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House bill mandating infertility insurance be offered

For more information about these global packages, please do not hesitate to call our office at 410-296-6132.

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The packages exclude medications, outside labs, labwork before and after treatment, and egg donor compensation.For full details about the Connecticut Insurance Mandate for infertility treatment and procedures read Bulletin HC-104.Read about RMA’s fertility treatment financing program.However,you will find companies,such as Gillette,who are self-insured and still provide infertility treatment benefits because they understand it’s “the right thing to do”.Please note that many insurance companies provide online access to benefits or call centers to assist you.“Treatment for infertility” means procedures consistent with established medical practices in the treatment of infertility by licensed physicians and surgeons including, but not limited to, diagnosis, diagnostic tests, medication, surgery, and gamete intrafallopian transfer.

“In vitro fertilization” means the laboratory medical procedures involving the actual in vitro fertilization process.(c) On and after January 1, 1990, every health care service plan that is a health maintenance organization, as defined in Section 1373.10, and that issues, renews, or amends a health care service plan contract that provides group coverage for hospital, medical, or surgical expenses shall offer the coverage specified in subdivision (a), according to the terms and conditions that may be agreed upon between the group subscriber and the plan to group contractholders with at least 20 employees to whom the plan is offered.

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Existing law imposes various requirements and restrictions on health care service plans and health insurers, including, among other things, a requirement that every group health care service plan contract or health insurance policy that is issued, amended, or renewed on or after January 1, 1990, offer coverage for the treatment of infertility, except in vitro fertilization, under those terms and conditions as may be agreed upon between the group subscriber or the group policyholder and the plan or the insurer, except as provided.

This bill would require that the coverage for the treatment of infertility be offered and, if purchased, provided without discrimination on the basis of age, ancestry, color, disability, domestic partner status, gender, gender expression, gender identity, genetic information, marital status, national origin, race, religion, sex, or sexual orientation.

Because a willful violation of the bill’s provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.(2) The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state.