May 16, 2017
On April 19, 2017, the New York Department of Financial Services published Insurance Circular Letter No. 7 (2017). The purpose of the letter is to provide guidance to insurers on coverage for infertility treatment under NY law, regardless of sexual orientation or marital status. According to the bulletin, current standards that are relied on in determining eligibility for infertility treatment don’t distinguish between heterosexual individuals in a relationship or who are married, individuals in a same-sex relationship or who are married, single individuals, or gender identity. Thus, if an individual meets the definition of infertility and otherwise qualifies for coverage, then the carrier must provide coverage for infertility regardless of sexual orientation, marital status or gender identity. In addition, since the definition of “infertility” expressly permits a provider to provide for treatment earlier than 12 months, carriers should be mindful that, with respect to individuals in a same-sex relationship or single individuals, earlier treatment may be justified.
The letter contains no new employer compliance obligations, but does help serve as a useful resource for employees with questions relating to infertility coverage under a fully insured plan in New York.
Insurance Circular Letter No. 7 (2017) »