§431:10A-116.5  In vitro fertilizationprocedure coverage.  (a)  All individual and group accident and health orsickness insurance policies which provide pregnancy-related benefits shallinclude in addition to any other benefits for treating infertility, a one-timeonly benefit for all outpatient expenses arising from in vitro fertilizationprocedures performed on the insured or the insured's dependent spouse; providedthat:

(1)  Benefits under this section shall be provided tothe same extent as the benefits provided for other pregnancy-related benefits;

(2)  The patient is the insured or covered dependentof the insured;

(3)  The patient's oocytes are fertilized with thepatient's spouse's sperm;

(4)  The:

(A)  Patient and the patient's spouse have a historyof infertility of at least five years' duration; or

(B)  Infertility is associated with one or moreof the following medical conditions:

(i)  Endometriosis;

(ii)  Exposure in utero to diethylstilbestrol,commonly known as DES;

(iii)  Blockage of, or surgical removal of, one orboth fallopian tubes (lateral or bilateral salpingectomy); or

(iv)  Abnormal male factors contributing to theinfertility;

(5)  The patient has been unable to attain asuccessful pregnancy through other applicable infertility treatments for whichcoverage is available under the insurance contract; and

(6)  The in vitro fertilization procedures areperformed at medical facilities that conform to the American College ofObstetric and Gynecology guidelines for in vitro fertilization clinics or tothe American Society for Reproductive Medicine minimal standards for programsof in vitro fertilization.

(b)  For the purposes of this section, the term"spouse" means a person who is lawfully married to the patient underthe laws of the State.

(c)  The requirements of this section shallapply to all new policies delivered or issued for delivery in this State afterJune 26, 1987. [L 1987, c 332, §1 and L 1989, c 276, §4; am L 2003, c 212, §72]