro
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fertilization clinics or to the American Fertility | ||
Society minimal
standards for programs of in vitro | ||
fertilization.
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(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 religious
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institution or organization that finds the procedures | ||
required to be
covered under this Section to violate its | ||
religious
and moral teachings and beliefs.
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(c) For purpose of this Section, "infertility" means the | ||
inability to
conceive after one year of unprotected sexual | ||
intercourse, the inability to conceive after one year of | ||
attempts to produce conception, the inability to conceive after | ||
an individual is diagnosed with a condition affecting | ||
fertility, or the inability
to sustain a successful pregnancy.
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(Source: P.A. 89-669, eff. 1-1-97.)
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