PRINTER'S NO. 971 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL No.922 Session of 2025 INTRODUCED BY MAYES, O'MARA, MALAGARI, GIRAL, WAXMAN, MADDEN, ABNEY, CERRATO, FREEMAN, HANBIDGE, KENYATTA, SCHLOSSBERG, HOHENSTEIN, OTTEN, SANCHEZ, INGLIS AND RABB, MARCH 17, 2025 REFERRED TO COMMITTEE ON INSURANCE, MARCH 17, 2025 AN ACT Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An act relating to insurance; amending, revising, and consolidating the law providing for the incorporation of insurance companies, and the regulation, supervision, and protection of home and foreign insurance companies, Lloyds associations, reciprocal and inter-insurance exchanges, and fire insurance rating bureaus, and the regulation and supervision of insurance carried by such companies, associations, and exchanges, including insurance carried by the State Workmen's Insurance Fund; providing penalties; and repealing existing laws," in casualty insurance, providing for fertility preservation coverage. The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows: Section 1. The act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, is amended by adding a section to read: Section 635.11 . Fertility Preservation Coverage.--(a) An individual or group health insurance policy offered, issued or renewed in this Commonwealth or a government program shall include coverage for fertility preservation services as specified in subsection (b) and shall waive cost-sharing 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 requirements related to fertility preservation care. (b) Fertility preservation specified under subsection (c) shall apply to covered individuals not older than forty-five (45) years of age who are at risk of iatrogenic infertility. (c) Fertility preservation care services under this section shall include services related to fertility preservation as a result of iatrogenic infertility, including for the consultation, diagnosis and treatment of iatrogenic infertility, as well as the following: (1) Cryopreservation and thawing of eggs, sperm and embryos. (2) Cryopreservation of ovarian tissue. (3) Cryopreservation of testicular tissue. (4) Intrauterine insemination. (5) Embryo biopsy. (6) Diagnostic testing. (7) Fresh and frozen embryo transfers. (8) Egg retrievals with unlimited embryo transfers in accordance with the guidelines determined by the Department of Health. The guidelines should be informed by standards of practice as developed by the American Society for Reproductive Medicine, including the use of single embryo transfers when recommended and medically appropriate. (9) Assisted hatching. (10) Intracytoplasmic sperm injection. (11) Ovulation induction. (12) Storage of oocytes, sperm, embryos and tissue. (13) Medical and laboratory services that reduce excess embryo creation through egg cryopreservation and thawing. (14) Therapeutic devices. (15) Standard fertility preservation services for an 20250HB0922PN0971 - 2 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 individual who has a medical condition and is expected to undergo medication therapy, surgery, radiation, chemotherapy or other medical treatment that is recognized by a medical professional to cause a risk of impairment to fertility. (16) Any nonexperimental procedure for infertility determined by the Department of Health. (17) Any other services, procedures, medications or devices related to the consultation, diagnosis and treatment for fertility preservation. (18) In vitro fertilization, including in vitro fertilization through the use of donor eggs, sperm or embryos and in vitro fertilization that involves the transfer of embryos to a gestational carrier or surrogate. (d) A health insurance policy or government program covered under this section may not: (1) contain preexisting condition exclusions or preexisting waiting periods to access fertility preservation care coverage required under this section; (2) contain limitations on coverage for fertility preservation benefits based solely on arbitrary factors, including the number of fertility preservation attempts or cost of fertility preservation care. (e) Storage requirements under subsection (c)(12) shall be covered by a health insurance policy or a government program for five consecutive years unless: (1) If the covered individual receiving service coverage under subsection (b) is not yet eighteen (18) years of age, in addition to requirements under this subsection, a health insurance policy or government program shall also cover storage requirements as necessary until the covered individual attains 20250HB0922PN0971 - 3 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 eighteen (18) years of age. (2) If a covered individual receiving services under subsection (c)(12) under one health insurance policy or government program changes coverage to another health insurance policy or government program during the five-consecutive-year window under this subsection, the subsequent health insurance policy or government program shall continue to provide coverage of services required under subsection (c)(12) for the remaining storage time under this subsection. (f) Nothing in this section shall be construed to interfere with the clinical judgment of a physician. (g) As used in this section, the following words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise: "Cost-sharing" means the share of costs covered by the patient, including a deductible, coinsurance, copayment or similar charge. The term does not include the payment of a health insurance policy or government program premium. "Covered individual" means an individual covered under a health insurance policy or government program, including covered spouses and covered nonspouse dependents which is provided without discrimination on the basis of ancestry, color, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex or sexual orientation. "Fertility preservation" means health care services used in saving or protecting embryos, eggs, ovarian tissue, sperm or testicular tissue for future reproduction. "Government program" means a program of government sponsored or subsidized health care coverage, including: 20250HB0922PN0971 - 4 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 (1) The children's health insurance program under Article XXIII-A. (2) Subdivision (f) of Article IV of the act of June 13, 1967 (P.L.31, No.21), known as the "Human Services Code." "Health insurance policy" means as follows: (1) The term includes an individual or group health insurance policy, subscriber contract, certificate or plan that provides medical or health care coverage on an expense-incurred service or prepaid basis and that is offered by or is governed under any of the following: (i) This act, including section 630. (ii) The act of December 29, 1972 (P.L.1701, No.364), known as the "Health Maintenance Organization Act." (iii) 40 Pa.C.S. Chs. 61 (relating to hospital plan corporations) and 63 (relating to professional health services plan corporations). (2) The term does not include any of the following plans: (i) Accident only. (ii) Credit only. (iii) Long-term care or disability income. (iv) Specified disease. (v) Medicare supplement. (vi) TRICARE, including the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) supplement. (vii) Fixed indemnity. (viii) Dental only. (ix) Vision only. (x) Workers' compensation. (xi) An automobile medical payment under 75 Pa.C.S. (relating to vehicles). 20250HB0922PN0971 - 5 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 "Iatrogenic infertility" means infertility arising from medical treatments that directly or indirectly cause infertility. "Infertility" means a disease historically defined by the failure to achieve a successful pregnancy after six to twelve months or more of regular, unprotected sexual intercourse or due to an individual's status and capacity to reproduce as an individual or with a partner. "Physician" means an individual licensed as a medical doctor by the State Board of Medicine to practice in this Commonwealth. Section 2. The following shall apply: (1) For health insurance policies for which either rates or forms are required to be filed with the Federal Government or the Insurance Department, this act shall apply to any policy for which a form or rate is first filed on or after the effective date of this section. (2) For health insurance policies for which rates or forms are required to be filed with the Federal Government or the Insurance Department, this act shall apply to any policy issued or renewed on or after 180 days after the effective date of this section. Section 3. This act shall take effect in 60 days. 20250HB0922PN0971 - 6 - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22