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Bill > SF130

IA SF130

A bill for an act relating to health insurance coverage for infertility.

summary

Introduced
01/23/2025
In Committee
01/23/2025
Crossed Over
Passed
Dead

Introduced Session

91st General Assembly

Bill Summary

This bill relates to health insurance coverage for the diagnosis of and treatment for infertility, and standard fertility preservation services (preservation services). The bill requires a policy, contract, or plan (plan) providing for third-party payment or prepayment of health or medical expenses to provide coverage for the diagnosis of and treatment for infertility, and for preservation services. “Diagnosis of and treatment for infertility”, “infertility”, and “standard fertility preservation services” are defined in the bill. Required coverage includes up to three completed oocyte retrievals with unlimited embryo transfers, using single embryo transfer if recommended and medically appropriate. Coverage of fertility medications shall not be less favorable than coverage for any other prescription medications under the plan. Deductibles, copayments, coinsurance, benefit maximums, waiting periods, or other limitations on coverage for the diagnosis of and treatment for infertility and preservation services shall not be any less favorable than those imposed on benefits for services covered under the plan that are not related to infertility. The bill provides an exception for a religious employer to request an exclusion from the required coverage and requires the religious employer to provide notice to employees of the exclusion. The bill applies to third-party payment provider contracts, policies, or plans delivered, issued for delivery, continued, or renewed in this state on or after July 1, 2025, by the third-party payment providers enumerated in the bill. The bill specifies the types of specialized health-related insurance not subject to the bill. The commissioner of insurance may adopt rules to administer the bill.

AI Summary

This bill requires health insurance providers to cover diagnosis and treatment of infertility, as well as fertility preservation services, for covered individuals. The bill defines key terms such as "infertility" (which includes failure to conceive or a medical professional's diagnosis based on medical history and testing) and "standard fertility preservation services" (procedures to protect fertility for patients undergoing medical treatments that might impair fertility). Specifically, the bill mandates coverage for up to three completed egg retrievals with unlimited embryo transfers, using single embryo transfer when medically appropriate. Insurance providers must offer fertility medication coverage at least as favorable as other prescription medications, and cannot impose more restrictive deductibles, copayments, or waiting periods for infertility-related services compared to other medical services. Religious employers can request an exclusion from the coverage if it conflicts with their religious beliefs, but must notify employees of such an exclusion. The bill applies to various types of health insurance plans starting July 1, 2025, and does not apply to certain specialized insurance types like dental, vision, or workers' compensation. The commissioner of insurance is authorized to create rules to implement this legislation.

Committee Categories

Business and Industry

Sponsors (11)

Last Action

Subcommittee: Driscoll, Klimesh, and Petersen. S.J. 143. (on 01/27/2025)

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