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Self insured companies do not have to comply with the infert

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Posted: Mon Nov 02, 2009 4:30 pm Post subject: Self insured companies do not have to comply with the infert

Self insured companies do not have to comply with the infertility mandate? if so. Why? Dr's (infertility) offices are telling me that people have more overage that their insurance policies state and that they constantly fight for infertility coverage all the time. Does the infertility mandate apply to self-insured companies in illinois at all? insured with walgreens new insurance for 2010. HMO was dropped and I was forced into a ppo with little infertility coverage, what are my option?

junkmale36

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Joined: 02 Nov 2009
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Posted: Tue Nov 03, 2009 9:59 am Post subject:

The Family Building Act was passed in Illinois in 1991. It requires the treatment and diagnosis of infertility for over 25 employees under different group health insurance plans. You'll find more information about it at the website of the IL Dept. of Financial and Professional Regulation. _________________ Register Now to have your Insurance queries solved.

Pinkfloydfan

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Posted: Wed Nov 04, 2009 12:15 am Post subject:

Unfortunately, you're correct. Self-insured groups are exempt from the requirements that exist in certain states regarding coverage for infertility. 15 states have laws requiring individual and group insurance plans to cover treatment for infertility, and every single one exempts self-insured plans. Why? Self-insured plans are under federal law and not subject to state jurisdiction. Self-insured plans are subject to the Employee Retirement and Income Security Act (ERISA) laws, and ERISA law has no provision for infertility treatment. Sorry 'bout that...I am familiar with the situation and wish I could offer better news... InsTeacher _________________ It is what it is...

InsTeacher

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