SB558: relative to insurance coverage for infertility treatments, protection from discrimination during IVF treatments, parental leave, and adoption.

SB 558-FN - AS AMENDED BY THE SENATE

04/11/2024 1488s

2024 SESSION

24-3108

12/08

SENATE BILL 558-FN

AN ACT relative to insurance coverage for infertility treatments, protection from discrimination during IVF treatments, parental leave, and adoption.

SPONSORS: Sen. Perkins Kwoka, Dist 21; Sen. Whitley, Dist 15; Sen. Fenton, Dist 10; Sen. Watters, Dist 4; Sen. Rosenwald, Dist 13; Sen. Soucy, Dist 18; Sen. D'Allesandro, Dist 20; Sen. Altschiller, Dist 24; Rep. Grote, Rock. 24; Rep. Simpson, Rock. 33

COMMITTEE: Health and Human Services

AMENDED ANALYSIS

This bill requires insurance companies to certify coverage for fertility treatment and prohibits employer discrimination based upon that treatment.

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

04/11/2024 1488s 24-3108

12/08

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Twenty Four

AN ACT relative to insurance coverage for infertility treatments, protection from discrimination during IVF treatments, parental leave, and adoption.

Be it Enacted by the Senate and House of Representatives in General Court convened:

1 Short Title. This act shall be known as "The Modern Economy Act."

2 Access to Fertility Treatment. Amend RSA 417-G:2, IV to read as follows:

IV. Each health carrier that issues or renews any group policy, plan, or contract of health insurance providing benefits for medical or hospital expenses, shall provide certificate holders of such insurance coverage for up to 6 rounds of intrauterine insemination per plan year regardless of whether or not the individual has a diagnosis of infertility.

V. Coverage under paragraphs [I-III] I-IV shall not apply to plans available through the Small Business Health Options Program (SHOP) or to Extended Transition to Affordable Care Act-Compliant Policies.

3 Unlawful Discrimination; Fertility Treatment. Amend RSA 354-A:7, VI to read as follows:

VI.(a) For the purposes of this chapter, the word "sex" includes pregnancy and medical conditions which cause or result from pregnancy or are otherwise related to pregnancy, including but not limited to fertility treatment as defined in RSA 417-G:1 or pregnancy loss or related bereavement time.

(b) An employer shall permit a female employee to take leave of absence and attend appointments for the period of temporary physical disability resulting from pregnancy, childbirth or related medical conditions, including but not limited to well-being checkups, in-vitro fertilization follow up, and postpartum care. When the employee is physically able to return to work, [her] that employee's original job or a comparable position shall be made available to [her] them by the employer unless business necessity makes this impossible or unreasonable.

4 Effective Date. This act shall take effect 60 days after its passage.

LBA

24-3108

Amended 4/18/24

SB 558-FN- FISCAL NOTE

AS AMENDED BY THE SENATE (AMENDMENT #2024-1488s)

AN ACT relative to insurance coverage for infertility treatments, protection from discrimination during IVF treatments, parental leave, and adoption.

FISCAL IMPACT: [ X ] State [ X ] County [ X ] Local [ ] None

Estimated State Impact - Increase / (Decrease)

FY 2024

FY 2025

FY 2026

FY 2027

Revenue

$0

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Revenue Fund(s)

General Fund

Insurance Premium Tax

Expenditures

$0

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Funding Source(s)

General Fund

Various Government Funds

Appropriations

$0

$0

$0

$0

Funding Source(s)

None

• Does this bill provide sufficient funding to cover estimated expenditures? [X] No

• Does this bill authorize new positions to implement this bill? [X] No

Estimated Political Subdivision Impact - Increase / (Decrease)

FY 2024

FY 2025

FY 2026

FY 2027

County Revenue

$0

$0

$0

$0

County Expenditures

$0

Indeterminable Increase

Indeterminable Increase

Indeterminable Increase

Local Revenue

$0

$0

$0

$0

Local Expenditures

$0

Indeterminable

Indeterminable

Indeterminable

METHODOLOGY:

This bill requires insurance companies to certify coverage for fertility treatment and prohibits employer discrimination based upon that treatment. The Insurance Department assumes this bill would result in higher total claims costs associated with intrauterine insemination (IUI). Based on analysis of plan year 2023 data, the Department estimated an additional annual cost to commercial fully insured market of approximately $144,000 or $0.05 per member per month. The Department indicates insurers may respond with increased premium rates to reflect the higher costs. Policyholders may respond by paying increased premiums or forgoing insurance if premiums are too high. This may have an impact on state premium tax revenue and state, county and local employers expenditures for insurance coverage.

The Department of Administrative Services states this bill would allow an employee to attend well-being appointments, in vitro fertilization follow up and postpartum care while providing the employee job protection during their absence. The Department assumes the bill would apply to all employers in the State, including the State as an employer. It is further assumed that if a person, employed by the State, were to take leave of absence and not be required to use their accrued leave, the employee would be placed on an "unpaid leave" status. The length in time in which person may be placed on "unpaid leave" is indeterminable. The Department indicates the fiscal impact to the State is indeterminable because there is no way to project how many employees will seek fertility treatment that would be covered under the proposed legislation or how long they may be out on unpaid leave. The Department assumes there could be indeterminable productivity costs associated with such employees not being present for work.

The New Hampshire Municipal Association states it is unclear if the modifications made to the definitions in RSA 417-G:2, IV, would result in an increase to insurance premium amounts paid by municipal employers. Many municipalities may have an established personnel policy, contract or collective bargaining agreement that would already limit the use of accrued paid time off for parental leave or adoption. It is unclear how many municipalities would be impacted by this bill, what the cost would be to those impacted.

The New Hampshire Association of Counties indicates the majority of counties already offer a version of this benefits. The Association states there would be a cost to the counties as the time off may create a hardship in most departments. The Association is unable to determine how many individuals may take advantage of this leave and is not able to calculate the associated costs.

AGENCIES CONTACTED:

Departments of Insurance and Administrative Services, New Hampshire Municipal Association and New Hampshire Association of Counties