Section 49-20-418 - Expanded infertility treatment benefit(1) As used in this section:(a) "Assisted reproductive technology" means the same as the term is defined in 42 U.S.C. Sec. 263a-7.(b) "Physician" means the same as the term is defined in Section 58-67-102.(c) "Qualified assisted reproductive technology cycle" means the use of assisted reproductive technology to transfer a single embryo for implantation.(d) "Qualified individual" means an individual:(i) covered within the state risk pool; and(ii) eligible for maternity benefits under the program.(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.(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:(a) the qualified individual is the patient who will use the assisted reproductive technology;(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(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;(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(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)(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.(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.Amended by Chapter 422, 2024 General Session ,§ 1, eff. 7/1/2024.Amended by Chapter 195, 2021 General Session ,§ 1, eff. 5/5/2021.Amended by Chapter 64, 2021 General Session ,§ 17, eff. 5/5/2021.Added by Chapter 357, 2018 General Session ,§ 1, eff. 5/8/2018. Affected by 63I-1-249 on 1/1/2025