Utah Code 49-20-418. Expanded infertility treatment benefit
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(1) As used in this section:
Terms Used In Utah Code 49-20-418
- Plan: means the Utah Governors' and Legislators' Retirement Plan created by Chapter 19, Utah Governors' and Legislators' Retirement Act, the New Public Employees' Tier II Defined Contribution Plan created by Chapter 22, Part 4, Tier II Defined Contribution Plan, the New Public Safety and Firefighter Tier II Defined Contribution Plan created by Chapter 23, Part 4, Tier II Defined Contribution Plan, or the defined contribution plans created under Section 49-11-801. See Utah Code 49-11-102
- Program: means the Public Employees' Benefit and Insurance Program. See Utah Code 49-20-102
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(1)(a) “Assisted reproductive technology” means the same as the term is defined in 42 U.S.C. § 263a-7.
(1)(b) “Physician” means the same as the term is defined in Section 58-67-102 .
(1)(c) “Qualified assisted reproductive technology cycle” means the use of assisted reproductive technology to transfer a single embryo for implantation.
(1)(d) “Qualified individual” means an individual:
(1)(d)(i) covered within the state risk pool; and
(1)(d)(ii) eligible for maternity benefits under the program.
(2)
(2)(a) The program shall offer a benefit of $4,000 to a qualified individual toward the costs of each qualified assisted reproductive technology cycle.
(2)(b) The benefit is subject to the same cost sharing requirements as the qualified individual’s plan.
(3) A qualified individual shall receive the benefit described in Subsection (2) if:
(3)(a) the qualified individual is the patient who will use the assisted reproductive technology;
(3)(b)
(3)(b)(i) the patient’s physician verifies that the patient or the patient’s spouse has a demonstrated condition recognized by a physician as a cause of infertility; or
(3)(b)(ii) the patient attests that the patient is unable to conceive a pregnancy or carry a pregnancy to a live birth after a year or more of regular sexual relations without contraception;
(3)(c) the patient attests that the patient has been unable to attain a successful pregnancy through any less-costly, potentially effective infertility treatments for which coverage is available under the health benefit plan; and
(3)(d) the use of the assisted reproductive technology procedure complies with the program’s clinical policies and is performed at a medical facility that conforms to the minimal standards for programs of assisted reproductive technology procedures adopted by the American Society for Reproductive Medicine.
(4)
(4)(a) The provision of a benefit in accordance with this section shall satisfy, in accordance with Subsection 31A-22-610.1 (1)(c)(ii), the requirement to provide an adoption indemnity benefit to a qualified individual under Section 31A-22-610.1 .
(4)(b) If a qualified individual has received the adoption indemnity benefit required under Section 31A-22-610.1 , the qualified individual may not receive a benefit in accordance with this section.