Coverage and Definition of “Infertility” Expanded

On July 5, Gov. Raimondo signed SB 821 into law. The new law expands the coverage and definition of “infertility” for plans issued in Rhode Island. Specifically, plans that provide coverage for pregnancy-related benefits must provide coverage for medically necessary expenses related to the diagnosis and treatment of infertility for female plan participants ages 25 to 42 and for standard fertility preservation services when medically necessary treatments can directly or indirectly cause iatrogenic infertility to plan participants.

For this purpose, “infertility” under prior law meant the inability of otherwise presumably healthy married individuals to conceive or sustain a pregnancy during a one-year period. The new law adds to that definition by explaining that “standard fertility preservation services” means procedures consistent with established medical practices and professional guidelines established the American Society for Reproductive Medicine, the American Society of Clinical Oncology or other reputable professional organizations. In addition, “iatrogenic infertility” means impairment of fertility caused by chemotherapy, radiation, surgery or other medical treatments that affect reproductive organs or processes.

The new law contains no new employer compliance obligations, but employers should be aware of the infertility benefits available under their plans should employees have questions.

SB 821 »