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A2287
ASSEMBLY, No. 2287
STATE OF NEW JERSEY
222nd LEGISLATURE
�
PRE-FILED FOR INTRODUCTION IN THE 2026 SESSION
Sponsored by:
Assemblywoman MARGIE DONLON, M.D.
District 11 (Monmouth)
SYNOPSIS
���� Adds storage of sperm and oocytes for certain persons
to current health insurance coverage regarding iatrogenic fertility.
CURRENT VERSION OF TEXT
���� Introduced Pending Technical Review by Legislative
Counsel.
��
An Act
concerning health insurance coverage of
iatrogenic fertility and amending various parts of the statutory law.
����
Be It
Enacted
by the Senate and General Assembly of
the State of New Jersey:
���� 1.��� Section 1 of P.L.2019,
c.306 (C.17:48-6rr) is amended to read as follows:
���� 1.��� a. A hospital service
corporation contract which provides hospital or medical expense benefits for
groups with more than 50 persons and is delivered, issued, executed or renewed
in this State, or approved for issuance or renewal in this State by the Commissioner
of Banking and Insurance, on or after the effective date of this act, shall
provide coverage for standard fertility preservation services when a medically
necessary treatment may directly or indirectly cause iatrogenic infertility.
���� For the purposes of this
section:
���� "Iatrogenic
infertility" means an impairment of fertility caused by surgery,
radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
���� "May directly or
indirectly cause" means a medical treatment with a likely side effect of
iatrogenic infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or as defined by the New
Jersey Department of Health.
���� "Standard fertility
preservation services" means procedures consistent with established
medical practices and professional guidelines published by the American Society
for Reproductive Medicine, the American Society of Clinical Oncology, or as defined
by the New Jersey Department of Health.� "Standard fertility preservation
services" shall
[
not
]
include the
storage of sperm or oocytes
for a covered person up to 21 years of age
.
���� The benefits shall be provided
to the same extent as for any other medical condition under the contract.� The
same copayments, deductibles, and benefit limits shall apply to the provision
of standard fertility preservation services pursuant to this section as those
applied to other medical or surgical benefits under the contract.
���� b.��� A hospital service
corporation providing coverage under this section shall not determine the
provision of standard fertility preservation services based on a covered
person's expected length of life, present or predicted disability, degree of
medical dependency, perceived quality of life, or other health conditions, or
based on personal characteristics, including age, sex, sexual orientation,
marital status, or gender identity.
���� c.���� This section shall
apply to those hospital service corporation contracts in which the hospital
service corporation has reserved the right to change the premium.
(cf: P.L.2019, c.306, s.1)
���� 2.��� Section 2 of P.L.2019,
c.306 (C.17:48A-7oo) is amended to read as follows:
���� 2. a. A medical service
corporation contract which provides hospital or medical expense benefits for
groups with more than 50 persons and is delivered, issued, executed or renewed
in this State, or approved for issuance or renewal in this State by the Commissioner
of Banking and Insurance, on or after the effective date of this act, shall
provide coverage for standard fertility preservation services when a medically
necessary treatment may directly or indirectly cause iatrogenic infertility.
���� For the purposes of this
section:
���� "Iatrogenic
infertility" means an impairment of fertility caused by surgery,
radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
���� "May directly or
indirectly cause" means a medical treatment with a likely side effect of
iatrogenic infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or as defined by the New
Jersey Department of Health.
���� "Standard fertility
preservation services" means procedures consistent with established
medical practices and professional guidelines published by the American Society
for Reproductive Medicine, the American Society of Clinical Oncology, or as defined
by the New Jersey Department of Health.� "Standard fertility preservation
services" shall
[
not
]
include the
storage of sperm or oocytes
for a covered person up to 21 years of age
.
���� The benefits shall be provided
to the same extent as for any other medical condition under the contract.� The
same copayments, deductibles, and benefit limits shall apply to the provision
of standard fertility preservation services pursuant to this section as those
applied to other medical or surgical benefits under the contract.
���� b.��� A medical service
corporation providing coverage under this section shall not determine the
provision of standard fertility preservation services based on a covered
person's expected length of life, present or predicted disability, degree of
medical dependency, perceived quality of life, or other health conditions, or
based on personal characteristics, including age, sex, sexual orientation,
marital status, or gender identity.�
���� c.���� This section shall
apply to those medical service corporation contracts in which the medical
service corporation has reserved the right to change the premium.
(cf: P.L.2019, c.306, s.2)
���� 3.��� Section 3 of P.L.2019,
c.306 (C.17:48E-35.42) is amended to read as follows:
���� 3.��� a. A health service
corporation contract which provides hospital or medical expense benefits for
groups with more than 50 persons and is delivered, issued, executed or renewed
in this State, or approved for issuance or renewal in this State by the Commissioner
of Banking and Insurance, on or after the effective date of this act shall
provide coverage for standard fertility preservation services when a medically
necessary treatment may directly or indirectly cause iatrogenic infertility.
