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SB1347 • 2026

health insurance; fertility preservation; coverage

SB1347 - health insurance; fertility preservation; coverage

Healthcare Labor
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Carine Werner, Hildy Angius
Last action
2026-03-10
Official status
House second read
Effective date
Not listed

Plain English Breakdown

The official summary does not provide specific details on the cost implications for private health plans or local government health plans.

Health Insurance Coverage for Fertility Preservation

This bill requires health insurers to cover fertility preservation services starting January 1, 2028, if a person is diagnosed with cancer and their treatment may cause iatrogenic infertility.

What This Bill Does

  • Requires health insurance companies to provide coverage for standard fertility preservation services starting January 1, 2028, if a person is within reproductive age and diagnosed with cancer whose medically necessary treatment is likely to cause iatrogenic infertility.
  • Defines 'iatrogenic infertility' as loss of fertility caused by medical treatments like cancer therapy.
  • Specifies that covered services include preserving eggs or sperm and storing them for at least three plan years.
  • Requires insurers to process urgent requests for these services within 72 hours.
  • Allows religious employers to request an exemption from providing this coverage if it conflicts with their sincerely held religious beliefs.

Who It Names or Affects

  • People diagnosed with cancer who are of reproductive age and at risk of losing fertility due to medical treatment.
  • Health insurance companies that offer individual health plans in Arizona.
  • Religious employers seeking exemptions based on sincerely held religious beliefs.

Terms To Know

Iatrogenic infertility
Loss of fertility caused by medical treatments such as cancer therapy.
Standard fertility preservation services
Includes procedures like egg and sperm freezing, and storage for at least three plan years.

Limits and Unknowns

  • The bill does not specify what happens if a person changes insurance plans during the three-year storage period.
  • It is unclear how much this will cost private health plans and local government health plans.
  • Additional impacts on healthcare premium tax collections cannot be determined in advance.

Amendments

These notes stay tied to the official amendment files and metadata from the legislature.

Plain English: Fifty-seventh Legislature Finance Second Regular Session S.B.

  • Fifty-seventh Legislature Finance Second Regular Session S.B.
  • 1347 COMMITTEE ON FINANCE SENATE AMENDMENTS TO S.B.
  • 1347 (Reference to printed bill) The bill as proposed to be amended is reprinted as follows: 1 Section 1.
  • Title 20, chapter 4, article 3, Arizona Revised 2 Statutes, is amended by adding section 20-841.14, to read: 3 20-841.14.
  • This amendment summary is using official source text because generated interpretation was skipped for this run.

Plain English: Fifty-seventh Legislature Finance Second Regular Session S.B.

  • Fifty-seventh Legislature Finance Second Regular Session S.B.
  • 1347 PROPOSED SENATE AMENDMENTS TO S.B.
  • 1347 (Reference to printed bill) The bill as proposed to be amended is reprinted as follows: 1 Section 1.
  • Title 20, chapter 4, article 3, Arizona Revised 2 Statutes, is amended by adding section 20-841.14, to read: 3 20-841.14.
  • This amendment summary is using official source text because generated interpretation was skipped for this run.

Plain English: Amendment explanation prepared by Molly Graver 2/27/2026 Bill Number: S.B.

  • Amendment explanation prepared by Molly Graver 2/27/2026 Bill Number: S.B.
  • 1347 Werner SUB Floor Amendment Reference to: printed bill Amendment drafted by: Leg.
  • Council F LOOR AMENDMENT EXPLANATION 1.
  • Requires standard fertility preservation services insurance coverage to include at least three plan years of storage.
  • This amendment summary is using official source text because generated interpretation was skipped for this run.

