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repealed and the following is substituted in lieu thereof (Effective 2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