Bill Text: IL SB2639 | 2023-2024 | 103rd General Assembly | Introduced

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Reinserts the provisions of the introduced bill with the following changes. Provides that, for a group policy of accident and health insurance that provides pregnancy related benefits (rather than providing coverage for more than 25 employees that provides pregnancy-related benefits) that is issued, amended, delivered, or renewed in this State after January 1, 2026 (rather than the effective date of the amendatory Act), if a covered individual obtains, from a physician licensed to practice medicine in all its branches, a recommendation approving the covered individual to seek in vitro fertilization, gamete intrafallopian tube transfer, or zygote intrafallopian tube transfer based on any of the following: the covered individual's medical, sexual, and reproductive history; the covered individual's age; physical findings; or diagnostic testing, then the procedure shall be covered without any other restrictions or requirements. Amends 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 require plans under those Acts to comply with provisions of the Illinois Insurance Code requiring coverage for the diagnosis and treatment of infertility. Adds a January 1, 2026 effective date.

Spectrum: Moderate Partisan Bill (Democrat 32-6)

Status: (Engrossed) 2024-05-03 - Rule 19(a) / Re-referred to Rules Committee [SB2639 Detail]

Download: Illinois-2023-SB2639-Introduced.html

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103RD GENERAL ASSEMBLY State of Illinois 2023 and 2024 SB2639 Introduced 11/7/2023, by Sen. Michael E. Hastings SYNOPSIS AS INTRODUCED:
215 ILCS 5/356m from Ch. 73, par. 968m
Amends the Illinois Insurance Code. Provides that, for a group policy of accident and health insurance providing coverage for more than 25 employees that provides pregnancy related benefits that is issued, amended, delivered, or renewed in this State after the effective date of the amendatory Act, if a covered individual obtains, from a physician licensed to practice medicine in all its branches, a recommendation approving the covered individual to seek in vitro fertilization, gamete intrafallopian tube transfer, or zygote intrafallopian tube transfer based on any of the following: the covered individual's medical, sexual, and reproductive history; the covered individual's age; physical findings; or diagnostic testing, then the procedure shall be covered without any other restrictions or requirements.
LRB103 35235 RPS 65226 b
A BILL FOR
SB2639 LRB103 35235 RPS 65226 b
AN ACT concerning regulation.
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 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) 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

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if:
(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;
(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.
(1.5) For a group policy of accident and health
insurance providing coverage for more than 25 employees
that provides pregnancy related benefits that is issued,
amended, delivered, or renewed in this State after the
effective date of this amendatory Act of the 103rd General
Assembly, if the requirements of paragraph (1) are met or
if the covered individual obtains, from a physician
licensed to practice medicine in all its branches, a
recommendation approving the covered individual to seek in

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vitro fertilization, gamete intrafallopian tube transfer,
or zygote intrafallopian tube transfer based on any of the
following: (i) the covered individual's medical, sexual,
and reproductive history; (ii) the covered individual's
age; (iii) physical findings; or (iv) diagnostic testing,
then the procedure shall be covered without any other
restrictions or requirements.
(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) 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

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