ASSEMBLY, No. 4411

STATE OF NEW JERSEY

218th LEGISLATURE

 

INTRODUCED SEPTEMBER 13, 2018

 


 

Sponsored by:

Assemblywoman  BRITNEE N. TIMBERLAKE

District 34 (Essex and Passaic)

Assemblywoman  CLEOPATRA G. TUCKER

District 28 (Essex)

Assemblywoman  VERLINA REYNOLDS-JACKSON

District 15 (Hunterdon and Mercer)

 

Co-Sponsored by:

Assemblywoman Speight, Assemblyman Caputo, Assemblywoman Sumter, Assemblyman Holley, Assemblywoman McKnight, Assemblymen Wimberly and Conaway

 

 

 

 

SYNOPSIS

     Requires health insurers, SHBP, and SEHBP to provide coverage for oncofertility treatments.

 

CURRENT VERSION OF TEXT

     As introduced.

  


An Act requiring health insurance coverage for oncofertility treatments and supplementing various parts of the statutory law.

 

     Be It Enacted by the Senate and General Assembly of the State of New Jersey:

 

     1.    a.  A hospital service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1938, c.366 (C.17:48-1 et seq.), 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract. 

     d.    This section shall apply to those hospital service corporation contracts in which the hospital service corporation has reserved the right to change the premium.

 

     2.    a.  A medical service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1940, c.74 (C.17:48A-1 et seq.), 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract.   

     d.    This section shall apply to those medical service corporation contracts in which the medical service corporation has reserved the right to change the premium.

 

     3.    a.  A health service corporation contract that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1985, c.236 (C.17:48E-1 et seq.), 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract. 

     d.    This section shall apply to those health service corporation contracts in which the health service corporation has reserved the right to change the premium.

 

     4.    a.  An individual health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to N.J.S.17B:26-1 et seq., 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the policy. 

     d.    This section shall apply to those individual health insurance policies in which the insurer has reserved the right to change the premium.

 

     5.    a.  A group health insurance policy that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to N.J.S.17B:27-26 et seq., 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the policy. 

     d.    This section shall apply to those group health insurance policies in which the insurer has reserved the right to change the premium.

 

     6.    a.  An individual health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.161 (C.17B:27A-2 et seq.), 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the health benefits plan. 

     d.    This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.

 

     7.    a.  A small employer health benefits plan that provides hospital and medical expense benefits and is delivered, issued, executed, or renewed in this State pursuant to P.L.1992, c.162 (C.17B:27A-17 et seq.), 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the health benefits plan.

     d.    This section shall apply to those health benefits plans in which the carrier has reserved the right to change the premium.

 

     8.    a.  A health maintenance organization contract for health care services that is delivered, issued, executed, or renewed in this State pursuant to P.L.1973, c.337 (C.26:2J-1 et seq.), 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 expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract for services. 

     d.    This section shall apply to those contracts for health care services under which the health maintenance organization has reserved the right to change the schedule of charges for enrollee coverage.

 

     9.    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 and medical expense benefits shall provide coverage for expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract. 

 

     10.  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 and medical expense benefits shall provide coverage for expenses incurred in providing oncofertility treatments.

     b.    For the purposes of this section:

     “Oncofertility treatments” means fertility treatments including but not limited to sperm banking, testicular sperm extraction, egg banking, and ovarian transposition, which are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments.

     c.    The benefits provided by this section shall be provided to the same extent and with the same deductibles, coinsurance, and other cost sharing as apply to similar services under the contract. 

 

     11.  This act shall take effect on the first day of the seventh month next following enactment.

 

 

STATEMENT

 

     This bill requires health insurers and health maintenance organizations, as well as health benefits plans or contracts which are issued or purchased pursuant to the New Jersey Individual Health Coverage Program, New Jersey Small Employer Health Benefits Program, State Health Benefits Program, and School Employees’ Health Benefits Program, to provide coverage for expenses incurred in providing oncofertility treatments.

     Oncofertility treatments are fertility treatments that are undertaken in order to counteract the negative effects on fertility caused by cancer or cancer treatments. Oncofertility treatments are different from other fertility treatments in that they are often carried out preemptively. For example, a person who has been prescribed a course of chemotherapy may need to freeze some of his or her reproductive cells beforehand in order to preserve his or her fertility, because the chemotherapy is likely to permanently diminish it. Under current law, infertility coverage extends only to people who are currently infertile, not to people who are likely to become infertile in the future as a result of cancer treatments.