Bill Text: IL HB3709 | 2021-2022 | 102nd General Assembly | Introduced
NOTE: There are more recent revisions of this legislation. Read Latest Draft
Bill Title: Amends the Illinois Insurance Code. Provides that 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, 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 the Section, that are different from those imposed upon benefits for services not related to infertility. Changes the definition of "infertility" to mean a disease, condition, or status characterized by: 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; a person's inability to reproduce either as a single individual or with a partner without medical intervention; or a licensed physician's findings based on a patient's medical, sexual, and reproductive history, age, physical findings, or diagnostic testing.
Spectrum: Partisan Bill (Democrat 33-0)
Status: (Passed) 2021-07-27 - Public Act . . . . . . . . . 102-0170 [HB3709 Detail]
Download: Illinois-2021-HB3709-Introduced.html
Bill Title: Amends the Illinois Insurance Code. Provides that 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, 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 the Section, that are different from those imposed upon benefits for services not related to infertility. Changes the definition of "infertility" to mean a disease, condition, or status characterized by: 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; a person's inability to reproduce either as a single individual or with a partner without medical intervention; or a licensed physician's findings based on a patient's medical, sexual, and reproductive history, age, physical findings, or diagnostic testing.
Spectrum: Partisan Bill (Democrat 33-0)
Status: (Passed) 2021-07-27 - Public Act . . . . . . . . . 102-0170 [HB3709 Detail]
Download: Illinois-2021-HB3709-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 Section 356m 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) As used in For purpose of this Section, "infertility" | ||||||
26 | means the inability to
conceive after one year of unprotected |
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1 | sexual intercourse, the inability to conceive after one year | ||||||
2 | of attempts to produce conception or , the inability to | ||||||
3 | conceive after an individual is diagnosed with a condition | ||||||
4 | affecting fertility , or the inability
to sustain a successful | ||||||
5 | pregnancy .
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6 | (d) The coverage of diagnosis and treatment of infertility | ||||||
7 | shall be provided without discrimination on the basis of age, | ||||||
8 | ancestry, color, disability, domestic partner status, gender, | ||||||
9 | gender expression, gender identity, genetic information, | ||||||
10 | marital status, national origin, race, religion, sex, or | ||||||
11 | sexual orientation. | ||||||
12 | (Source: P.A. 99-421, eff. 1-1-16 .)
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