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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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