Bill History

  1. 2026-03-10 House

    House second read

  2. 2026-03-09 House

    House Rules: None

  3. 2026-03-09 House

    House Health & Human Services: DP

  4. 2026-03-09 House

    House first read

  5. 2026-03-02 House

    Transmitted to House

  6. 2026-03-02 Senate

    Senate third read passed

  7. 2026-03-02 Senate

    Senate committee of the whole

  8. 2026-02-25 Senate

    Senate minority caucus

  9. 2026-02-23 Senate

    Senate majority caucus

  10. 2026-01-27 Senate

    Senate second read

  11. 2026-01-26 Senate

    Senate Rules: PFC

  12. 2026-01-26 Senate

    Senate Finance: DPA

  13. 2026-01-26 Senate

    Senate first read

Official Summary Text

SB1347 - 572R - Senate Fact Sheet

Assigned to
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PASSED BY COW

ARIZONA STATE SENATE

Fifty-Seventh
Legislature, Second Regular Session

REVISED

AMENDED

FACT SHEET FOR
S.B. 1347

health insurance;
fertility preservation; coverage

Purpose

Effective
January 1, 2028, requires a health insurer to provide coverage for standard
fertility preservation services to an insured who is within reproductive age,
who is diagnosed with cancer and whose medically necessary treatment is likely
to cause iatrogenic infertility. Prescribes procedures for a religious employer
to request an exemption from the coverage requirement.

Background

The Department
of Insurance and Financial Institutions (DIFI) regulates policies,
certificates, evidences of coverage and contracts of insurance (insurance
policies) that are issued or delivered by insurers. Every insurer that offers
individual health insurance coverage in the individual market in Arizona must
provide guaranteed availability of coverage to eligible individuals who desire
to enroll in individual health insurance coverage (
A.R.S.
� 20-1379
).

Fertility
preservation is a health care service for patients undergoing treatment for
medical conditions that may result in fertility impairment caused by medical
treatment that has a potential side effect of impaired fertility.

The Joint
Legislative Budget Committee (JLBC) issued a revised fiscal note on S.B. 1347 which
estimates a cost to the state General Fund of $305,900 and a total funds cost
of $611,800 annually, beginning in plan year 2028. JLBC notes an additional
impact on local government health plans and health care premium tax
collections, but the magnitude of the fiscal impact cannot be determined in
advance. Additionally, DIFI estimates that S.B. 1347 would generate additional
state costs between $2.4 million and $3.6 million to defray the costs to
private health plans that provide the required coverage for standard fertility
preservation services (
JLBC
Fiscal Note
).

Provisions

1.

Requires a health insurer that issues, amends or renews an insurance
policy on or after January 1, 2027, to provide coverage for standard fertility
preservation services to an insured who is within reproductive age, who is
diagnosed with cancer and whose medically necessary treatment is likely to cause
iatrogenic infertility.

2.

Defines
iatrogenic infertility
as an impairment of fertility that
is caused directly or indirectly by medically necessary treatment for cancer,
sickle cell disease or lupus.

3.

Defines

standard fertility preservation services
to:

a)

mean oocyte and sperm preservation procedures that are consistent with
established medical practices or professional guidelines published by the American
Society of Clinical Oncology or the American Society for Reproductive Medicine;

b)

mean the storage for at least three plan years of preserved ovarian
tissue, sperm and oocyte; and

c)

include
cryopreservation of ovarian tissue, sperm and oocyte.

4.

Requires standard fertility preservation services coverage to include at
least three plan years of storage.

5.

Stipulates that, if an insured changes insurance plans during the
three-year storage period, the prior health insurer and the new health insurer
are not responsible for the three plan years of storage.

6.

Requires a health insurer to process prior authorization requests for standard
fertility preservation services as urgent and to respond within 72 hours on
request.

7.

Allows an insurance policy to contain provisions for maximum benefits
and to require standard fertility preservation services to be subject to the
same deductibles, copayments, coinsurance and reasonable limitations and
exclusions.

8.

Allows a religious employer to submit a written request to the insurer
for an exemption from the requirement to provide coverage for standard
fertility preservation services for an insured who is within reproductive age,
who is diagnosed with cancer and whose medically necessary treatment may cause
iatrogenic infertility.

9.

Requires the health insurer to grant a requested exemption if the
coverage conflicts with the employer's religious beliefs and requires a
religious employer that obtains an exemption to provide written notice of the
exemption to prospective insureds.

10.

Specifies
that the requirement to provide coverage for standard fertility preservation
services does not prevent an insured from purchasing a supplemental insurance
policy that covers standard fertility preservation services at the insured's
own expense.

11.

Defines
terms.

12.

Becomes
effective on January 1, 2028.

Amendments Adopted by
Committee

1.

Specifies that the medically necessary treatment must be likely to cause
iatrogenic infertility in order for the services to be covered.

2.

Redefines
religious employer
.

3.

Clarifies that standard fertility preservation services include storage
for three plan years, rather than three years.

