Connecticut 2019 Regular Session

Connecticut Senate Bill SB00975 Compare Versions

Only one version of the bill is available at this time.
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33 LCO No. 4705 1 of 5
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55 General Assembly Raised Bill No. 975
66 January Session, 2019
77 LCO No. 4705
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1010 Referred to Committee on INSURANCE AND REAL ESTATE
1111
1212
1313 Introduced by:
1414 (INS)
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1919 AN ACT CONCERNING RE QUIRED HEALTH INSURANCE
2020 COVERAGE FOR INFERTI LITY TREATMENT AND R EQUIRING THE
2121 INSURANCE COMMISSION ER TO STUDY COVERAGE BARRIERS
2222 POSED TO INDIVIDUALS WITH IATROGENIC INFERTILITY.
2323 Be it enacted by the Senate and House of Representatives in General
2424 Assembly convened:
2525
2626 Section 1. Subsection (b) of section 38a-509 of the general statutes is 1
2727 repealed and the following is substituted in lieu thereof (Effective 2
2828 January 1, 2020, and applicable to policies delivered, issued for delivery, 3
2929 amended, renewed or continued on or after said date): 4
3030 (b) Such policy may: 5
3131 [(1) Limit such coverage to an individual until the date of such 6
3232 individual's fortieth birthday;] 7
3333 [(2)] (1) Limit such coverage for ovulation induction to a lifetime 8
3434 maximum benefit of four cycles; 9
3535 [(3)] (2) Limit such coverage for intrauterine insemination to a 10
3636 lifetime maximum benefit of three cycles; 11 Raised Bill No. 975
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3838
3939
4040 LCO No. 4705 2 of 5
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4242 [(4)] (3) Limit lifetime benefits to a maximum of two cycles, with not 12
4343 more than two embryo implantations per cycle, for in -vitro 13
4444 fertilization, gamete intra-fallopian transfer, zygote intra-fallopian 14
4545 transfer or low tubal ovum transfer, provided each such fertilization or 15
4646 transfer shall be credited toward such maximum as one cycle; 16
4747 [(5)] (4) Limit coverage for in-vitro fertilization, gamete intra-17
4848 fallopian transfer, zygote intra-fallopian transfer and low tubal ovum 18
4949 transfer to those individuals who have been unable to conceive or 19
5050 produce conception or sustain a successful pregnancy through less 20
5151 expensive and medically viable infertility treatment or procedures 21
5252 covered under such policy. Nothing in this subdivision shall be 22
5353 construed to deny the coverage required by this section to any 23
5454 individual who foregoes a particular infertility treatment or procedure 24
5555 if the individual's physician determines that such treatment or 25
5656 procedure is likely to be unsuccessful; 26
5757 [(6)] (5) Require that covered infertility treatment or procedures be 27
5858 performed at facilities that conform to the standards and guidelines 28
5959 developed by the American Society of Reproductive Medicine or the 29
6060 Society of Reproductive Endocrinology and Infertility; 30
6161 [(7)] (6) Limit coverage to individuals who have maintained 31
6262 coverage under such policy for at least twelve months; and 32
6363 [(8)] (7) Require disclosure by the individual seeking such coverage 33
6464 to such individual's existing health insurance carrier of any previous 34
6565 infertility treatment or procedures for which such individual received 35
6666 coverage under a different health insurance policy. Such disclosure 36
6767 shall be made on a form and in the manner prescribed by the 37
6868 Insurance Commissioner. 38
6969 Sec. 2. Subsection (b) of section 38a-536 of the general statutes is 39
7070 repealed and the following is substituted in lieu thereof (Effective 40
7171 January 1, 2020, and applicable to policies delivered, issued for delivery, 41
7272 amended, renewed or continued on or after said date): 42 Raised Bill No. 975
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7676 LCO No. 4705 3 of 5
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7878 (b) Such policy may: 43
7979 [(1) Limit such coverage to an individual until the date of such 44
8080 individual's fortieth birthday;] 45
8181 [(2)] (1) Limit such coverage for ovulation induction to a lifetime 46
8282 maximum benefit of four cycles; 47
8383 [(3)] (2) Limit such coverage for intrauterine insemination to a 48
8484 lifetime maximum benefit of three cycles; 49
8585 [(4)] (3) Limit lifetime benefits to a maximum of two cycles, with not 50
8686 more than two embryo implantations per cycle, for in -vitro 51
8787 fertilization, gamete intra-fallopian transfer, zygote intra-fallopian 52
8888 transfer or low tubal ovum transfer, provided each such fertilization or 53
8989 transfer shall be credited toward such maximum as one cycle; 54
9090 [(5)] (4) Limit coverage for in-vitro fertilization, gamete intra-55
9191 fallopian transfer, zygote intra-fallopian transfer and low tubal ovum 56
9292 transfer to those individuals who have been unable to conceive or 57
9393 produce conception or sustain a successful pregnancy through less 58
9494 expensive and medically viable infertility treatment or procedures 59
9595 covered under such policy. Nothing in this subdivision shall be 60
9696 construed to deny the coverage required by this section to any 61
9797 individual who foregoes a particular infertility treatment or procedure 62
9898 if the individual's physician determines that such treatment or 63
9999 procedure is likely to be unsuccessful; 64
100100 [(6)] (5) Require that covered infertility treatment or procedures be 65
101101 performed at facilities that conform to the standards and guidelines 66
102102 developed by the American Society of Reproductive Medicine or the 67
103103 Society of Reproductive Endocrinology and Infertility; 68
104104 [(7)] (6) Limit coverage to individuals who have maintained 69
105105 coverage under such policy for at least twelve months; and 70
106106 [(8)] (7) Require disclosure by the individual seeking such coverage 71
107107 to such individual's existing health insurance carrier of any previous 72 Raised Bill No. 975
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113113 infertility treatment or procedures for which such individual received 73
114114 coverage under a different health insurance policy. Such disclosure 74
115115 shall be made on a form and in the manner prescribed by the 75
116116 Insurance Commissioner. 76
117117 Sec. 3. (NEW) (Effective from passage) (a) The Insurance 77
118118 Commissioner shall conduct a study concerning the barriers posed to 78
119119 individuals diagnosed with iatrogenic infertility for health insurance 79
120120 coverage for fertility preservation and infertility treatments. 80
121121 (b) Not later than January 1, 2020, the commissioner shall report the 81
122122 results of the study, in accordance with section 11-4a of the general 82
123123 statutes, to the joint standing committee of the General Assembly 83
124124 having cognizance of matters relating to insurance. 84
125125 This act shall take effect as follows and shall amend the following
126126 sections:
127127
128128 Section 1 January 1, 2020, and
129129 applicable to policies
130130 delivered, issued for
131131 delivery, amended,
132132 renewed or continued on or
133133 after said date
134134 38a-509(b)
135135 Sec. 2 January 1, 2020, and
136136 applicable to policies
137137 delivered, issued for
138138 delivery, amended,
139139 renewed or continued on or
140140 after said date
141141 38a-536(b)
142142 Sec. 3 from passage New section
143143
144144
145145
146146 Statement of Purpose:
147147 To: (1) Eliminate an age restriction concerning required health
148148 insurance coverage for infertility treatment; and (2) require the Raised Bill No. 975
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152152 LCO No. 4705 5 of 5
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154154 Insurance Commissioner to conduct a study concerning coverage
155155 barriers posed to individuals diagnosed with iatrogenic infertility.
156156 [Proposed deletions are enclosed in brackets. Proposed additions are indicated by underline,
157157 except that when the entire text of a bill or resolution or a section of a bill or resolution is new, it is
158158 not underlined.]
159159