[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2759 Introduced in House (IH)]






109th CONGRESS
  1st Session
                                H. R. 2759

To assure equitable treatment of fertility and impotence in health care 
   coverage under group health plans, health insurance coverage, and 
   health plans under the Federal employees' health benefits program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              June 7, 2005

 Mr. Andrews introduced the following bill; which was referred to the 
Committee on Energy and Commerce, and in addition to the Committees on 
 Education and the Workforce and Government Reform, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
  of such provisions as fall within the jurisdiction of the committee 
                               concerned

_______________________________________________________________________

                                 A BILL


 
To assure equitable treatment of fertility and impotence in health care 
   coverage under group health plans, health insurance coverage, and 
   health plans under the Federal employees' health benefits program.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Equity in Fertility Coverage Act of 
2005''.

SEC. 2. EQUITY IN PROVISION OF PRESCRIPTION DRUG COVERAGE.

    (a) Group Health Plans.--
            (1) Public health service act amendments.--(A) Subpart 2 of 
        part A of title XXVII of the Public Health Service Act is 
        amended by adding at the end the following new section:

``SEC. 2707. EQUITY IN FERTILITY COVERAGE.

    ``(a) In General.--A group health plan, and a health insurance 
issuer offering group health insurance coverage, that provides for 
coverage of impotency medications such as viagra shall also provide 
coverage of fertility treatments.
    ``(b) Construction.--Nothing in this section shall be construed as 
preventing a plan or issuer from--
            ``(1) restricting the drugs for which benefits are provided 
        under the plan or health insurance coverage, or
            ``(2) imposing a limitation on the amount of benefits 
        provided with respect to such coverage or the cost-sharing that 
        may be imposed with respect to such coverage,
so long as such restrictions and limitations are consistent with 
subsection (a).
    ``(c) Notice.--A group health plan under this part shall comply 
with the notice requirement under section 714(c) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
of this section as if such section applied to such plan.''.
            (B) Section 2723(c) of such Act (42 U.S.C. 300gg-23(c)) is 
        amended by striking ``section 2704'' and inserting ``sections 
        2704 and 2707''.
            (2) ERISA amendments.--(A) Subpart B of part 7 of subtitle 
        B of title I of the Employee Retirement Income Security Act of 
        1974 is amended by adding at the end the following new section:

``SEC. 714. EQUITY IN FERTILITY COVERAGE.

    ``(a) In General.--A group health plan, and a health insurance 
issuer offering group health insurance coverage, that provides for 
coverage of impotency medications such as viagra shall also provide 
coverage of fertility treatments.
    ``(b) Construction.--Nothing in this section shall be construed as 
preventing a plan or issuer from--
            ``(1) restricting the drugs for which benefits are provided 
        under the plan or health insurance coverage, or
            ``(2) imposing a limitation on the amount of benefits 
        provided with respect to such coverage or the cost-sharing that 
        may be imposed with respect to such coverage,
so long as such restrictions and limitations are consistent with 
subsection (a).
    ``(c) Notice Under Group Health Plan.--The imposition of the 
requirements of this section shall be treated as a material 
modification in the terms of the plan described in section 102(a)(1), 
for purposes of assuring notice of such requirements under the plan; 
except that the summary description required to be provided under the 
last sentence of section 104(b)(1) with respect to such modification 
shall be provided by not later than 60 days after the first day of the 
first plan year in which such requirements apply.''.
            (B) Section 731(c) of such Act (29 U.S.C. 1191(c)) is 
        amended by striking ``section 711'' and inserting ``sections 
        711 and 714''.
            (C) Section 732(a) of such Act (29 U.S.C. 1191a(a)) is 
        amended by striking ``section 711'' and inserting ``sections 
        711 and 714''.
            (D) The table of contents in section 1 of such Act is 
        amended by inserting after the item relating to section 713 the 
        following new item:

``714. Equity in fertility coverage.''.
    (b) Individual Health Insurance.--(1) Part B of title XXVII of the 
Public Health Service Act is amended by inserting after section 2752 
the following new section:

``SEC. 2753. EQUITY IN FERTILITY COVERAGE.

    ``(a) In General.--The provisions of section 2707 (other than 
subsection (c)) shall apply to health insurance coverage offered by a 
health insurance issuer in the individual market in the same manner as 
it applies to health insurance coverage offered by a health insurance 
issuer in connection with a group health plan in the small or large 
group market.
    ``(b) Notice.--A health insurance issuer under this part shall 
comply with the notice requirement under section 714(c) of the Employee 
Retirement Income Security Act of 1974 with respect to the requirements 
referred to in subsection (a) as if such section applied to such issuer 
and such issuer were a group health plan.''.
    (2) Section 2762(b)(2) of such Act (42 U.S.C. 300gg-62(b)(2)) is 
amended by striking ``section 2751'' and inserting ``sections 2751 and 
2753''.
    (c) FEHBP.--Section 8902 of title 5, United States Code, is amended 
by adding at the end the following the following new subsection:
    ``(p) A contract may not be made or a plan approved which does not 
comply with the requirements of section 2753 of the Public Health 
Service Act.''.
    (d) Effective Dates.--(1) The amendments made by subsection (a) 
shall apply with respect to group health plans for plan years beginning 
on or after January 1, 2006.
    (2) The amendments made by subsection (b) shall apply with respect 
to health insurance coverage offered, sold, issued, renewed, in effect, 
or operated in the individual market on or after January 1, 2006.
    (3) The amendment made by subsection (c) shall apply with respect 
to contracts for periods beginning on and after January 1, 2006.
    (e) Coordinated Regulations.--Section 104(1) of Health Insurance 
Portability and Accountability Act of 1996 is amended by striking 
``this subtitle (and the amendments made by this subtitle and section 
401)'' and inserting ``the provisions of part 7 of subtitle B of title 
I of the Employee Retirement Income Security Act of 1974, and the 
provisions of parts A and C of title XXVII of the Public Health Service 
Act''.
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