‘‘(C) January 1, 2027; 
‘‘(2) in the case of a participant or beneficiary 
not enrolled in the plan or coverage on the date of 
transmission under paragraph (1), upon initial en-
rollment of such participant or beneficiary; and 
‘‘(3) on an annual basis after the transmission 
under paragraph (1) or (2). 
‘‘(h) LEVEL
AND TYPE
OF REIMBURSEMENTS.— 
Nothing in this section shall be construed to prevent a 
group health plan or a health insurance issuer offering 
group health insurance coverage from negotiating the level 
and type of reimbursement with a provider for care pro-
vided in accordance with this section.’’. 
(B) CLERICAL AMENDMENT.—The table of 
contents in section 1 of the Employee Retire-
ment Income Security Act of 1974 (29 U.S.C. 
1001 et seq.) is amended by inserting after the 
item relating to section 725 the following new 
item: 
‘‘Sec. 726. Standards relating to benefits for fertility treatment.’’. 
(3) IRC.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 100 of the Internal Revenue Code of 1986 
is amended by adding at the end the following: 
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‘‘SEC. 9826. STANDARDS RELATING TO BENEFITS FOR FER-
TILITY TREATMENT. 
‘‘(a) IN GENERAL.—A group health plan shall pro-
vide coverage for fertility treatment, if such plan provides 
coverage for obstetrical services. 
‘‘(b) DEFINITION.—In this section, the term ‘fertility 
treatment’ includes the following: 
‘‘(1) Preservation of human oocytes, sperm, or 
embryos. 
‘‘(2) 
Artificial 
insemination, 
including 
intravaginal insemination, intracervical insemination, 
and intrauterine insemination. 
‘‘(3) Assisted reproductive technology, including 
in vitro fertilization and other treatments or proce-
dures in which reproductive genetic material, such as 
oocytes, sperm, and embryos, are handled, when 
clinically appropriate. 
‘‘(4) Genetic testing of embryos. 
‘‘(5) Medications prescribed or obtained over- 
the-counter, as indicated for fertility. 
‘‘(6) Gamete donation. 
‘‘(7) Such other information, referrals, treat-
ments, procedures, medications, laboratory testing, 
technologies, and services relating to fertility as the 
Secretary of Health and Human Services determines 
appropriate. 
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‘‘(c) REQUIRED COVERAGE.—A group health plan 
that includes coverage for obstetrical services shall provide 
coverage for fertility treatment determined appropriate by 
the health care provider, regardless of whether the partici-
pant or beneficiary receiving such treatment has been di-
agnosed with infertility as defined by the American Society 
for Reproductive Medicine, if the treatment is performed 
at, or prescribed by, a medical facility that is in compli-
ance with relevant standards set by an appropriate Fed-
eral agency. 
‘‘(d) 
LIMITATION.—Cost-sharing, 
including 
deductibles and coinsurance, or other limitations for fer-
tility treatment may not be imposed with respect to the 
services required to be covered under subsection (c) to the 
extent that such cost-sharing exceeds the cost-sharing ap-
plied to other medical services under the group health plan 
or health insurance coverage or such other limitations are 
different from limitations imposed with respect to such 
medical services, except where such limitation is more fa-
vorable with respect to fertility treatment. The Secretary 
shall promulgate interim final regulations to carry out this 
subsection, notwithstanding the notice and comment re-
quirements of section 553 of title 5, United States Code. 
‘‘(e) PROHIBITIONS.—A group health plan may not— 
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‘‘(1) provide incentives (monetary or otherwise) 
to a participant or beneficiary to encourage such 
participant or beneficiary not to seek or obtain fer-
tility treatment to which such participant or bene-
ficiary is entitled under this section or to providers 
to induce such providers not to provide medically ap-
propriate fertility treatments to participants or bene-
ficiaries; 
‘‘(2) prohibit a provider from discussing with a 
participant or beneficiary fertility treatment relating 
to this section; 
‘‘(3) penalize or otherwise reduce or limit the 
reimbursement of a provider because such provider 
provided fertility treatment to a qualified participant 
or beneficiary in accordance with this section; or 
‘‘(4) on the ground prohibited under title VI of 
the Civil Rights Act of 1964 (42 U.S.C. 2000d et 
seq.), title IX of the Education Amendments of 1972 
(20 U.S.C. 1681 et seq.), the Age Discrimination 
Act of 1975 (42 U.S.C. 6101 et seq.), section 504 
of the Rehabilitation Act of 1973 (29 U.S.C. 794), 
or section 1557 of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 18116), exclude any 
individual from coverage in accordance with this sec-
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tion, or discriminate against any individual with re-
spect to such coverage. 
‘‘(f) RULE OF CONSTRUCTION.—Nothing in this sec-
tion shall be construed to require a participant or bene-
ficiary to undergo fertility treatment. 
‘‘(g) NOTICE.—A group health plan shall provide no-
tice to each participant and beneficiary under such plan 
regarding the coverage required by this section in accord-
ance with regulations promulgated by the Secretary. Such 
notice shall be in writing and prominently positioned in 
any literature or correspondence made available or distrib-
uted by the plan and shall be transmitted— 
‘‘(1) not later than the earlier of— 
‘‘(A) in the first standard mailing made by 
the plan to the participant or beneficiary fol-
lowing the effective date of such regulations; 
‘‘(B) as part of any yearly informational 
packet sent to the participant or beneficiary; or 
‘‘(C) January 1, 2027; 
‘‘(2) in the case of a participant or beneficiary 
not enrolled in the plan on the date of transmission 
under paragraph (1), upon initial enrollment of such 
participant or beneficiary; and 
‘‘(3) on an annual basis after the transmission 
under paragraph (1) or (2). 
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