SB 272 — An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for infertility care coverage.

PRINTER'S NO.    226

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 272
                                               Session of
                                                 2025

     INTRODUCED BY CAPPELLETTI, PENNYCUICK, HAYWOOD, COLLETT,
        PISCIOTTANO, COSTA, TARTAGLIONE, SANTARSIERO AND KANE,
        FEBRUARY 20, 2025

     REFERRED TO BANKING AND INSURANCE, FEBRUARY 20, 2025


                                    AN ACT
 1   Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
 2      act relating to insurance; amending, revising, and
 3      consolidating the law providing for the incorporation of
 4      insurance companies, and the regulation, supervision, and
 5      protection of home and foreign insurance companies, Lloyds
 6      associations, reciprocal and inter-insurance exchanges, and
 7      fire insurance rating bureaus, and the regulation and
 8      supervision of insurance carried by such companies,
 9      associations, and exchanges, including insurance carried by
10      the State Workmen's Insurance Fund; providing penalties; and
11      repealing existing laws," in casualty insurance, providing
12      for infertility care coverage.
13      The General Assembly of the Commonwealth of Pennsylvania
14   hereby enacts as follows:
15      Section 1.    The act of May 17, 1921 (P.L.682, No.284), known
16   as The Insurance Company Law of 1921, is amended by adding a
17   section to read:
18      Section 635.11.    Infertility Care Coverage.--(a)   A health
19   insurance policy covered under this section shall include
20   coverage for infertility care and shall waive cost-sharing
21   requirements related to infertility care.
22      (b)   Infertility care coverage under this section shall be
 1   provided to covered individuals, including covered spouses and
 2   covered nonspouse dependents. Infertility care coverage under
 3   this section shall be provided without discrimination on the
 4   basis of age, ancestry, color, disability, domestic partner
 5   status, gender, gender expression, gender identity, genetic
 6   information, marital status, national origin, race, religion,
 7   sex or sexual orientation. Nothing in this subsection shall be
 8   construed to interfere with the clinical judgment of a
 9   physician.
10      (c)    Infertility care coverage under this section shall be
11   for the consultation, diagnosis and treatment of infertility,
12   including the following:
13      (1)    Intrauterine insemination.
14      (2)    Cryopreservation and thawing of eggs, sperm and embryos.
15      (3)    Cryopreservation of ovarian tissue.
16      (4)    Cryopreservation of testicular tissue.
17      (5)    Embryo biopsy.
18      (6)    Diagnostic testing.
19      (7)    Fresh and frozen embryo transfers.
20      (8)    Egg retrievals with unlimited embryo transfers in
21   accordance with the guidelines of the American Society for
22   Reproductive Medicine, including the use of single embryo
23   transfers when recommended and medically appropriate.
24      (9)    In vitro fertilization, including in vitro fertilization
25   through the use of donor eggs, sperm or embryos and in vitro
26   fertilization that involves the transfer of embryos to a
27   gestational carrier or surrogate.
28      (10)    Assisted hatching.
29      (11)    Intracytoplasmic sperm injection.
30      (12)    Infertility medications.

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 1      (13)   Ovulation induction.
 2      (14)   Storage of oocytes, sperm, embryos and tissue.
 3      (15)   Surgery to address disorders of the female reproductive
 4   tract that impair fertility and to address disorders of sperm
 5   production or anatomic disorders of the male reproductive tract
 6   that impair fertility.
 7      (16)   Medical and laboratory services that reduce excess
 8   embryo creation through egg cryopreservation and thawing.
 9      (17)   Surrogacy, including the costs associated with the
10   preparation for reception or introduction of embryos, oocytes or
11   donor sperm into a surrogate or gestational carrier.
12      (18)   Gamete intrafallopian transfers.
13      (19)   Therapeutic devices.
14      (20)   Standard fertility preservation services for an
15   individual who has a medical condition and is expected to
16   undergo medication therapy, surgery, radiation, chemotherapy or
17   other medical treatment that is recognized by a medical
18   professional to cause a risk of impairment to fertility.
19      (21)   Any nonexperimental procedure for infertility
20   recognized by the American Society for Reproductive Medicine,
21   the American College of Obstetricians and Gynecologists or the
22   Society for Assisted Reproductive Technology or by an
23   infertility expert identified by the Department of Health.
24      (22)   Any other services, procedures, medications or devices
25   related to the consultation, diagnosis and treatment of
26   infertility.
27      (d)    A health insurance policy covered under this section may
28   not:
29      (1)    contain preexisting condition exclusions or preexisting
30   condition waiting periods to access the infertility care

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 1   coverage required under this section;
 2      (2)     use the prior diagnosis of infertility or prior
 3   treatment for infertility as a basis for excluding, limiting or
 4   otherwise restricting the availability of infertility care
 5   coverage required under this section; or
 6      (3)     contain limitations on coverage for infertility benefits
 7   based solely on arbitrary factors, including the number of
 8   infertility care attempts or cost of infertility care.
 9      (e)     As used in this section, the following words and phrases
10   shall have the meanings given to them in this subsection unless
11   the context clearly indicates otherwise:
12      "Cost-sharing."     The share of costs covered by the patient,
13   including a deductible, coinsurance, copayment or similar
14   charge. The term does not include the payment of a health
15   insurance policy premium.
16      "Health insurance policy."     As follows:
17      (1)     Any individual or group health insurance policy,
18   subscriber contract, certificate or plan that provides medical
19   or health care coverage by a health care facility or licensed
20   health care provider on an expense-incurred service or prepaid
21   basis and that is offered by or is governed under any of the
22   following:
23      (i)     This act, including section 630.
24      (ii)     The children's health insurance program under Article
25   XXIII-A.
26      (iii)     Subdivision (f) of Article IV of the act of June 13,
27   1967 (P.L.31, No.21), known as the "Human Services Code."
28      (iv)     The act of December 29, 1972 (P.L.1701, No.364), known
29   as the "Health Maintenance Organization Act."
30      (v)     40 Pa.C.S. Chs. 61 (relating to hospital plan

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 1   corporations) and 63 (relating to professional health services
 2   plan corporations).
 3      (2)    The term does not include any of the following:
 4      (i)    Accident only.
 5      (ii)    Credit only.
 6      (iii)    Long-term care or disability income.
 7      (iv)    Specified disease.
 8      (v)    Medicare supplement.
 9      (vi)    Tricare, including the Civilian Health and Medical
10   Program of the Uniformed Services (CHAMPUS) supplement.
11      (vii)    Fixed indemnity.
12      (viii)    Dental only.
13      (ix)    Vision only.
14      (x)    Workers' compensation.
15      (xi)    An automobile medical payment under 75 Pa.C.S.
16   (relating to vehicles).
17      "Infertility."     A disease historically defined by the failure
18   to achieve a successful pregnancy after six to twelve months or
19   more of regular, unprotected sexual intercourse or due to an
20   individual's status and capacity to reproduce as an individual
21   or with a partner.
22      "Physician."    An individual licensed as a medical doctor by
23   the State Board of Medicine to practice in this Commonwealth.
24      Section 2.    This act shall take effect in 60 days.




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