Pennsylvania 2025-2026 Regular Session

Pennsylvania Senate Bill SB351 Latest Draft

Bill / Introduced Version

                             
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 
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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.
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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 
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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.
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