§1036.1. Required coverage for standard fertility preservation services; conditions
applicable to coverage; storage limitations; exemptions; definitions
A.
(1)A health insurance issuer offering health coverage plans in this state that
provide hospital, medical, or surgical benefits for individuals covered under a respective plan
shall provide coverage for medically necessary expenses for standard fertility preservation
services when a medically necessary treatment may directly or indirectly cause iatrogenic
infertility.
(2)(a) A health coverage plan shall provide coverage for standard fertility
preservation services for a covered individual who has been diagnosed with cancer for which
necessary cancer treatment may directly or indirectly cause iatrogenic infertility.
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§1036.1. Required coverage for standard fertility preservation services; conditions
applicable to coverage; storage limitations; exemptions; definitions
A.(1) A health insurance issuer offering health coverage plans in this state that
provide hospital, medical, or surgical benefits for individuals covered under a respective plan
shall provide coverage for medically necessary expenses for standard fertility preservation
services when a medically necessary treatment may directly or indirectly cause iatrogenic
infertility.
(2)(a) A health coverage plan shall provide coverage for standard fertility
preservation services for a covered individual who has been diagnosed with cancer for which
necessary cancer treatment may directly or indirectly cause iatrogenic infertility.
(b) Coverage for standard fertility preservation services as defined in this Section
includes the costs associated with storage of oocytes and sperm, but a health coverage plan
may exclude the costs of storage after three years.
(c) A health coverage plan shall not require preauthorization for coverage of standard
fertility preservation services; however, a health coverage plan may contain provisions for
maximum benefits and may apply a deductible, copayment, coinsurance, and reasonable
limitations and exclusions to the extent that these applications are not inconsistent with the
requirements of this Section.
B.(1) A religious employer may submit a written request for exemption to a health
insurance issuer, and the issuer shall grant the exemption if the coverage required by this
Section conflicts with the religious employer's bona fide religious beliefs and practices. A
religious employer that obtains an exemption pursuant to this Subsection shall provide
prospective enrollees of its health coverage plan with written notice of the exemption.
(2) Nothing in this Subsection prohibits an enrollee of a health coverage plan
provided by his religious employer from purchasing, at his own expense, a supplemental
insurance policy that covers standard fertility preservation services.
C. For purposes of this Section, the following terms apply:
(1) "Health coverage plan" means any hospital, health, or medical expense insurance
policy, hospital or medical service contract, employee welfare benefit plan, contract or
agreement with a health maintenance organization or a preferred provider organization,
health and accident insurance policy or any other insurance contract of this type, and the
office of group benefits programs. "Health coverage plan" does not include a plan providing
coverage for excepted benefits as defined in R.S. 22:1061, limited benefit health insurance
plans, or short-term policies that have a term of less than twelve months.
(2) "Iatrogenic infertility" means an impairment of fertility caused directly or
indirectly by surgery, chemotherapy, radiation, or other medical treatment.
(3) "Medical treatment that may directly or indirectly cause iatrogenic infertility"
means medical treatment with a potential side effect of impaired fertility as established by
the American Society of Clinical Oncology or the American Society for Reproductive
Medicine.
(4) "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, convention, or association of churches as defined in
Section 3121(w)(3)(A) of the Internal Revenue Code and that qualifies as a tax-exempt
organization under Section 501(c)(3) of the Internal Revenue Code.
(5) "Standard fertility preservation services" means 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.