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3 | 3 | | LCO No. 4705 1 of 5 |
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4 | 4 | | |
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5 | 5 | | General Assembly Raised Bill No. 975 |
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6 | 6 | | January Session, 2019 |
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7 | 7 | | LCO No. 4705 |
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8 | 8 | | |
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9 | 9 | | |
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10 | 10 | | Referred to Committee on INSURANCE AND REAL ESTATE |
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11 | 11 | | |
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12 | 12 | | |
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13 | 13 | | Introduced by: |
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14 | 14 | | (INS) |
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15 | 15 | | |
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16 | 16 | | |
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17 | 17 | | |
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18 | 18 | | |
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19 | 19 | | AN ACT CONCERNING RE QUIRED HEALTH INSURANCE |
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20 | 20 | | COVERAGE FOR INFERTI LITY TREATMENT AND R EQUIRING THE |
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21 | 21 | | INSURANCE COMMISSION ER TO STUDY COVERAGE BARRIERS |
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22 | 22 | | POSED TO INDIVIDUALS WITH IATROGENIC INFERTILITY. |
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23 | 23 | | Be it enacted by the Senate and House of Representatives in General |
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24 | 24 | | Assembly convened: |
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25 | 25 | | |
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26 | 26 | | Section 1. Subsection (b) of section 38a-509 of the general statutes is 1 |
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27 | 27 | | repealed and the following is substituted in lieu thereof (Effective 2 |
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28 | 28 | | January 1, 2020, and applicable to policies delivered, issued for delivery, 3 |
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29 | 29 | | amended, renewed or continued on or after said date): 4 |
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30 | 30 | | (b) Such policy may: 5 |
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31 | 31 | | [(1) Limit such coverage to an individual until the date of such 6 |
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32 | 32 | | individual's fortieth birthday;] 7 |
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33 | 33 | | [(2)] (1) Limit such coverage for ovulation induction to a lifetime 8 |
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34 | 34 | | maximum benefit of four cycles; 9 |
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35 | 35 | | [(3)] (2) Limit such coverage for intrauterine insemination to a 10 |
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36 | 36 | | lifetime maximum benefit of three cycles; 11 Raised Bill No. 975 |
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37 | 37 | | |
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38 | 38 | | |
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39 | 39 | | |
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40 | 40 | | LCO No. 4705 2 of 5 |
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41 | 41 | | |
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42 | 42 | | [(4)] (3) Limit lifetime benefits to a maximum of two cycles, with not 12 |
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43 | 43 | | more than two embryo implantations per cycle, for in -vitro 13 |
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44 | 44 | | fertilization, gamete intra-fallopian transfer, zygote intra-fallopian 14 |
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45 | 45 | | transfer or low tubal ovum transfer, provided each such fertilization or 15 |
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46 | 46 | | transfer shall be credited toward such maximum as one cycle; 16 |
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47 | 47 | | [(5)] (4) Limit coverage for in-vitro fertilization, gamete intra-17 |
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48 | 48 | | fallopian transfer, zygote intra-fallopian transfer and low tubal ovum 18 |
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49 | 49 | | transfer to those individuals who have been unable to conceive or 19 |
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50 | 50 | | produce conception or sustain a successful pregnancy through less 20 |
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51 | 51 | | expensive and medically viable infertility treatment or procedures 21 |
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52 | 52 | | covered under such policy. Nothing in this subdivision shall be 22 |
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53 | 53 | | construed to deny the coverage required by this section to any 23 |
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54 | 54 | | individual who foregoes a particular infertility treatment or procedure 24 |
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55 | 55 | | if the individual's physician determines that such treatment or 25 |
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56 | 56 | | procedure is likely to be unsuccessful; 26 |
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57 | 57 | | [(6)] (5) Require that covered infertility treatment or procedures be 27 |
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58 | 58 | | performed at facilities that conform to the standards and guidelines 28 |
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59 | 59 | | developed by the American Society of Reproductive Medicine or the 29 |
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60 | 60 | | Society of Reproductive Endocrinology and Infertility; 30 |
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61 | 61 | | [(7)] (6) Limit coverage to individuals who have maintained 31 |
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62 | 62 | | coverage under such policy for at least twelve months; and 32 |
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63 | 63 | | [(8)] (7) Require disclosure by the individual seeking such coverage 33 |
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64 | 64 | | to such individual's existing health insurance carrier of any previous 34 |
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65 | 65 | | infertility treatment or procedures for which such individual received 35 |
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66 | 66 | | coverage under a different health insurance policy. Such disclosure 36 |
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67 | 67 | | shall be made on a form and in the manner prescribed by the 37 |
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68 | 68 | | Insurance Commissioner. 38 |
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69 | 69 | | Sec. 2. Subsection (b) of section 38a-536 of the general statutes is 39 |
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70 | 70 | | repealed and the following is substituted in lieu thereof (Effective 40 |
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71 | 71 | | January 1, 2020, and applicable to policies delivered, issued for delivery, 41 |
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72 | 72 | | amended, renewed or continued on or after said date): 42 Raised Bill No. 975 |
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73 | 73 | | |
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74 | 74 | | |
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75 | 75 | | |
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76 | 76 | | LCO No. 4705 3 of 5 |
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77 | 77 | | |
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78 | 78 | | (b) Such policy may: 43 |
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79 | 79 | | [(1) Limit such coverage to an individual until the date of such 44 |
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80 | 80 | | individual's fortieth birthday;] 45 |
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81 | 81 | | [(2)] (1) Limit such coverage for ovulation induction to a lifetime 46 |
