LEGISLATIVE SERVICES AGENCY
OFFICE OF FISCAL AND MANAGEMENT ANALYSIS
FISCAL IMPACT STATEMENT
LS 6448 NOTE PREPARED: Dec 31, 2024
BILL NUMBER: HB 1205 BILL AMENDED:
SUBJECT: Fertility Insurance Coverage.
FIRST AUTHOR: Rep. Bauer M BILL STATUS: As Introduced
FIRST SPONSOR:
FUNDS AFFECTED:XGENERAL IMPACT: State & Local
XDEDICATED
FEDERAL
Summary of Legislation: This bill requires a state employee health plan (SEHP), a policy of accident and
sickness insurance, and a health maintenance organization contract to provide coverage for fertility
preservation services. It also requires a SEHP, a policy of accident and sickness insurance, and a health
maintenance organization contract to provide coverage for fertility treatment if certain conditions are
satisfied.
Effective Date: July 1, 2025.
Explanation of State Expenditures: State Employee Health Plan (SEHP): The bill requires the SEHP to
cover fertility preservation services and fertility treatments, including in vitro fertilization, as prescribed in
the bill. This is expected to result in an increase in state expenditures for the SEHP of approximately
$500,000 per year. Actual increases in state expenditures will depend on multiple factors, including the
utilization of the newly covered services, the negotiated rates for such services, and when the individual
receiving the services reach their plan’s deductible and out-of-pocket maximum.
Insurance Requirements: The bill will increase workload for the Indiana Department of Insurance (DOI) to
ensure compliance with the bill’s requirements but should be able to be implemented using existing staffing
and resources. [The DOI is funded through a dedicated agency fund.]
Additional Information:
State Employee Health Plan (SEHP): In Indiana, during CY 2021 (the latest year with available data) a total
of 1,115 live births (1.4% of all live births) utilized assisted reproductive technology (ART) procedures. In
CY 2024 there were 705 live births covered under the SEHP. Applying this percentage to the number of
births under the SEHP, it is estimated there could be a total of 10 ART births per year under the SEHP.
[According to the US Department of Health and Human Services, in vitro fertilization accounts for over 99%
of all ART procedures.]
As of CY 2024, there are 11,484 men between the ages of 18-45 that are covered under the SEHP. The
HB 1205 1 average rate of impaired fecundity and infertility of men aged 15–49 in the United States, as reported by the
National Center for Health Statistics, is 11.4%. Applying this percentage, it is estimated there will be a total
of 1,309 men covered under the SEHP that may utilize the fertility services prescribed in the bill. However,
not all eligible men will opt to receive such services in a given year. This estimate assumes that 10% (131)
of men will actually receive these services each year.
The estimated average cost per person associated with the services prescribed in the bill total $20,500 for
women and $2,235 for men, based on an analysis conducted by the New Hampshire Insurance Department
as a result of New Hampshire SB 198-2023. The estimated costs were based on allowed amounts and the
plan’s contracted amount with providers. Certain services are generally excluded such as the cost of donor
eggs and donor sperm. Cost data were developed from claims data and public price lists. Furthermore, the
cost estimate is based on allowed amounts and does not consider the amount of patient share such as co-pays
and deductibles.
Using these costs, the estimated number of ART births per year under the SEHP will increase expenditures
by $205,000 per year. The estimated cost for fertility services for men under the SEHP will increase
expenditures by approximately $293,000 per year, for a total estimated increase in state expenditures of
$498,000.
Explanation of State Revenues:
Explanation of Local Expenditures: Local units offering health plans may have increased costs due to the
bill’s requirements. Any increase in costs is indeterminable and will depend on utilization of newly-covered
services and medications.
Explanation of Local Revenues:
State Agencies Affected: State Personnel Department; Indiana Department of Insurance.
Local Agencies Affected: Local units offering health plans.
Information Sources: Christy Tittle, SPD; www.cdc.gov/nchs//data/nhsr/nhsr202.pdf;
www.hhs.gov/about/news/2024/03/13/fact-sheet-in-vitro-fertilization-ivf-use-across-united-states.html;
https://mm.nh.gov/files/uploads/nhid/documents/nh-sb-198-cost-study-september-2023.pdf.
Fiscal Analyst: Jason Barrett, 317-232-9809.
HB 1205 2