Illinois Health Care Law's Infertility Benefits Requirement Amended: Employment Law Manual Updated, Legal Timetable Entry Added

Author: Tracy Morley, XpertHR Legal Editor

The Illinois Insurance Code requiring group health plans that cover more than 25 employees and that provide pregnancy-related benefits to also provide benefits for the diagnosis and treatment of infertility has been amended. Effective January 1, 2016, coverage for in vitro fertilization, gamete intrafallopian tube transfer or zygote intrafallopian tube transfer will be required for a covered individual who is unable to attain or maintain a viable pregnancy. Plus, the definition of infertility is amended to cover the inability to conceive after one year of attempts to produce conception and the inability to conceive after an individual is diagnosed with a condition affecting fertility.

Currently, coverage for in vitro fertilization, gamete intrafallopian tube transfer or zygote intrafallopian tube transfer is required for a covered individual who is unable to attain or sustain a successful pregnancy, and infertility means the inability to conceive after one year of unprotected sexual intercourse or the inability to sustain a successful pregnancy.

In light of this development, the Health Care Benefits: Illinois section of the Employment Law Manual has been updated and a Legal Timetable entry has been added.