Illinois Administrative Code › Title 50 - INSURANCE › Part 2015 - INFERTILITY COVERAGE › Section 2015.30 - Definitions

Current through Register Vol. 48, No. 28, July 12, 2024
For purposes of this Part and Section 356m of the Code:
"Artificial insemination" or "AI" means the introduction of
				sperm into an individual's vagina or uterus by noncoital methods, for the
				purpose of conception.
"Assisted reproductive technologies" or "ART" means treatments
				and/or procedures in which the human oocytes and/or sperm are retrieved and the
				human oocytes and/or embryos are manipulated in the laboratory. ART shall
				include prescription drug therapy used during the cycle where an oocyte
				retrieval is performed.
"Code"
				means the Illinois Insurance Code [215 ILCS 5
				].
"Donor" means an oocyte donor or a sperm donor.
"Embryo" means a fertilized egg that has begun cell division
				and has completed the pre-embryonic stage.
"Embryo transfer" means the placement of the pre-embryo into
				the uterus or, in the case of zygote intrafallopian tube transfer, into the
				fallopian tube.
"Gamete" means a reproductive cell, which is either a sperm or
				an egg (ovum).
"Gamete intrafallopian tube transfer" or "GIFT" means the
				direct transfer of a sperm/egg mixture into the fallopian tube. Fertilization
				takes place inside the tube.
"Gestational surrogacy" mean the process by which a
				woman attempts to carry and give birth to a child created through in vitro
				fertilization using the gamete or gametes of at least one of the intended
				parents.
[750 ILCS 47/10 ] For purposes of
				this Part, the term applies whether or not the surrogate has made a genetic
				contribution to the child.
"Infertility" has the meaning ascribed in Section 356m(c) of
				the Code.
"Infertility coverage" means insurance or health maintenance
				organization coverage required by Section 356m of the Code for the diagnosis
				and treatment, including prescription drug therapy, of infertility.
"In vitro fertilization" or "IVF" means a process in which an
				egg and sperm are combined in a laboratory dish where fertilization occurs. The
				fertilized and dividing egg is transferred into the individual's uterus.
"Low tubal ovum transfer" means the procedure in which oocytes
				are transferred past a blocked or damaged section of the fallopian tube to an
				area closer to the uterus.
"Oocyte" means the egg or ovum, formed in an ovary.
"Oocyte donor" means an individual determined by a physician to
				be capable of donating eggs in accordance with the standards recommended by the
				American Society for Reproductive Medicine.
"Oocyte retrieval" means the procedure by which eggs are
				obtained by inserting a needle into the ovarian follicle and removing the fluid
				and the egg by suction. This is also called ova aspiration. Oocyte retrieval is
				included, for example, in the procedures for GIFT, IVF, and ZIFT.
"Pregnancy Related Benefit" means benefits that cover any
				related medical condition that may be associated with pregnancy, including
				complications of pregnancy.
"Surrogate" or
"gestational surrogate" means a woman
				who agrees to engage in a gestational surrogacy
. [750 ILCS
				47/10 ]
"Unprotected sexual intercourse" should include appropriate
				measures to ensure the health and safety of sexual partners and means, with
				respect to infertility benefits, sexual union involving the insertion of a
				penis into a partner's vagina without the use of any process, device or method
				that prevents conception, including but not limited to oral contraceptives,
				chemicals, physical or barrier contraceptives, natural abstinence or voluntary
				permanent surgical procedures. Without limiting any person's actual or
				perceived gender identity, the term "woman" in Section 356m(c)(1) of the Code
				refers to the sexual partner with the vagina for purposes of this
				definition.
"Uterine embryo lavage" means a procedure by which the uterus
				is flushed to recover a preimplantation embryo.
"Zygote" means a fertilized egg before cell division
				begins.
"Zygote intrafallopian tube transfer" or "ZIFT" means a
				procedure by which an egg is fertilized in vitro and the zygote is transferred
				to the fallopian tube at the pronuclear stage before cell division takes place.
				The eggs are harvested and fertilized on one day and the embryo is transferred
				at a later time.