25 LC 52 0845S
The Senate Committee on Insurance and Labor offered the following
substitute to HB 94:
A BILL TO BE ENTITLED
AN ACT
To amend Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to1
insurance generally, so as to require certain health benefit policies to include coverage for2
certain expenses for standard fertility preservation services when a medically necessary3
treatment for cancer, sickle cell disease, or lupus may directly or indirectly cause an4
impairment of fertility; to provide for definitions; to provide for exclusions; to allow for5
certain cost-sharing requirements; to provide for rules and regulations; to provide for related6
matters; to provide for an effective date; to repeal conflicting laws; and for other purposes.7
BE IT ENACTED BY THE GENERAL ASSEMBLY OF GEORGIA:8
SECTION 1.9
Chapter 24 of Title 33 of the Official Code of Georgia Annotated, relating to insurance10
generally, is amended by adding a new Code section to read as follows:11
"33-24-59.34.12
(a) As used in this Code section, the term:13
(1) 'Health benefit policy' means any individual or group plan, policy, or contract for14
healthcare services issued, delivered, issued for delivery, or renewed in this state by an15
insurer that provides major medical benefits. Such term shall not include any plans,16
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policies, or contracts executed by the state on behalf of state employees under Article 117
of Chapter 18 of Title 45 and shall not apply to the provision of healthcare services18
pursuant to a contract entered into by an insurer and the Department of Community19
Health for recipients of Medicaid. Such term shall not include self-funded, employer20
sponsored health insurance plans subject to the exclusive jurisdiction of the federal21
Employee Retirement Income Security Act of 1974, as codified and amended at 2922
U.S.C. Section 1001, et seq.23
(2) 'Iatrogenic infertility' means an impairment of fertility caused directly or indirectly24
by a medically necessary treatment for cancer, sickle cell disease, or lupus.25
(3) 'Insurer' means any person, corporation, or other entity authorized to provide health26
benefit policies under this title, including a healthcare corporation, health maintenance27
organization, preferred provider organization, accident and sickness insurer, fraternal28
benefit society, hospital service corporation, medical service corporation, or any similar29
entity.30
(4) 'Medically necessary treatment' means a medically necessary treatment for cancer,31
sickle cell disease, or lupus that has a potential side effect of iatrogenic infertility. Such32
treatment includes but is not limited to the surgical removal of the primary or secondary33
reproductive organs, chemotherapy, radiation therapy, and bone marrow transplantation.34
(5) 'Standard fertility preservation services' means procedures to preserve fertility that35
are consistent with established medical practices or professional guidelines. Such36
services include but are not limited to egg, sperm, embryo, and ovarian tissue37
cryopreservation.38
(b) Every health benefit policy renewed or issued after January 1, 2026, shall include39
coverage for expenses for standard fertility preservation services when a medically40
necessary treatment may directly or indirectly cause iatrogenic infertility in any covered41
person. Such coverage shall include evaluation expenses, laboratory assessments,42
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medications, and treatments associated with standard fertility preservation services,43
including storage of gametes for up to one year.44
(c) The coverage provided for in subsection (b) of this Code section may:45
(1) Exclude costs associated with storage of gametes for more than one year;46
(2) Include age restrictions;47
(3) Include a lifetime limit per procedure per eligible insured; and48
(4) Be limited to nonexperimental procedures.49
(d) The benefits in a health benefit policy as provided in subsection (b) of this Code50
section shall be subject to the same deductibles, coinsurance, and copayment provisions51
established for all covered benefits within such health benefit policy. Special deductibles,52
coinsurance, copayment, or other limitations that are not generally applicable to other53
hospital, medical, or surgical services covered by a health benefit policy shall not be54
imposed on coverage for standard fertility preservation services.55
(e) The Commissioner shall promulgate rules and regulations necessary to implement the56
provisions of this Code section in accordance with current guidelines established by57
professional medical organizations such as the American Society of Clinical Oncology or58
the American Society for Reproductive Medicine."59
SECTION 2.60
This Act shall become effective upon its approval by the Governor or upon its becoming law61
without such approval.62
SECTION 3.63
All laws and parts of laws in conflict with this Act are repealed.64
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