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Bill > S1966


NJ S1966

NJ S1966
Revises health insurance coverage requirements for treatment of infertility.


summary

Introduced
01/09/2024
In Committee
01/09/2024
Crossed Over
Passed
01/09/2024
Dead
01/09/2024
Signed/Enacted/Adopted
01/09/2024

Introduced Session

2024-2025 Regular Session

Bill Summary

This bill updates current law on health insurance coverage of infertility by requiring certain health insurance carriers (including hospital service corporations, medical service corporations, health service corporations, and health maintenance organizations authorized to issue health benefits plans in New Jersey, commercial group health insurance providers, and any entities contracted to administer health benefits in connection with the State Health Benefits Program and School Employees' Health Benefits Program) to cover infertility services for a partner of a person who has successfully reversed a voluntary sterilization. The bill also requires health insurance carriers to cover any services related to infertility in accordance with American Society for Reproductive Medicine guidelines and as determined by a physician, including intrauterine insemination, genetic testing, in vitro fertilization using donor eggs, in vitro fertilization where the embryo is transferred to a gestational carrier or surrogate, and unlimited embryo transfers, in accordance with guidelines from the American Society for Reproductive Medicine, and any other services related to infertility recommended by a physician. Additionally, the bill revises the current statutory definition of "infertility" and adds a definition of "treatment of infertility." The bill also provides that nothing in the definition of "infertility" may be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation and prohibits health insurance carriers from imposing restrictions concerning the coverage of infertility services based on age. Finally, the bill excludes coverage for infertility services if an individual's infertility resulted solely from a voluntary unreversed sterilization; provided, however, that coverage for infertility services shall not be excluded if the voluntary sterilization is successfully reversed.

AI Summary

This bill expands health insurance coverage for infertility treatments by requiring various health insurance carriers, including hospital service corporations, medical service corporations, health service corporations, health maintenance organizations (HMOs), commercial group health insurers, and administrators for the State and School Employees' Health Benefits Programs, to cover infertility services for partners of individuals who have reversed voluntary sterilization. It mandates coverage for a broad range of infertility services, such as intrauterine insemination, genetic testing, in vitro fertilization (IVF) with donor eggs or for gestational carriers, and unlimited embryo transfers, all in accordance with guidelines from the American Society for Reproductive Medicine (ASRM) and as determined by a physician. The bill also revises the definition of "infertility" to be more inclusive, ensuring it cannot be used to deny or delay treatment based on relationship status or sexual orientation, and prohibits age-based restrictions on coverage. Furthermore, it clarifies that infertility resulting solely from a voluntary sterilization will not be covered unless that sterilization is successfully reversed, and it explicitly states that no exclusions or limitations can be placed on fertility services provided by or to a third party.

Committee Categories

Business and Industry

Sponsors (4)

Last Action

Withdrawn Because Approved P.L.2023, c.258. (on 01/09/2024)

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