SB 351 — 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 coverage for infertility treatment.

PRINTER'S NO.   288

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                        SENATE BILL
                        No. 351
                                               Session of
                                                 2025

     INTRODUCED BY BOSCOLA, STREET, SAVAL, COMITTA, FONTANA, KEARNEY,
        SCHWANK, COLLETT, TARTAGLIONE, COSTA, HAYWOOD, KANE AND
        SANTARSIERO, FEBRUARY 26, 2025

     REFERRED TO BANKING AND INSURANCE, FEBRUARY 26, 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 coverage for infertility treatment.
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 633.2.    Coverage for Infertility Treatment.--(a)
19   Every health insurance policy that provides pregnancy-related
20   benefits and is delivered, issued, executed or renewed in this
21   Commonwealth on or after the effective date of this section
22   shall provide coverage for the expenses of diagnosis and
 1   treatment of infertility, including:
 2      (1)   In vitro fertilization.
 3      (2)   Embryo transfer.
 4      (3)   Artificial insemination.
 5      (4)   Gamete intrafallopian tube transfer.
 6      (5)   Zygote intrafallopian tube transfer.
 7      (6)   Low tubal ovum transfer.
 8      (b)   The coverage required under subsection (a) may impose
 9   the following restrictions:
10      (1)   Exclude reversal of elective sterilization or use of
11   assisted reproductive techniques when infertility is the result
12   of elective sterilization.
13      (2)   Restrictions or waiting periods before assisted
14   reproductive techniques may be employed. The restrictions or
15   waiting periods imposed must be within the recommended treatment
16   guidelines issued by the American Society for Reproductive
17   Medicine or the American College of Obstetricians and
18   Gynecologists.
19      (3)   Exclude coverage for women beyond childbearing years.
20      (4)   Restrict coverage for assisted reproductive techniques
21   to the policyholder and dependent spouse. All treatments to
22   remedy conditions that could impair fertility must be covered
23   for policyholder and all dependents, including minor children.
24      (5)   Require that in vitro fertilization, gamete
25   intrafallopian tube transfer or zygote intrafallopian tube
26   transfer be performed at medical facilities that conform to the
27   American College of Obstetricians and Gynecologists guidelines
28   for in vitro fertilization clinics or to the American Society
29   for Reproductive Medicine minimal standards for programs of in
30   vitro fertilization.

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 1      (6)   A limitation of three assisted reproductive technology
 2   procedures that a covered individual may attempt.
 3      (7)   Require copayment or deductibles for assisted
 4   reproductive technology treatments. Any copayment or deduction
 5   may not exceed those applied to pregnancy-related benefits under
 6   the same policy, contract or plan.
 7      (c)   The procedures required to be covered under this section
 8   may be contained in any policy or plan issued to a religious
 9   institution or organization or to any entity sponsored by a
10   religious institution or organization that finds the procedure
11   required to be covered under this section to violate the
12   religious institution's or organization's religious and moral
13   teachings and beliefs.
14      (d)   As used in this section:
15      "Health insurance policy" means an individual or group health
16   insurance policy, contract or plan that provides medical or
17   health care coverage by any health care facility or licensed
18   health care provider on an expense-incurred service or prepaid
19   basis and that is offered by or is governed under any of the
20   following:
21      (1)   This act.
22      (2)   Subdivision (f) of Article IV of the act of June 13,
23   1967 (P.L.31, No.21), known as the "Human Services Code."
24      (3)   The act of December 29, 1972 (P.L.1701, No.364), known
25   as the "Health Maintenance Organization Act."
26      (4)   The act of May 18, 1976 (P.L.123, No.54), known as the
27   "Individual Accident and Sickness Insurance Minimum Standards
28   Act."
29      (5)   A nonprofit corporation subject to 40 Pa.C.S. Ch. 61
30   (relating to hospital plan corporations) or 63 (relating to

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 1   professional health services plan corporations).
 2   The term does not include accident only, fixed indemnity,
 3   limited benefit, credit, dental, vision, specified disease,
 4   Medicare supplement, Civilian Health and Medical Program of the
 5   Uniformed Services supplement, long-term care or disability
 6   income, workers' compensation or automobile medical payment
 7   insurance.
 8      "Infertility" means the inability to conceive after one year
 9   of unprotected sexual intercourse or the inability to sustain a
10   successful pregnancy.
11      Section 2.   This act shall take effect in 60 days.




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