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82 | 82 | | maximum benefit of four cycles; 47 |
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83 | 83 | | [(3)] (2) Limit such coverage for intrauterine insemination to a 48 |
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84 | 84 | | lifetime maximum benefit of three cycles; 49 |
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85 | 85 | | [(4)] (3) Limit lifetime benefits to a maximum of two cycles, with not 50 |
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86 | 86 | | more than two embryo implantations per cycle, for in -vitro 51 |
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87 | 87 | | fertilization, gamete intra-fallopian transfer, zygote intra-fallopian 52 |
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88 | 88 | | transfer or low tubal ovum transfer, provided each such fertilization or 53 |
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89 | 89 | | transfer shall be credited toward such maximum as one cycle; 54 |
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90 | 90 | | [(5)] (4) Limit coverage for in-vitro fertilization, gamete intra-55 |
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91 | 91 | | fallopian transfer, zygote intra-fallopian transfer and low tubal ovum 56 |
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92 | 92 | | transfer to those individuals who have been unable to conceive or 57 |
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93 | 93 | | produce conception or sustain a successful pregnancy through less 58 |
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94 | 94 | | expensive and medically viable infertility treatment or procedures 59 |
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95 | 95 | | covered under such policy. Nothing in this subdivision shall be 60 |
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96 | 96 | | construed to deny the coverage required by this section to any 61 |
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97 | 97 | | individual who foregoes a particular infertility treatment or procedure 62 |
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98 | 98 | | if the individual's physician determines that such treatment or 63 |
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99 | 99 | | procedure is likely to be unsuccessful; 64 |
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100 | 100 | | [(6)] (5) Require that covered infertility treatment or procedures be 65 |
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101 | 101 | | performed at facilities that conform to the standards and guidelines 66 |
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102 | 102 | | developed by the American Society of Reproductive Medicine or the 67 |
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103 | 103 | | Society of Reproductive Endocrinology and Infertility; 68 |
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104 | 104 | | [(7)] (6) Limit coverage to individuals who have maintained 69 |
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105 | 105 | | coverage under such policy for at least twelve months; and 70 |
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106 | 106 | | [(8)] (7) Require disclosure by the individual seeking such coverage 71 |
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107 | 107 | | to such individual's existing health insurance carrier of any previous 72 Raised Bill No. 975 |
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108 | 108 | | |
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109 | 109 | | |
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110 | 110 | | |
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111 | 111 | | LCO No. 4705 4 of 5 |
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112 | 112 | | |
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113 | 113 | | infertility treatment or procedures for which such individual received 73 |
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114 | 114 | | coverage under a different health insurance policy. Such disclosure 74 |
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115 | 115 | | shall be made on a form and in the manner prescribed by the 75 |
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116 | 116 | | Insurance Commissioner. 76 |
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117 | 117 | | Sec. 3. (NEW) (Effective from passage) (a) The Insurance 77 |
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118 | 118 | | Commissioner shall conduct a study concerning the barriers posed to 78 |
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119 | 119 | | individuals diagnosed with iatrogenic infertility for health insurance 79 |
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120 | 120 | | coverage for fertility preservation and infertility treatments. 80 |
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121 | 121 | | (b) Not later than January 1, 2020, the commissioner shall report the 81 |
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122 | 122 | | results of the study, in accordance with section 11-4a of the general 82 |
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123 | 123 | | statutes, to the joint standing committee of the General Assembly 83 |
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124 | 124 | | having cognizance of matters relating to insurance. 84 |
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125 | 125 | | This act shall take effect as follows and shall amend the following |
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126 | 126 | | sections: |
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127 | 127 | | |
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128 | 128 | | Section 1 January 1, 2020, and |
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129 | 129 | | applicable to policies |
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130 | 130 | | delivered, issued for |
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131 | 131 | | delivery, amended, |
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132 | 132 | | renewed or continued on or |
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133 | 133 | | after said date |
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134 | 134 | | 38a-509(b) |
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135 | 135 | | Sec. 2 January 1, 2020, and |
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136 | 136 | | applicable to policies |
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137 | 137 | | delivered, issued for |
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138 | 138 | | delivery, amended, |
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139 | 139 | | renewed or continued on or |
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140 | 140 | | after said date |
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141 | 141 | | 38a-536(b) |
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142 | 142 | | Sec. 3 from passage New section |
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143 | 143 | | |
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144 | 144 | | |
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145 | 145 | | |
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146 | 146 | | Statement of Purpose: |
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147 | 147 | | To: (1) Eliminate an age restriction concerning required health |
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148 | 148 | | insurance coverage for infertility treatment; and (2) require the Raised Bill No. 975 |
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149 | 149 | | |
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150 | 150 | | |
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151 | 151 | | |
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152 | 152 | | LCO No. 4705 5 of 5 |
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153 | 153 | | |
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154 | 154 | | Insurance Commissioner to conduct a study concerning coverage |
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155 | 155 | | barriers posed to individuals diagnosed with iatrogenic infertility. |
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156 | 156 | | [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline, |
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157 | 157 | | except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is |
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158 | 158 | | not underlined.] |
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159 | 159 | | |
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