PA 17-55—sHB 7124

Insurance and Real Estate Committee

AN ACT CONCERNING HEALTH INSURANCE COVERAGE FOR FERTILITY PRESERVATION FOR INSUREDS DIAGNOSED WITH CANCER

SUMMARY: This act expands the range of people eligible for infertility coverage under certain individual and group health insurance policies.

By law, these policies must cover the medically necessary costs of diagnosing and treating infertility. Through its definition of “infertility,” prior law limited coverage to those who are presumably healthy and unable to conceive, produce conception, or sustain a successful pregnancy during a one-year period. The act removes the “presumably healthy” limitation, thus extending infertility coverage to those who are not healthy. It appears also to extend coverage to anyone who requires medically necessary infertility treatment.

The act applies to policies delivered, issued, renewed, amended, or continued in Connecticut on and after January 1, 2018, that cover (1) basic hospital expenses; (2) basic medical-surgical expenses; (3) major medical expenses; or (4) hospital or medical services, including those provided under an HMO plan. Because of the federal Employee Retirement Income Security Act, state insurance benefit mandates do not apply to self-insured benefit plans.

The law, unchanged by the act, allows (1) insurers to impose certain specified limits on infertility coverage and (2) religious employers and individuals to exclude infertility coverage from their policies if it is contrary to their religious tenets.

EFFECTIVE DATE: January 1, 2018