���� For the purposes of this
section:
���� "Iatrogenic
infertility" means an impairment of fertility caused by surgery,
radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
���� "May directly or
indirectly cause" means a medical treatment with a likely side effect of
iatrogenic infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or as defined by the New
Jersey Department of Health.
���� "Standard fertility
preservation services" means procedures consistent with established
medical practices and professional guidelines published by the American Society
for Reproductive Medicine, the American Society of Clinical Oncology, or as defined
by the New Jersey Department of Health.� "Standard fertility preservation
services" shall
[
not
]
include the
storage of sperm or oocytes
for a covered person up to 21 years of age
.
���� The benefits shall be provided
to the same extent as for any other medical condition under the contract.� The
same copayments, deductibles, and benefit limits shall apply to the provision
of standard fertility preservation services pursuant to this section as those
applied to other medical or surgical benefits under the contract.
���� b.��� A health service
corporation providing coverage under this section shall not determine the
provision of standard fertility preservation services based on a covered
person's expected length of life, present or predicted disability, degree of
medical dependency, perceived quality of life, or other health conditions, or
based on personal characteristics, including age, sex, sexual orientation,
marital status, or gender identity.�
���� c.���� This section shall
apply to those health service corporation contracts in which the health service
corporation has reserved the right to change the premium.
(cf: P.L.2019, c.306, s.3)
���� 4.��� Section 4 of P.L.2019,
c.306 (C.17B:27-46.1rr) is amended to read as follows:�������������
���� 4.��� a. A group health
insurance policy which provides hospital or medical expense benefits for groups
with more than 50 persons and is delivered, issued, executed or renewed in this
State, or approved for issuance or renewal in this State by the Commissioner of
Banking and Insurance, on or after the effective date of this act, shall
provide coverage for standard fertility preservation services when a medically
necessary treatment may directly or indirectly cause iatrogenic infertility.
���� For the purposes of this
section:
���� "Iatrogenic
infertility" means an impairment of fertility caused by surgery,
radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
���� "May directly or
indirectly cause" means a medical treatment with a likely side effect of
iatrogenic infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or as defined by the New
Jersey Department of Health.
���� "Standard fertility
preservation services" means procedures consistent with established
medical practices and professional guidelines published by the American Society
for Reproductive Medicine, the American Society of Clinical Oncology, or as defined
by the New Jersey Department of Health.� "Standard fertility preservation
services" shall
[
not
]
include the
storage of sperm or oocytes
for a covered person up to 21 years of age
.
���� The benefits shall be provided
to the same extent as for any other medical condition under the policy.� The
same copayments, deductibles, and benefit limits shall apply to the provision
of standard fertility preservation services pursuant to this section as those
applied to other medical or surgical benefits under the policy.
���� b.��� An insurer providing
coverage under this section shall not determine the provision of standard
fertility preservation services based on an insured's expected length of life,
present or predicted disability, degree of medical dependency, perceived
quality of life, or other health conditions, or based on personal
characteristics, including age, sex, sexual orientation, marital status, or
gender identity.
���� c.���� This section shall
apply to those group health insurance policies in which the insurer has
reserved the right to change the premium.
(cf: P.L.2019, c.306, s.4)
���� 5.��� Section 5 of P.L.2019,
c.306 (C.26:2J-4.43) is amended to read as follows:
���� 5.��� a. A health maintenance
organization contract that provides hospital or medical expense benefits for
groups with more than 50 persons and is delivered, issued, executed or renewed
in this State, or approved for issuance or renewal in this State by the Commissioner
of Banking and Insurance, on or after the effective date of this act, shall
provide coverage for standard fertility preservation services when a medically
necessary treatment may directly or indirectly cause iatrogenic infertility.
���� For the purposes of this
section:
���� "Iatrogenic
infertility" means an impairment of fertility caused by surgery,
radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
���� "May directly or
indirectly cause" means a medical treatment with a likely side effect of
iatrogenic infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or as defined by the New
Jersey Department of Health.
���� "Standard fertility
preservation services" means procedures consistent with established
medical practices and professional guidelines published by the American Society
for Reproductive Medicine, the American Society of Clinical Oncology, or as defined
by the New Jersey Department of Health.� "Standard fertility preservation
services" shall
[
not
]
include the
storage of sperm or oocytes
for a covered person up to 21 years of age
.
���� The benefits shall be provided
to the same extent as for any other medical condition under the contract.� The
same copayments, deductibles, and benefit limits shall apply to the provision
of standard fertility preservation services pursuant to this section as those
applied to other medical or surgical benefits under the contract.
