NJ State Law - Insurance

I understand in NJ there is a state law that says something like:
if you work for a company that employees over 50,000 people, they are required to pay for IVF or at least most of it.

My husband and I both work for large companies. We've asked our insurance and spoken with a few people who say this is true but it sounds too good to be ture.
My fingers are crossed though... we have a consultation in May to find out details.

Does anyone live in NJ? Has anyone heard of this?

TIA

Re: NJ State Law - Insurance

I live in NJ and work in HR and I have not heard of this - from what I have experienced it depends on your insurance coverage. But I will see if I can find any more info on that...

Re: NJ State Law - Insurance

Yes it is true. But, there are some exceptions. I know that if the company is self-insured they do not have to comply with the state mandate.

Message edited 4/15/2007 10:04:52 AM.

Re: NJ State Law - Insurance

NJ Mandate:

NEW JERSEY

2001
NJ Laws, Chap. 236

DEFINITION OF INFERTILITY/PATIENT REQUIREMENTS

Infertility means a disease or condition that results in the abnormal function of the reproductive system such that:
a male is unable to impregnate a female;
a female under 35 years of age is unable to conceive after two years of unprotected sexual intercourse;
a female 35 years of age and over is unable to conceive after one year of unprotected sexual intercourse;
the male or female is medically sterile; or
the female is unable to carry a pregnancy to live birth.
Infertility does not mean a person who has been voluntarily sterilized regardless of whether the person has attempted to reverse the sterilization.
Must be less than 46 years of age.
The patient has been unable to obtain successful pregnancy through any less costly infertility treatments covered by insurance.
COVERAGE

Group insurers and HMOs that provide pregnancy related coverage must provide infertility treatment including, but not limited to:
artificial insemination;
assisted hatching;
diagnosis and diagnostic testing;
fresh and frozen embryo transfers;
4 completed egg retrievals per lifetime;
IVF, including IVF using donor eggs and IVF where the embryo is transferred to a gestational carrier or surrogate;
ICSI;
GIFT;
ZIFT;
medications;
ovulation induction; and
surgery, including microsurgical sperm aspiration.
The procedures must be performed at facilities that conform with ACOG and ASRM guidelines.

EXCEPTIONS

Employers with fewer than 50 employees do not have to provide coverage.
Cryoperservation is not covered.
Nonmedical costs of egg or sperm donor are not covered.
Infertility treatments that are experimental or investigational are not covered.
Does not require religious employers to cover infertility treatment.
Employers who self-insure are exempt from the requirements of the law.

Re: NJ State Law - Insurance

Yes it is true. I recently changed jobs to get the insurance. I live in Phila and work in NJ and have the coverage. I have Horizon BC/BS and get 4 IVF in a lifetime. My medications are also paid for. I am one of the lucky people on this board as far as the insurance. Good luck to you, I hope you can get it.

Re: NJ State Law - Insurance

Thank you for all the info!

I actually have Horizon as well and they did tell me it was all paid for... I'm just keeping my fingers crossed until it happens.

Thanks again!

Re: NJ State Law - Insurance

What juju posted above is correct. When I worked for a previous employer in NJ, they were self-insured, and therefore I was not covered fro IVF. They did have 6 lifetime IUI's as part of their policy.