HB3874 102ND GENERAL ASSEMBLY

LRB102 15052 BMS 20407 b

102ND GENERAL ASSEMBLY
State of Illinois
2021 and 2022
HB3874

Introduced 2/22/2021, by Rep. Janet Yang Rohr

SYNOPSIS AS INTRODUCED:

215 ILCS 5/356m	from Ch. 73, par. 968m
215 ILCS 5/356z.33

Amends the Illinois Insurance Code. In provisions concerning infertility coverage and coverage for epinephrine injectors, provides that on or after the effective date of the amendatory Act, specified coverage shall be applicable to policies of insurance written in other states that insure an Illinois resident.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

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 Sections 356m and 356z.33 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 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.

(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) 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.

(d) On or after the effective date of this amendatory Act of the 102nd General Assembly, coverage required under this Section shall be applicable to policies of insurance written in other states that insure an Illinois resident.

(Source: P.A. 99-421, eff. 1-1-16.)

(215 ILCS 5/356z.33)

Sec. 356z.33. Coverage for epinephrine injectors.

(a) A group or individual policy of accident and health insurance or a managed care plan that is amended, delivered, issued, or renewed on or after January 1, 2020 (the effective date of Public Act 101-281) this amendatory Act of the 101st General Assembly shall provide coverage for medically necessary epinephrine injectors for persons 18 years of age or under. As used in this Section, "epinephrine injector" has the meaning given to that term in Section 5 of the Epinephrine Injector Act.

(b) On or after the effective date of this amendatory Act of the 102nd General Assembly, coverage required under this Section shall be applicable to policies of insurance written in other states that insure an Illinois resident.

(Source: P.A. 101-281, eff. 1-1-20; revised 10-16-19.)