HB 922 — 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 fertility preservation coverage.

PRINTER'S NO.    971

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 922
                                               Session of
                                                 2025

     INTRODUCED BY MAYES, O'MARA, MALAGARI, GIRAL, WAXMAN, MADDEN,
        ABNEY, CERRATO, FREEMAN, HANBIDGE, KENYATTA, SCHLOSSBERG,
        HOHENSTEIN, OTTEN, SANCHEZ, INGLIS AND RABB, MARCH 17, 2025

     REFERRED TO COMMITTEE ON INSURANCE, MARCH 17, 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 fertility preservation 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.    Fertility Preservation Coverage.--(a)   An
19   individual or group health insurance policy offered, issued or
20   renewed in this Commonwealth or a government program shall
21   include coverage for fertility preservation services as
22   specified in subsection (b) and shall waive cost-sharing
 1   requirements related to fertility preservation care.
 2      (b)    Fertility preservation specified under subsection (c)
 3   shall apply to covered individuals not older than forty-five
 4   (45) years of age who are at risk of iatrogenic infertility.
 5      (c)    Fertility preservation care services under this section
 6   shall include services related to fertility preservation as a
 7   result of iatrogenic infertility, including for the
 8   consultation, diagnosis and treatment of iatrogenic infertility,
 9   as well as the following:
10      (1)    Cryopreservation and thawing of eggs, sperm and embryos.
11      (2)    Cryopreservation of ovarian tissue.
12      (3)    Cryopreservation of testicular tissue.
13      (4)    Intrauterine insemination.
14      (5)    Embryo biopsy.
15      (6)    Diagnostic testing.
16      (7)    Fresh and frozen embryo transfers.
17      (8)    Egg retrievals with unlimited embryo transfers in
18   accordance with the guidelines determined by the Department of
19   Health. The guidelines should be informed by standards of
20   practice as developed by the American Society for Reproductive
21   Medicine, including the use of single embryo transfers when
22   recommended and medically appropriate.
23      (9)    Assisted hatching.
24      (10)    Intracytoplasmic sperm injection.
25      (11)    Ovulation induction.
26      (12)    Storage of oocytes, sperm, embryos and tissue.
27      (13)    Medical and laboratory services that reduce excess
28   embryo creation through egg cryopreservation and thawing.
29      (14)    Therapeutic devices.
30      (15)    Standard fertility preservation services for an

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 1   individual who has a medical condition and is expected to
 2   undergo medication therapy, surgery, radiation, chemotherapy or
 3   other medical treatment that is recognized by a medical
 4   professional to cause a risk of impairment to fertility.
 5      (16)    Any nonexperimental procedure for infertility
 6   determined by the Department of Health.
 7      (17)    Any other services, procedures, medications or devices
 8   related to the consultation, diagnosis and treatment for
 9   fertility preservation.
10      (18)    In vitro fertilization, including in vitro
11   fertilization through the use of donor eggs, sperm or embryos
12   and in vitro fertilization that involves the transfer of embryos
13   to a gestational carrier or surrogate.
14      (d)    A health insurance policy or government program covered
15   under this section may not:
16      (1)    contain preexisting condition exclusions or preexisting
17   waiting periods to access fertility preservation care coverage
18   required under this section;
19      (2)    contain limitations on coverage for fertility
20   preservation benefits based solely on arbitrary factors,
21   including the number of fertility preservation attempts or cost
22   of fertility preservation care.
23      (e)    Storage requirements under subsection (c)(12) shall be
24   covered by a health insurance policy or a government program for
25   five consecutive years unless:
26      (1)    If the covered individual receiving service coverage
27   under subsection (b) is not yet eighteen (18) years of age, in
28   addition to requirements under this subsection, a health
29   insurance policy or government program shall also cover storage
30   requirements as necessary until the covered individual attains

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 1   eighteen (18) years of age.
 2      (2)   If a covered individual receiving services under
 3   subsection (c)(12) under one health insurance policy or
 4   government program changes coverage to another health insurance
 5   policy or government program during the five-consecutive-year
 6   window under this subsection, the subsequent health insurance
 7   policy or government program shall continue to provide coverage
 8   of services required under subsection (c)(12) for the remaining
 9   storage time under this subsection.
10      (f)   Nothing in this section shall be construed to interfere
11   with the clinical judgment of a physician.
12      (g)   As used in this section, the following words and phrases
13   shall have the meanings given to them in this subsection unless
14   the context clearly indicates otherwise:
15      "Cost-sharing" means the share of costs covered by the
16   patient, including a deductible, coinsurance, copayment or
17   similar charge. The term does not include the payment of a
18   health insurance policy or government program premium.
19      "Covered individual" means an individual covered under a
20   health insurance policy or government program, including covered
21   spouses and covered nonspouse dependents which is provided
22   without discrimination on the basis of ancestry, color,
23   disability, domestic partner status, gender, gender expression,
24   gender identity, genetic information, marital status, national
25   origin, race, religion, sex or sexual orientation.
26      "Fertility preservation" means health care services used in
27   saving or protecting embryos, eggs, ovarian tissue, sperm or
28   testicular tissue for future reproduction.
29      "Government program" means a program of government sponsored
30   or subsidized health care coverage, including:

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 1      (1)     The children's health insurance program under Article
 2   XXIII-A.
 3      (2)     Subdivision (f) of Article IV of the act of June 13,
 4   1967 (P.L.31, No.21), known as the "Human Services Code."
 5      "Health insurance policy" means as follows:
 6      (1)     The term includes an individual or group health
 7   insurance policy, subscriber contract, certificate or plan that
 8   provides medical or health care coverage on an expense-incurred
 9   service or prepaid basis and that is offered by or is governed
10   under any of the following:
11      (i)     This act, including section 630.
12      (ii)     The act of December 29, 1972 (P.L.1701, No.364), known
13   as the "Health Maintenance Organization Act."
14      (iii)     40 Pa.C.S. Chs. 61 (relating to hospital plan
15   corporations) and 63 (relating to professional health services
16   plan corporations).
17      (2)     The term does not include any of the following plans:
18      (i)     Accident only.
19      (ii)     Credit only.
20      (iii)     Long-term care or disability income.
21      (iv)     Specified disease.
22      (v)     Medicare supplement.
23      (vi)     TRICARE, including the Civilian Health and Medical
24   Program of the Uniformed Services (CHAMPUS) supplement.
25      (vii)     Fixed indemnity.
26      (viii)     Dental only.
27      (ix)     Vision only.
28      (x)     Workers' compensation.
29      (xi)     An automobile medical payment under 75 Pa.C.S.
30   (relating to vehicles).

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 1      "Iatrogenic infertility" means infertility arising from
 2   medical treatments that directly or indirectly cause
 3   infertility.
 4      "Infertility" means a disease historically defined by the
 5   failure to achieve a successful pregnancy after six to twelve
 6   months or more of regular, unprotected sexual intercourse or due
 7   to an individual's status and capacity to reproduce as an
 8   individual or with a partner.
 9      "Physician" means an individual licensed as a medical doctor
10   by the State Board of Medicine to practice in this Commonwealth.
11      Section 2.    The following shall apply:
12          (1)     For health insurance policies for which either rates
13      or forms are required to be filed with the Federal Government
14      or the Insurance Department, this act shall apply to any
15      policy for which a form or rate is first filed on or after
16      the effective date of this section.
17          (2)     For health insurance policies for which rates or
18      forms are required to be filed with the Federal Government or
19      the Insurance Department, this act shall apply to any policy
20      issued or renewed on or after 180 days after the effective
21      date of this section.
22      Section 3.    This act shall take effect in 60 days.




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