1Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
2act relating to insurance; amending, revising, and
3consolidating the law providing for the incorporation of
4insurance companies, and the regulation, supervision, and
5protection of home and foreign insurance companies, Lloyds
6associations, reciprocal and inter-insurance exchanges, and
7fire insurance rating bureaus, and the regulation and
8supervision of insurance carried by such companies,
9associations, and exchanges, including insurance carried by
10the State Workmen's Insurance Fund; providing penalties; and
11repealing existing laws," in health and accident insurance,
12providing for insurance coverage for infertility treatment
13services.

14The General Assembly of the Commonwealth of Pennsylvania
15hereby enacts as follows:

16Section 1. The act of May 17, 1921 (P.L.682, No.284), known
17as The Insurance Company Law of 1921, is amended by adding a
18section to read:

19Section 633.1. Coverage for Infertility Treatment.--(a)
20Every health insurance policy that provides pregnancy-related
21benefits and is delivered, issued, executed or renewed in this
22Commonwealth on or after the effective date of this section
23shall provide coverage for the expenses of diagnosis and

1treatment of infertility, including, but not limited to, in
2vitro fertilization, embryo transfer, artificial insemination,
3gamete intrafallopian tube transfer, zygote intrafallopian tube
4transfer and low tubal ovum transfer.

5(b) The coverage required under subsection (a) of this
6section may impose the following restrictions:

7(1) Exclude reversal of elective sterilization or use of
8assisted reproductive techniques when infertility is the result
9of elective sterilization.

10(2) Impose restrictions or waiting periods before assisted
11reproductive techniques may be employed. The restrictions or
12waiting periods imposed must be within the recommended treatment
13guidelines issued by the American Society for Reproductive
14Medicine or the American College of Obstetricians and
15Gynecologists.

16(3) Exclude coverage for women beyond childbearing years.

17(4) Restrict coverage for assisted reproductive techniques
18to the policyholder and dependent spouse. All treatments to
19remedy conditions that could impair fertility must be covered
20for policyholder and all dependents, including minor children.

21(5) Require in vitro fertilization, gamete intrafallopian
22tube transfer or zygote intrafallopian tube transfer be
23performed at medical facilities that conform to the American
24College of Obstetricians and Gynecologists guidelines for in
25vitro fertilization clinics or to the American Society for
26Reproductive Medicine minimal standards for programs of in vitro
27fertilization.

28(6) Impose a limitation of three assisted reproductive
29technology procedures that a covered individual may attempt.

30(7) Require copayment or deductibles for assisted

1reproductive technology treatments. Any copayment or deduction
2may not exceed those applied to pregnancy-related benefits under
3the same policy, contract or plan.

4(c) The procedures required to be covered under this section
5may be contained in any policy or plan issued to a religious
6institution or organization or to any entity sponsored by a
7religious institution or organization that finds the procedure
8required to be covered under this section to violate its
9religious and moral teachings and beliefs.

10(d) (1) The term "health insurance policy" when used in 
11this section means an individual or group health insurance 
12policy, contract or plan that provides medical or health care 
13coverage by any health care facility or licensed health care 
14provider on an expense-incurred service or prepaid basis and 
15that is offered by or is governed under any of the following:

16(i) This act.

17(ii) Subdivision (f) of Article IV of the act of June 13, 
181967 (P.L.31, No.21), known as the "Public Welfare Code."

19(iii) The act of December 29, 1972 (P.L.1701, No.364), known 
20as the "Health Maintenance Organization Act."

21(iv) The act of May 18, 1976 (P.L.123, No.54), known as the 
22"Individual Accident and Sickness Insurance Minimum Standards 
23Act."

24(v) A nonprofit corporation subject to 40 Pa.C.S. Ch. 61 
25(relating to hospital plan corporations) or 63 (relating to 
26professional health services plan corporations).

27(2) The term "infertility" when used in this section means 
28the inability to conceive after one year of unprotected sexual 
29intercourse or the inability to sustain a successful pregnancy.

30Section 2. This act shall take effect in 60 days.