���� b.��� A health maintenance
organization providing coverage under this section shall not determine the
provision of standard fertility preservation services based on an enrollee's
expected length of life, present or predicted disability, degree of medical
dependency, perceived quality of life, or other health conditions, or based on
personal characteristics, including age, sex, sexual orientation, marital
status, or gender identity.�
���� c.���� This section shall
apply to those health maintenance organization contracts in which the health
maintenance organization has reserved the right to change the premium.
(cf: P.L.2019, c.306, s.5)
���� 6.��� Section 6 of P.L.2019,
c.306 (C.52:14-17.29bb) is amended to read as follows:
���� 6.��� a. The State Health
Benefits Commission shall ensure that every contract purchased by the
commission on or after the effective date of this act that provides hospital or
medical expense benefits shall provide coverage for standard fertility
preservation services when a medically necessary treatment may directly or
indirectly cause iatrogenic infertility.
���� For the purposes of this
section:
���� "Iatrogenic
infertility" means an impairment of fertility caused by surgery,
radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
���� "May directly or
indirectly cause" means a medical treatment with a likely side effect of
iatrogenic infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or as defined by the New
Jersey Department of Health.
���� "Standard fertility
preservation services" means procedures consistent with established
medical practices and professional guidelines published by the American Society
for Reproductive Medicine, the American Society of Clinical Oncology, or as defined
by the New Jersey Department of Health.� "Standard fertility preservation
services" shall
[
not
]
include the
storage of sperm or oocytes
for a covered person up to 21 years of age
.
���� The benefits shall be provided
to the same extent as for any other medical condition under the contract.� The
same copayments, deductibles, and benefit limits shall apply to the provision
of standard fertility preservation services pursuant to this section as those
applied to other medical or surgical benefits under the contract.
���� b.��� The State Health
Benefits Commission shall not purchase a contract that determines the provision
of standard fertility preservation services based on a covered person's
expected length of life, present or predicted disability, degree of medical
dependency, perceived quality of life, or other health conditions, or based on
personal characteristics, including age, sex, sexual orientation, marital
status, or gender identity.
(cf: P.L.2019, c.306, s.6)
���� 7.��� Section 7 of P.L.2019,
c.306 (C52:14-17.46.6m) is amended to read as follows:
���� 7.��� a. The School Employees'
Health Benefits Commission shall ensure that every contract purchased by the
commission on or after the effective date of this act that provides hospital or
medical expense benefits shall provide coverage for standard fertility preservation
services when a medically necessary treatment may directly or indirectly cause
iatrogenic infertility.
���� For the purposes of this
section:
�
���� "Iatrogenic
infertility" means an impairment of fertility caused by surgery,
radiation, chemotherapy, or other medical treatment affecting reproductive
organs or processes.
���� "May directly or
indirectly cause" means a medical treatment with a likely side effect of
iatrogenic infertility as established by the American Society for Reproductive
Medicine, the American Society of Clinical Oncology, or as defined by the New
Jersey Department of Health.
���� "Standard fertility
preservation services" means procedures consistent with established
medical practices and professional guidelines published by the American Society
for Reproductive Medicine, the American Society of Clinical Oncology, or as defined
by the New Jersey Department of Health.� "Standard fertility preservation
services" shall
[
not
]
include the
storage of sperm or oocytes
for a covered person up to 21 years of age
.
���� The benefits shall be provided
to the same extent as for any other medical condition under the contract.� The
same copayments, deductibles, and benefit limits shall apply to the provision
of standard fertility preservation services pursuant to this section as those
applied to other medical or surgical benefits under the contract.
���� b.��� The School Employees'
Health Benefits Program shall not purchase a contract that determines the
provision of standard fertility preservation services based on a covered
person's expected length of life, present or predicted disability, degree of
medical dependency, perceived quality of life, or other health conditions, or
based on personal characteristics, including age, sex, sexual orientation,
marital status, or gender identity.
(cf: P.L.2019, c.306, s.7)
���� 8.��� This act shall take
effect on the first day of the fourth month next following enactment and shall
apply to contracts and policies that are delivered, issued, executed, or
renewed on or after that date.
STATEMENT
����� This bill adds storage of sperm and oocytes for
covered persons up to age 21 years of age to current coverage requirements for
standard fertility preservation services when a medically necessary treatment
may directly or indirectly cause iatrogenic infertility.� This bill applies to
hospital, medical and health service corporations, commercial group insurers
and health maintenance organizations that provide benefits to groups of more
than 50 persons.� The bill also applies to health benefits plans issued pursuant
to the State Health Benefits Program and the School Employees� Health Benefits
Program.