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 coverage for certain fertility preservation services.

PRINTER'S NO. 1736
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No. 1315
Session of
2026
INTRODUCED BY PENNYCUICK, MILLER, HAYWOOD, BARTOLOTTA, SCHWANK,
VOGEL, PISCIOTTANO, MALONE, COSTA, J. WARD, BOSCOLA, FARRY,
COLLETT, CULVER, KIM AND KANE, MAY 21, 2026
REFERRED TO BANKING AND INSURANCE, MAY 21, 2026
AN ACT
Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An
act relating to insurance; amending, revising, and
consolidating the law providing for the incorporation of
insurance companies, and the regulation, supervision, and
protection of home and foreign insurance companies, Lloyds
associations, reciprocal and inter-insurance exchanges, and
fire insurance rating bureaus, and the regulation and
supervision of insurance carried by such companies,
associations, and exchanges, including insurance carried by
the State Workmen's Insurance Fund; providing penalties; and
repealing existing laws," in casualty insurance, providing
for coverage for certain fertility preservation services.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. The act of May 17, 1921 (P.L.682, No.284), known
as The Insurance Company Law of 1921, is amended by adding a
section to read:
Section 635.11. Coverage for Certain Fertility Preservation
Services.--(a) An insurer that offers, issues or renews a
health insurance policy in this Commonwealth shall include
fertility preservation services as a covered benefit for a
covered person if a medically necessary treatment may directly
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or indirectly cause iatrogenic infertility in the covered
person. The following shall apply to coverage under this
section:
(1) Coverage under this section shall include storage for
not less than three years at an in-network facility.
(2) If an insurer does not have an in-network facility
available for storage or an in-network facility becomes
unavailable during the period specified under clause (1), the
in-network requirement under clause (1) shall not apply to
storage.
(3) An insurer may impose a lifetime maximum benefit for
coverage under this section if the lifetime maximum benefit is
not less than one hundred thousand dollars ($100,000) for each
covered person.
(4) An insurer may limit coverage under this section to a
period that ends on the earlier of the following:
(i) Three years after the date of the medically necessary
treatment that may directly or indirectly cause iatrogenic
infertility in the covered person.
(ii) The date on which the covered person is no longer
covered under the health insurance policy.
(5) Coverage under this section shall be subject to all of
the following:
(i) Article XXI.
(ii) The terms and conditions of the health insurance
policy, including determinations of medical necessity and
clinical review criteria used for utilization review of health
care services, copayment provisions, deductible provisions and
coinsurance provisions.
(6) Coverage under this section shall be administered in a
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similar manner to other health care services provided under the
terms and conditions of the health insurance policy.
(b) A religious employer may submit a written request to an
insurer for an exemption from the coverage required under
subsection (a). The insurer shall grant the exemption if the
coverage conflicts with the religious employer's bona fide
religious beliefs and practices.
(c) A religious employer that obtains an exemption under
subsection (b) shall provide written notice of the exemption to
each prospective enrollee covered under the health insurance
policy.
(d) Nothing in this section shall prohibit an enrollee
covered under a health insurance policy provided by a religious
employer from purchasing, at the enrollee's own expense, a
supplemental insurance policy that covers fertility preservation
services.
(e) As used in this section, the following words and phrases
shall have the meanings given to them in this subsection unless
the context clearly indicates otherwise:
"Fertility preservation service" means a procedure or service
to preserve fertility in accordance with nationally recognized
clinical or professional guidelines existing on the effective
date of this section. The term includes egg retrieval, sperm
retrieval, ovarian tissue retrieval and cryopreservation.
"Health care service" means a treatment, admission,
procedure, medical supply, medical equipment or other service,
including behavioral health, ordered or otherwise provided or
proposed to be provided by a health care provider to a patient
for the diagnosis, prevention, treatment, cure or relief of a
health condition, illness, injury or disease.
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"Health insurance policy" means as follows:
(1) An individual or group health insurance policy,
subscriber contract, certificate or plan that provides medical
or health care coverage by a health care facility or licensed
health care provider on an expense-incurred service or prepaid
basis and that is offered by or governed under any of the
following:
(i) This act.
(ii) The act of December 29, 1972 (P.L.1701, No.364), known
as the "Health Maintenance Organization Act."
(iii) 40 Pa.C.S. Ch. 61 (relating to hospital plan
corporations) or 63 (relating to professional health services
plan corporations).
(2) The term does not include any of the following policies:
(i) An accident only policy.
(ii) A credit only policy.
(iii) A long-term care or disability income policy.
(iv) A specified disease policy.
(v) A Medicare supplement policy.
(vi) A TRICARE policy, including a Civilian Health and
Medical Program of the Uniformed Services supplement policy.
(vii) A fixed indemnity policy.
(viii) A dental only policy.
(ix) A vision only policy.
(x) A workers' compensation policy.
(xi) An automobile medical payment policy under 75 Pa.C.S.
(relating to vehicles).
"Iatrogenic infertility" means an impairment of fertility
caused directly or indirectly by a medically necessary treatment
for cancer. The term includes an impairment of fertility caused
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directly or indirectly by surgery, chemotherapy, radiation or
another medical treatment with a potential side effect of
impaired fertility.
"Religious employer" means an employer that is a church,
convention or association of churches or an elementary or
secondary school that is controlled, operated or principally
supported by a church as defined in 26 U.S.C. § 3121(w)(3)(A)
(relating to definitions) and qualifies as a tax-exempt
organization under 26 U.S.C. § 501(c)(3) (relating to exemption
from tax on corporations, certain trusts, etc.).
Section 2. This act shall apply as follows:
(1) For a health insurance policy for which either rates
or forms are required to be filed with the Federal Government
or the Insurance Department, the addition of section 635.11
of the act shall apply to a policy for which a form or rate
is first filed on or after 180 days after the effective date
of this paragraph.
(2) For a health insurance policy for which neither
rates nor forms are required to be filed with the Federal
Government or the Insurance Department, the addition of
section 635.11 of the act shall apply to a policy issued or
renewed on or after 180 days after the effective date of this
paragraph.
Section 3. This act shall take effect immediately.
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