Amendments Adopted by
Committee of the Whole

1.

The committee amendment was withdrawn.

2.

Requires standard fertility preservation services coverage to include at
least three plan years of storage.

3.

Stipulates that, if an insured changes insurance plans during the
three-year storage period, the prior health insurer and the new health insurer
are not responsible for the three plan years of storage.

4.

Removes the prohibition against health insurers requiring prior
authorization for standard fertility preservation services and instead requires
a health insurer to process prior authorization requests for such services as
urgent and to respond within 72 hours on request.

5.

Specifies that the medically necessary treatment must be likely to cause
iatrogenic infertility in order for the standard fertility preservation
services to be covered.

6.

Redefines
religious employer
and
iatrogenic infertility
.

7.

Adds a delayed effective date of January 1, 2028.

Revisions

�

Updates the fiscal impact statement.

Senate
Action

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Prepared by Senate Research

April 1, 2026

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Current Bill Text

Read the full stored bill text
SB1347 - 572R - S Ver

Senate Engrossed

health insurance;
fertility preservation; coverage

State of Arizona

Senate

Fifty-seventh Legislature

Second Regular Session

2026

SENATE BILL 1347

AN
ACT

amending title 20, chapter 4, article 3, arizona
revised statutes, by adding section 20-841.14; amending title 20, chapter
4, article 9, arizona revised statutes, by adding SECTION 20-1057.21;
amending title 20, chapter 6, article 4, arizona revised statutes, by adding
section 20-1376.11; amending title 20, chapter 6, article 5, arizona
revised statutes, by adding section 20-1406.11; relating to health
insurance.

(TEXT OF BILL BEGINS ON NEXT PAGE)

Be it
enacted by the Legislature of the State of Arizona:

Section 1. Title 20, chapter 4, article 3,
Arizona Revised Statutes, is amended by adding section 20-841.14, to read:

START_STATUTE
20-841.14.

Fertility preservation coverage; requirements; religious
employer; exemption; definitions

A. A hospital
service corporation or medical service corporation that issues, amends or
renews a subscription contract on or after January 1, 2027 shall provide
coverage for standard fertility preservation services to a subscriber who is
within reproductive age, who is diagnosed with cancer and whose medically
necessary treatment
is likely to directly or
indirectly cause iatrogenic infertility.
Coverage
for standard fertility preservation services must include at least three plan
years of storage. If a subscriber changes insurance plans during the
three-year period, the prior hospital service corporation or the medical
service corporation that provided coverage and the new insurer are not
responsible for the three plan years of storage.

B. A hospital service corporation or
medical service corporation
shall process prior
authorization requests for standard fertility preservation services as urgent
and respond within seventy-two hours on request.

C. A religious employer may submit a
written request for an exemption from the requirements of this section to a
hospital service corporation or medical service corporation, and the hospital
service corporation or medical service corporation shall grant the exemption if
the coverage required by this section conflicts with the employer's religious
beliefs. A religious employer that obtains an exemption shall
provide written notice of the exemption to prospective subscribers.

D. This section does not prevent a
subscriber from purchasing a supplemental insurance policy that covers standard
fertility preservation services at the subscriber's own expense.

E. For the purposes of this section:

1. "Iatrogenic infertility"
means an impairment of fertility that is caused directly or indirectly by
medically necessary treatment for cancer, sickle cell disease or lupus.

2. "Religious employer":

(
a
) Means a
nongovernmental plan sponsor or entity that, based on sincerely held religious
beliefs, objects to the sponsor or entity establishing, maintaining, providing,
offering or arranging for coverage of standard fertility PRESERVATION services.

(
b
) Includes:

(
i
) A church,
an integrated auxiliary of a church, a convention or association of churches or
a religious order.

(
ii
) A
nonprofit organization.

(
iii
) A closely
held for-profit entity.

(
iv
) A for-profit
entity that is not closely held.

(
v
) Any other
nongovernmental employer.

3. "Reproductive age" means
the age range in which an individual is deemed fertile as established by the
American society of clinical oncology or the american society for reproductive
medicine.

4. "Standard fertility
preservation services":

(
a
) Means:

(
i
) Oocyte and
sperm preservation procedures that are consistent with established medical
practices or professional guidelines published by the american society of
clinical oncology or the american society for reproductive medicine.

