Coverage and Definition of Infertility Expanded

On June 20, 2017, Gov. Malloy signed HB 7124, creating Public Law No. 17-55. The new law expands the definition of “infertility” to mean conditions affecting plan participants who cannot conceive, produce conception or sustain a successful pregnancy during a one-year period, regardless of the insured’s health status. Prior law included the term “presumably healthy,” which potentially excluded those who may be unhealthy and unable to conceive. The law’s summary indicates that one potential class of “unhealthy” participants could be individuals with cancer, with the goal at expanding the “infertility” definition to include that class. Overall, the expanded definition takes effect Jan. 1, 2018.

Under current law, fully insured plans in Connecticut must provide coverage for infertility. Importantly, though, there is a religious employer exemption — employers that are organized to promote religious beliefs (such as churches or church-affiliated organizations) aren’t required to offer plans that provide coverage for diagnosis and treatment of infertility (if that practice conflicts with the employer’s religious beliefs).

The law contains no new employer compliance obligations, but awareness of the law will help employers address potential employee questions with respect to the definition and coverage of infertility.

Public Law No. 17-55 »