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| THE GENERAL ASSEMBLY OF PENNSYLVANIA |
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| SENATE BILL |
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| INTRODUCED BY BOSCOLA, WILLIAMS, TARTAGLIONE, LEACH, BREWSTER, FONTANA AND RAFFERTY, JANUARY 19, 2011 |
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| REFERRED TO BANKING AND INSURANCE, JANUARY 19, 2011 |
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| AN ACT |
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1 | Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An |
2 | act relating to insurance; amending, revising, and |
3 | consolidating the law providing for the incorporation of |
4 | insurance companies, and the regulation, supervision, and |
5 | protection of home and foreign insurance companies, Lloyds |
6 | associations, reciprocal and inter-insurance exchanges, and |
7 | fire insurance rating bureaus, and the regulation and |
8 | supervision of insurance carried by such companies, |
9 | associations, and exchanges, including insurance carried by |
10 | the State Workmen's Insurance Fund; providing penalties; and |
11 | repealing existing laws," in health and accident insurance, |
12 | providing for insurance coverage for infertility treatment |
13 | services. |
14 | The General Assembly of the Commonwealth of Pennsylvania |
15 | hereby enacts as follows: |
16 | Section 1. The act of May 17, 1921 (P.L.682, No.284), known |
17 | as The Insurance Company Law of 1921, is amended by adding a |
18 | section to read: |
19 | Section 633.1. Coverage for Infertility Treatment.--(a) |
20 | Every health insurance policy that provides pregnancy-related |
21 | benefits and is delivered, issued, executed or renewed in this |
22 | Commonwealth on or after the effective date of this section |
23 | shall provide coverage for the expenses of diagnosis and |
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1 | treatment of infertility, including, but not limited to, in |
2 | vitro fertilization, embryo transfer, artificial insemination, |
3 | gamete intrafallopian tube transfer, zygote intrafallopian tube |
4 | transfer and low tubal ovum transfer. |
5 | (b) The coverage required under subsection (a) of this |
6 | section may impose the following restrictions: |
7 | (1) Exclude reversal of elective sterilization or use of |
8 | assisted reproductive techniques when infertility is the result |
9 | of elective sterilization. |
10 | (2) Impose restrictions or waiting periods before assisted |
11 | reproductive techniques may be employed. Any and all |
12 | restrictions or waiting periods imposed must be within the |
13 | recommended treatment guidelines issued by the American Society |
14 | for Reproductive Medicine or the American College of |
15 | Obstetricians and Gynecologists. |
16 | (3) Exclude coverage for women beyond childbearing years. |
17 | (4) Restrict coverage for assisted reproductive techniques |
18 | to the policyholder and dependent spouse. Any and all treatments |
19 | to remedy conditions which could impair fertility must be |
20 | covered for policyholder and all dependents, including minor |
21 | children. |
22 | (5) Require in vitro fertilization, gamete intrafallopian |
23 | tube transfer or zygote intrafallopian tube transfer be |
24 | performed at medical facilities that conform to the American |
25 | College of Obstetricians and Gynecologists guidelines for in |
26 | vitro fertilization clinics or to the American Society for |
27 | Reproductive Medicine minimal standards for programs of in vitro |
28 | fertilization. |
29 | (6) Impose a limitation of three assisted reproductive |
30 | technology procedures that a covered individual may attempt. |
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1 | (7) Require copayment or deductibles for assisted |
2 | reproductive technology treatments. Any copayment or deduction |
3 | may not exceed those applied to pregnancy-related benefits under |
4 | the same policy, contract or plan. |
5 | (c) The procedures required to be covered under this section |
6 | may be contained in any policy or plan issued to a religious |
7 | institution or organization or to any entity sponsored by a |
8 | religious institution or organization that finds the procedure |
9 | required to be covered under this section to violate its |
10 | religious and moral teachings and beliefs. |
11 | (d) (1) The term "health insurance policy" when used in |
12 | this section means individual or group health insurance policy, |
13 | contract or plan which provides medical or health care coverage |
14 | by any health care facility or licensed health care provider on |
15 | an expense-incurred service or prepaid basis and which is |
16 | offered by or is governed under any of the following: |
17 | (i) This act. |
18 | (ii) Subdivision (f) of Article IV of the act of June 13, |
19 | 1967 (P.L.31, No.21), known as the "Public Welfare Code." |
20 | (iii) The act of December 29, 1972 (P.L.1701, No.364), known |
21 | as the "Health Maintenance Organization Act." |
22 | (iv) The act of May 18, 1976 (P.L.123, No.54), known as the |
23 | "Individual Accident and Sickness Insurance Minimum Standards |
24 | Act." |
25 | (v) A nonprofit corporation subject to 40 Pa.C.S. Ch. 61 |
26 | (relating to hospital plan corporations) or 63 (relating to |
27 | professional health services plan corporations). |
28 | (2) The term "infertility" when used in this section means |
29 | the inability to conceive after one year of unprotected sexual |
30 | intercourse or the inability to sustain a successful pregnancy. |
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1 | Section 2. This act shall take effect in 60 days. |
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