(
ii
) THe
storage for at least three
plan years of preserved
ovarian tissue, sperm and oocyte.

(
b
) Includes
cryopreservation of any of the following:

(
i
) Ovarian
tissue.

(
ii
) Sperm.

(
iii
) oocyte.
END_STATUTE

Sec. 2. Title 20, chapter 4, article 9, Arizona
Revised Statutes, is amended by adding section 20-1057.21, to read:

START_STATUTE
20-1057.21.

Fertility preservation coverage; requirements; religious
employer; exemption; definitions

A. A health care services
organization that issues, amends or renews an evidence of coverage on or after
January 1, 2027 shall provide coverage for standard fertility preservation
services to an enrollee who is within reproductive age, who is diagnosed with
cancer and whose medically necessary treatment
is likely
to directly or indirectly cause iatrogenic infertility.
Coverage for standard fertility preservation services must include at
least three plan years of storage. If an enrollee changes insurance plans
during the three-year period, the prior health care services organization
that provided coverage and the new insurer are not responsible for the three
plan years of storage.

B. A health care services
organization
shall process prior authorization requests
for standard fertility preservation services as urgent and respond within
seventy-two hours on request.

C. A religious employer may submit a
written request for an exemption from the requirements of this section to a
health care services organization, and the health care services organization
shall grant the exemption if the coverage required by this section conflicts
with the employer's religious beliefs. A religious employer that
obtains an exemption shall provide written notice of the exemption to
prospective enrollees.

D. This section does not prevent an
enrollee from purchasing a supplemental insurance policy that covers standard
fertility preservation services at the enrollee's own expense.

E. For the purposes of this section:

1. "Iatrogenic infertility"
means an impairment of fertility that is caused directly or indirectly by
a medically necessary treatment for cancer, sickle cell disease or
lupus.

2. "Religious employer":

(
a
) Means a
nongovernmental plan sponsor or entity that, based on sincerely held religious
beliefs, objects to the sponsor or entity establishing, maintaining, providing,
offering or arranging for coverage of standard fertility PRESERVATION services.

(
b
) Includes:

(
i
) A church,
an integrated auxiliary of a church, a convention or association of churches or
a religious order.

(
ii
) A
nonprofit organization.

(
iii
) A closely
held for-profit entity.

(
iv
) A for-profit
entity that is not closely held.

(
v
) Any other
nongovernmental employer.

3. "Reproductive age" means
the age range in which an individual is deemed fertile as established by the
American society of clinical oncology or the american society for reproductive
medicine.

4. "Standard fertility
preservation services":

(
a
) Means:

(
i
) Oocyte and
sperm preservation procedures that are consistent with established medical
practices or professional guidelines published by the american society of
clinical oncology or the american society for reproductive medicine.

(
ii
) The
storage for at least three
plan years of preserved
ovarian tissue, sperm and oocyte.

(
b
) Includes
cryopreservation of any of the following:

(
i
) Ovarian
tissue.

(
ii
) Sperm.

(
iii
) oocyte.
END_STATUTE

Sec. 3. Title 20, chapter 6, article 4, Arizona
Revised Statutes, is amended by adding section 20-1376.11, to read:

START_STATUTE
20-1376.11.

Fertility preservation coverage; requirements; religious
employer; exemption; definitions

A. A disability insurer that issues,
amends or renews a policy on or after January 1, 2027 shall provide coverage
for standard fertility preservation services to an insured who is within
reproductive age, who is diagnosed with cancer and whose medically necessary
treatment
is LIKELY to directly or indirectly cause
iatrogenic infertility.
Coverage for standard
fertility preservation services must include at least three plan years of
storage. If an insured changes insurance plans during the three-year
period, the prior disability insurer that provided coverage and the new insurer
are not responsible for the three plan years of storage.

B. A disability insurer
shall process prior authorization requests for standard fertility
preservation services as urgent and respond within seventy-two hours on
request.

C. A religious employer may submit a
written request for an exemption from the requirements of this section to a
disability insurer, and the disability insurer shall grant the exemption if the
coverage required by this section conflicts with the employer's religious
beliefs. A religious employer that obtains an exemption shall provide written
notice of the exemption to prospective insureds.

D. This section does not prevent an
insured from purchasing a supplemental insurance policy that covers standard
fertility preservation services at the insured's own expense.

