Health Care Availability and Access Committee

Filed: 3/8/2005

 

 


 

 


 
09400HB3494ham001 LRB094 10930 LJB 43273 a

1
AMENDMENT TO HOUSE BILL 3494

2     AMENDMENT NO. ______. Amend House Bill 3494 by replacing
3 everything after the enacting clause with the following:
 
4     "Section 5. The Illinois Insurance Code is amended by
5 changing Section 356m as follows:
 
6     (215 ILCS 5/356m)  (from Ch. 73, par. 968m)
7     Sec. 356m. Infertility coverage.
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 1991 unless the policy contains coverage for
13 the diagnosis and treatment of infertility including, but not
14 limited to, in vitro fertilization, uterine embryo lavage,
15 embryo transfer, artificial insemination, gamete
16 intrafallopian tube transfer, zygote intrafallopian tube
17 transfer, and low tubal ovum transfer.
18     (b) The coverage required under subsection (a) is subject
19 to the following conditions:
20         (1) Coverage for procedures for in vitro
21     fertilization, gamete intrafallopian tube transfer, or
22     zygote intrafallopian tube transfer shall be required only
23     if:
24             (A) the covered individual has been unable to

 

 

09400HB3494ham001 - 2 - LRB094 10930 LJB 43273 a

1         attain or sustain a successful pregnancy through
2         reasonable, less costly medically appropriate
3         infertility treatments for which coverage is available
4         under the policy, plan, or contract;
5             (B) the covered individual has not undergone 4
6         completed oocyte retrievals, except that if a live
7         birth follows a completed oocyte retrieval, then 2 more
8         completed oocyte retrievals shall be covered; and
9             (C) the procedures are performed at medical
10         facilities that conform to the American College of
11         Obstetric and Gynecology guidelines for in vitro
12         fertilization clinics or to the American Fertility
13         Society minimal standards for programs of in vitro
14         fertilization.
15         (2) The procedures required to be covered under this
16     Section are not required to be contained in any policy or
17     plan issued to or by a religious institution or
18     organization or to or by an entity sponsored by a religious
19     institution or organization that finds the procedures
20     required to be covered under this Section to violate its
21     religious and moral teachings and beliefs.
22     (c) For purpose of this Section, "infertility" means the
23 inability to conceive after one year of unprotected sexual
24 intercourse, or the inability to sustain a successful
25 pregnancy, or a medical condition that causes conception or
26 gestation to be unlikely without fertility treatment.
27 (Source: P.A. 89-669, eff. 1-1-97.)
 
28     Section 99. Effective date. This Act takes effect upon
29 becoming law.".