PRINTER'S NO. 288 THE GENERAL ASSEMBLY OF PENNSYLVANIA SENATE BILL No.351 Session of 2025 INTRODUCED BY BOSCOLA, STREET, SAVAL, COMITTA, FONTANA, KEARNEY, SCHWANK, COLLETT, TARTAGLIONE, COSTA, HAYWOOD, KANE AND SANTARSIERO, FEBRUARY 26, 2025 REFERRED TO BANKING AND INSURANCE, FEBRUARY 26, 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 coverage for infertility treatment. 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 633.2. Coverage for Infertility Treatment.--(a) Every health insurance policy that provides pregnancy-related benefits and is delivered, issued, executed or renewed in this Commonwealth on or after the effective date of this section shall provide coverage for the expenses of diagnosis and 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 treatment of infertility, including: (1) In vitro fertilization. (2) Embryo transfer. (3) Artificial insemination. (4) Gamete intrafallopian tube transfer. (5) Zygote intrafallopian tube transfer. (6) Low tubal ovum transfer. (b) The coverage required under subsection (a) may impose the following restrictions: (1) Exclude reversal of elective sterilization or use of assisted reproductive techniques when infertility is the result of elective sterilization. (2) Restrictions or waiting periods before assisted reproductive techniques may be employed. The restrictions or waiting periods imposed must be within the recommended treatment guidelines issued by the American Society for Reproductive Medicine or the American College of Obstetricians and Gynecologists. (3) Exclude coverage for women beyond childbearing years. (4) Restrict coverage for assisted reproductive techniques to the policyholder and dependent spouse. All treatments to remedy conditions that could impair fertility must be covered for policyholder and all dependents, including minor children. (5) Require that in vitro fertilization, gamete intrafallopian tube transfer or zygote intrafallopian tube transfer be performed at medical facilities that conform to the American College of Obstetricians and Gynecologists guidelines for in vitro fertilization clinics or to the American Society for Reproductive Medicine minimal standards for programs of in vitro fertilization. 20250SB0351PN0288 - 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 (6) A limitation of three assisted reproductive technology procedures that a covered individual may attempt. (7) Require copayment or deductibles for assisted reproductive technology treatments. Any copayment or deduction may not exceed those applied to pregnancy-related benefits under the same policy, contract or plan. (c) The procedures required to be covered under this section may be contained in any policy or plan issued to a religious institution or organization or to any entity sponsored by a religious institution or organization that finds the procedure required to be covered under this section to violate the religious institution's or organization's religious and moral teachings and beliefs. (d) As used in this section: "H ealth insurance policy " means an individual or group health insurance policy, contract or plan that provides medical or health care coverage by any health care facility or licensed health care provider on an expense-incurred service or prepaid basis and that is offered by or is governed under any of the following: (1) This act. (2) Subdivision (f) of Article IV of the act of June 13, 1967 (P.L.31, No.21) , known as the "Human Services Code." (3) The act of December 29, 1972 (P.L.1701, No.364) , known as the "Health Maintenance Organization Act." (4) The act of May 18, 1976 (P.L.123, No.54) , known as the "Individual Accident and Sickness Insurance Minimum Standards Act." (5) A nonprofit corporation subject to 40 Pa.C.S. Ch. 61 (relating to hospital plan corporations) or 63 (relating to 20250SB0351PN0288 - 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 professional health services plan corporations). The term does not include accident only, fixed indemnity, limited benefit, credit, dental, vision, specified disease, Medicare supplement, Civilian Health and Medical Program of the Uniformed Services supplement, long-term care or disability income, workers' compensation or automobile medical payment insurance. "Infertility " means the inability to conceive after one year of unprotected sexual intercourse or the inability to sustain a successful pregnancy. Section 2. This act shall take effect in 60 days. 20250SB0351PN0288 - 4 - 1 2 3 4 5 6 7 8 9 10 11