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Big News for Individuals Who Need Insurance Coverage for Fertility.

On April 13, 2022, Governor Polis signed into law HB22-1008 on Implementation of Fertility Coverage.

In 2020, Colorado passed HB20-1158 Colorado Building Families Act requiring insurance plans under Colorado law to provide coverage for fertility diagnosis, preservation, and treatment. However, a provision of the law required an affirmative determination that the law would not trigger defrayal (a requirement that the state could be financially responsible for any increase in premiums) under the Affordable Care Act. That determination was not made and the law did not go into effect. However, defrayal is not an issue under the Affordable Care Act for large group market plans, but the Colorado Building Families Act did not distinguish between different insurance markets.

HB22-1008 requires large group plans (applicable to employers with over 100 employees) under Colorado law to provide coverage for fertility diagnosis, preservation for cancer patients and others at risk of medically-induced fertility, and treatment, including up to three rounds of IVF and unlimited transfers, for plans initiated in 2023 or later.

Note that HB22-1008 did not resolve coverage for individual and small group markets under Colorado law. Further, Colorado law does not affect insurance plans under federal law (self insured, Medicare, Medicaid, TRICARE, etc.) or the law of another state, which may or may not require or provide fertility coverage. Be sure to check whether your employer is self-insured or fully-insured and part of the large group insurance market subject to Colorado law.

Dr. Dan Mazur specializes in male infertility and is on the board of Colorado Fertility Advocates (CFA). CFA continues to work with the National Infertility Association to advocate for fertility rights for men and women across the country.