On Aug. 20, 2015, Gov. Rauner signed SB 1764 into law. This law requires fully insured plans that cover more than 25 employees to provide coverage for the diagnosis and treatment of infertility if the plan covers pregnancy-related benefits. Specifically, such plans must cover in vitro fertilization, uterine embryo lavage, embryo transfer, artificial insemination, gamete intrafallopian tube transfer, zygote intrafallopian tube transfer and low tubal ovum transfer.
The law defines "infertility" as 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 being diagnosed with conditions affecting infertility or the inability to sustain successful pregnancies.
Further, coverage for vitro fertilization, gamete intrafallopian tube transfer or zygote intrafallopian tube transfer is required only if three conditions are met:
The participant must be unable to attain, maintain or sustain a viable and successful pregnancy through other covered, reasonable and less costly infertility treatments.The participant must not have gone through four completed oocyte retrievals. However, if a live birth follows one oocyte retrieval, then two more oocyte retrievals must be covered.The procedures must be performed at a medical facility that conforms to the American College of Obstetrics and Gynecology guidelines for in vitro fertilization clinics or to the American Fertility Society minimal standards for programs of in vitro fertilization.
The law also provides an exemption for religious institutions and organizations if such coverage violates their religious and moral teachings and beliefs.
The law takes effect for plans issued on or after Jan. 1, 2016.
SB 1764 »