Bill Text: IL HB4331 | 2009-2010 | 96th General Assembly | Introduced

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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 shall contain a provision that covers the diagnosis and treatment of infertility only if the individual was covered under the policy for at least one year. Deletes a definition for "infertility".

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Introduced - Dead) 2009-03-10 - Tabled By Sponsor Rep. Deborah Mell [HB4331 Detail]

Download: Illinois-2009-HB4331-Introduced.html

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96TH GENERAL ASSEMBLY State of Illinois 2009 and 2010 HB4331 Introduced 2/27/2009, by Rep. Deborah Mell SYNOPSIS AS INTRODUCED:
215 ILCS 5/356m from Ch. 73, par. 968m
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 shall contain a provision that covers the diagnosis and treatment of infertility only if the individual was covered under the policy for at least one year. Deletes a definition for "infertility".
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A BILL FOR
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AN ACT concerning insurance.
Be it enacted by the People of the State of Illinois,
represented in the General Assembly:
Section 5. 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 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 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) 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:

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(A) the covered individual has been unable to
attain or sustain a successful pregnancy through
reasonable, less costly medically appropriate
infertility treatments for which coverage is available
under the policy, plan, or contract;
(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
(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 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
providing coverage for more than 25 employees that provides
pregnancy related benefits shall contain a provision that
covers the diagnosis and treatment of infertility only if the

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individual was covered under the policy for at least one year.
For purpose of this Section, "infertility" means the inability
to conceive after one year of unprotected sexual intercourse or
the inability to sustain a successful pregnancy.
(Source: P.A. 89-669, eff. 1-1-97.)