Tuesday, October 15, 2013

Infertile in Illinois? Know the State Mandate Before Starting Treatments

If you work for a company headquartered in Illinois, you may be an infertility insurance winner. Illinois is one of a handful of states with laws mandating some level of coverage for infertility treatments. Take time to understand how the laws work, where the holes are, and how it may impact your out-of-pocket costs. Your investment will pay dividends down the road.

Holes in the Illinois Law

Did you notice the first sentence asks if you work for a company headquartered in Illinois, and not do you live or work in Illinois? The Illinois insurance mandate applies when the state has jurisdiction. Only companies headquartered in Illinois are likely to be subject to the mandate, which creates sets of winners and losers in the infertility insurance game.

The Winners

One set of winners are employees of one of the many large companies headquartered in the state, but with employees in branch locations out of state. Take Sears for example. Sears is headquartered in Illinois and may be subject to the state mandate. Employees working in a store located in a state with no infertility insurance mandate may have coverage.

The Losers

One set of losers are Illinois citizens who work for an employer with a branch location in Illinois, but happens to be headquartered in another state. Most states have no laws mandating infertility insurance coverage. This employer is not subject to the Illinois mandate, and its Illinois employees may not have infertility coverage even though there is a state law mandating such.

Did you notice that Sears may be subject to the mandate because it is headquartered in Illinois? The law regulates insurers and not employers. If Sears chooses to self insure, it may not be subject to the mandate, and can offer health insurance coverage that omits infertility treatments.

Know your Illinois laws before starting any treatments, and verify coverage before beginning treatments to avoid a nasty surprise.

No comments:

Post a Comment