BILL NUMBER: S3131B
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     PURPOSE:
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     To extend health care coverage to the diagnosis and treatment of
     infertility.

     SUMMARY OF PROVISIONS:
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     The bill amends section 3221 of the insurance law by adding a new
     paragraph 13 to subsection k and amends section 4303 of the insurance
     law by adding a new subsection (aa) thereto in order to extend health
     care coverage to the diagnosis and treatment of infertility. The bill
     would require contracts and policies of medical insurance for
     physician services, hospital coverage, surgical coverage, and major
     medical or similar comprehensive type coverage to include coverage for
     the diagnosis and treatment of medical conditions which result in
     infertility. Such coverage is subject to annual copayments,
     coinsurance and deductibles, which the contracts or policies provide
     for other diseases.

     This bill established a $60,000 lifetime limit on benefits.
     Prescription drugs, however, are not subject to the lifetime cap. The
     bill requires that a person be insured for 12 months before accessing
     infertility coverage. Certain procedures, such as reversal of
     sterilization, reversal of sex change operations, cloning or sperm or
     egg retrieval from deceased individuals, are not covered under the
     bill. The use of sperm or eggs from deceased individuals is covered,
     however, but only if the deceased provided prior written
     authorization.  This bill also requires the Superintendent of
     Insurance to order a study of the utilization trends and experience
     and the rate and premium impact to health insurance consumers. The
     study is required to be performed by a member of the American Academy
     of Actuaries. The bill requires that the study be completed and a
     report submitted to the Governor, the Temporary President of the
     Senate and the Speaker of the Assembly by March 1, 2002.

     EXISTING LAW:
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     Existing law provides that coverage may not be denied for diagnosis
     and treatment of medical conditions otherwise covered by the policy or
     contract solely because the medical condition resulted in fertility.

     JUSTIFICATION:
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     The desire to reproduce is one the strongest human drives, second only
     to survival itself. For many years, however, people have been
     confronted with the heartbreak that they were unable to conceive
     children. Medical science has advanced to a point where treatment is
     available to increase fertility and through assisted reproduction
     technologies, such as in vitro fertilization, embryo transfer and
     other procedures, many people are now able to fulfill that dream.
     Childbirth and family are among the most basic of human needs and
     rights; monetary costs should not be the determining factor in
     achieving their fulfillment.

     LEGISLATIVE HISTORY:
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     New bill.

     FISCAL IMPLICATIONS:
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     None to State.

     LOCAL FISCAL IMPLICATIONS:
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     EFFECTIVE DATE:
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     This act shall take effect July 1, 2000 and shall expire and be deemed
     repealed July 1, 2002. This act shall apply to all policies and
     contracts issued, renewed, altered or modified on any date during the
     period which the provisions of this act are in effect. Any rules or
     regulations necessary to implement the provisions of this act on its
     effective date are authorized and directed to be completed on or
     before such effective date.

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