8 LONG TITLE
9 General Description:
10 This bill amends the expanded infertility treatment coverage pilot program.
11 Highlighted Provisions:
12 This bill:
13 ▸ defines "qualified assisted reproductive technology cycle";
14 ▸ modifies the expanded infertility treatment coverage pilot program by:
15 • providing an additional three years of coverage; and
16 • providing coverage for each qualified assisted reproductive technology cycle;
17 ▸ provides reporting requirements to evaluate the expanded infertility treatment
18 coverage pilot program;
19 ▸ extends the repeal date of the expanded infertility treatment coverage pilot program;
21 ▸ makes technical changes.
22 Money Appropriated in this Bill:
24 Other Special Clauses:
26 Utah Code Sections Affected:
28 49-20-418, as enacted by Laws of Utah 2018, Chapter 357
29 63I-1-249, as last amended by Laws of Utah 2020, Chapter 98
31 Be it enacted by the Legislature of the state of Utah:
32 Section 1. Section 49-20-418 is amended to read:
33 49-20-418. Expanded infertility treatment coverage pilot program.
34 (1) As used in this section:
35 (a) "Assisted reproductive technology" means the same as the term is defined in 42
37 (b) "Physician" means the same as the term is defined in Section 58-67-102.
38 (c) "Pilot program" means the expanded infertility treatment coverage pilot program
39 described in Subsection (2).
40 (d) "Qualified assisted reproductive technology cycle" means the use of assisted
41 reproductive technology to transfer a single embryo for implantation.
43 maternity benefits under the program.
44 (2) (a) Beginning plan year 2018-19, and ending plan year [
45 program shall offer a [
46 a qualified individual for the use of an assisted reproductive technology.
48 offer a one-time[
49 reproductive technology for each qualified individual.
50 (ii) For plan year 2021-22, 2022-23, or 2023-24, the pilot program shall offer a benefit
51 of $4,000 to a qualified individual toward the costs of each qualified assisted reproductive
52 technology cycle.
53 (c) The [
54 cost sharing requirements as the covered individual's plan.
55 (3) Coverage offered under the pilot program applies if:
56 (a) the patient who will use the assisted reproductive technology is a qualified
58 (b) (i) the patient's physician verifies that the patient or the patient's spouse has a
59 demonstrated condition recognized by a physician as a cause of infertility; or
60 (ii) the patient attests that the patient is unable to conceive a pregnancy or carry a
61 pregnancy to a live birth after a year or more of regular sexual relations without contraception;
62 (c) the patient attests that the patient has been unable to attain a successful pregnancy
63 through any less-costly, potentially effective infertility treatments for which coverage is
64 available under the health benefit plan; and
65 (d) the use of the assisted reproductive technology procedure is performed at a medical
66 facility that conforms to the minimal standards for programs of assisted reproductive
67 technology procedures adopted by the American Society for Reproductive Medicine.
68 (4) Coverage offered under the pilot program:
71 requirement to provide an adoption indemnity benefit to a qualified individual under Section
72 31A-22-610.1; [
74 the adoption indemnity benefit required under Section 31A-22-610.1[
75 (c) for plan year 2021-22, 2022-23, or 2023-24, shall apply to a qualified individual,
76 even if the qualified individual received the benefit described in Subsection (2)(b)(i).
77 (5) (a) The purpose of the pilot program is to study the efficacy of providing coverage
78 for the use of an assisted reproductive technology and is not a mandate for coverage of an
79 assisted reproductive technology within all health plans offered by the program.
82 (b) The program shall report to the Retirement and Independent Entities Interim
83 Committee regarding the costs and benefits of the pilot program:
84 (i) on or before October 1; and
85 (ii) during calendar years 2022 and 2023.
86 (6) Under Section 63J-1-603, the Legislature intends that the cost of the pilot program
87 will be paid from money above the minimum recommended level in the public employees' state
88 risk pool reserve.
89 Section 2. Section 63I-1-249 is amended to read:
90 63I-1-249. Repeal dates, Title 49.
91 (1) Title 49, Chapter 11, Part 13, Phased Retirement, is repealed January 1, 2025.
92 (2) Section 49-20-418 is repealed January 1, [