E. For the purposes of this section:

1. "Iatrogenic infertility"
means an impairment of fertility that is caused directly or indirectly by
medically necessary treatment for cancer, sickle cell disease or lupus.

2. "Religious employer":

(
a
) Means a
nongovernmental plan sponsor or entity that, based on sincerely held religious
beliefs, objects to the sponsor or entity establishing, maintaining, providing,
offering or arranging for coverage of standard fertility PRESERVATION services.

(
b
) Includes:

(
i
) A church,
an integrated auxiliary of a church, a convention or association of churches or
a religious order.

(
ii
) A
nonprofit organization.

(
iii
) A closely
held for-profit entity.

(
iv
) A for-profit
entity that is not closely held.

(
v
) Any other
nongovernmental employer.

3. "Reproductive age" means
the age range in which an individual is deemed fertile as established by the
American society of clinical oncology or the american society for reproductive
medicine.

4. "Standard fertility
preservation services":

(
a
) Means:

(
i
) Oocyte and
sperm preservation procedures that are consistent with established medical
practices or professional guidelines published by the american society of
clinical oncology or the american society for reproductive medicine.

(
ii
) The
storage for at least three
plan years of preserved
ovarian tissue, sperm and oocyte.

(
b
) Includes
cryopreservation of any of the following:

(
i
) Ovarian
tissue.

(
ii
) Sperm.

(
iii
) oocyte.
END_STATUTE

Sec. 4. Title
20, chapter 6, article 5, Arizona Revised Statutes, is amended by adding
section 20-1406.11, to read:

START_STATUTE
20-1406.11.

Fertility preservation coverage; requirements; religious
employer; exemption; definitions

A. A
group or blanket disability insurer that issues, amends or renews a policy on
or after January 1, 2027 shall provide coverage for standard fertility
preservation services to an insured who is within reproductive age, who is
diagnosed with cancer and whose medically necessary treatment
is likely to directly or indirectly cause iatrogenic infertility.
Coverage for standard fertility preservation services must include at
least three plan years of storage. If an insured changes insurance
plans during the three-year period, the prior group or blanket disability
insurer that provided coverage and the new insurer are not responsible for the
three plan years of storage.

B. A group or blanket disability
insurer
shall process prior authorization requests for
standard fertility preservation services as urgent and respond within seventy-two
hours on request.

C. A religious employer may submit a
written request for an exemption from the requirements of this section to a
group or blanket disability insurer, and the group or blanket disability
insurer shall grant the exemption if the coverage required by this section
conflicts with the employer's religious beliefs. A religious
employer that obtains an exemption shall provide written notice of the
exemption to prospective insureds.

D. This section does not prevent an
insured from purchasing a supplemental insurance policy that covers standard
fertility preservation services at the insured's own expense.

E. For the purposes of this section:

1. "Iatrogenic infertility"
means an impairment of fertility that is caused directly or indirectly by
medically necessary treatment for cancer, sickle cell disease or lupus.

2. "Religious employer":

(
a
) Means a
nongovernmental plan sponsor or entity that, based on sincerely held religious
beliefs, objects to the sponsor or entity establishing, maintaining, providing,
offering or arranging for coverage of standard fertility PRESERVATION services.

(
b
) Includes:

(
i
) A church,
an integrated auxiliary of a church, a convention or association of churches or
a religious order.

(
ii
) A
nonprofit organization.

(
iii
) A closely
held for-profit entity.

(
iv
) A for-profit
entity that is not closely held.

(
v
) Any other
nongovernmental employer.

3. "Reproductive age" means
the age range in which an individual is deemed fertile as established by the
American society of clinical oncology or the american society for reproductive
medicine.

4. "Standard fertility
preservation services":

(
a
) Means:

(
i
) Oocyte and
sperm preservation procedures that are consistent with established medical
practices or professional guidelines published by the american society of
clinical oncology or the american society for reproductive medicine.

(
ii
) The
storage for at least three
plan years of preserved
ovarian tissue, sperm and oocyte.

(
b
) Includes
cryopreservation of any of the following:

(
i
) Ovarian
tissue.

(
ii
) Sperm.

(
iii
) oocyte.

END_STATUTE

Sec. 5.
Effective date

This act is effective from and after
December 31, 2027.