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ARIZONA STATE SENATE
Fifty-Seventh Legislature, Second Regular Session
AMENDED
health insurance; fertility preservation; coverage
Purpose
Effective January 1, 2028, requires a health insurer to provide coverage for standard fertility preservation services to an insured who is within reproductive age, who is diagnosed with cancer and whose medically necessary treatment is likely to cause iatrogenic infertility. Prescribes procedures for a religious employer to request an exemption from the coverage requirement.
Background
The Department of Insurance and Financial Institutions regulates policies, certificates, evidences of coverage and contracts of insurance (insurance policies) that are issued or delivered by insurers. Every insurer that offers individual health insurance coverage in the individual market in Arizona must provide guaranteed availability of coverage to eligible individuals who desire to enroll in individual health insurance coverage (A.R.S. § 20-1379).
Fertility preservation is a health care service for patients undergoing treatment for medical conditions that may result in fertility impairment caused by medical treatment that has a potential side effect of impaired fertility.
The Joint Legislative Budget Committee (JLBC) issued a revised fiscal note on S.B. 1347 estimates a cost to the state General Fund of $305,900 and a total funds cost of $611,800 annually, beginning in plan year 2027 which would be halved in fiscal year 2027 due to only covering six months of the plan year. JLBC notes that S.B. 1365 would have a fiscal impact on local government health plans and health care premium tax collections, but the magnitude of such impacts cannot be determined in advance (JLBC Fiscal Note).
Provisions
1. Requires a health insurer that issues, amends or renews an insurance policy on or after January 1, 2027, to provide coverage for standard fertility preservation services to an insured who is within reproductive age, who is diagnosed with cancer and whose medically necessary treatment is likely to cause iatrogenic infertility.
2. Defines iatrogenic infertility as an impairment of fertility that is caused directly or indirectly by medically necessary treatment for cancer, sickle cell disease or lupus.
3. Defines standard fertility preservation services to:
a) mean oocyte and sperm preservation procedures that are consistent with established medical practices or professional guidelines published by the American Society of Clinical Oncology or the American Society for Reproductive Medicine;
b) mean the storage for at least three plan years of preserved ovarian tissue, sperm and oocyte; and
c) include cryopreservation of ovarian tissue, sperm and oocyte.
4. Requires standard fertility preservation services coverage to include at least three plan years of storage.
5. Stipulates that, if an insured changes insurance plans during the three-year storage period, the prior health insurer and the new health insurer are not responsible for the three plan years of storage.
6. Requires a health insurer to process prior authorization requests for standard fertility preservation services as urgent and to respond within 72 hours on request.
7. Allows an insurance policy to contain provisions for maximum benefits and to require standard fertility preservation services to be subject to the same deductibles, copayments, coinsurance and reasonable limitations and exclusions.
8. Allows a religious employer to submit a written request to the insurer for an exemption from the requirement to provide coverage for standard fertility preservation services for an insured who is within reproductive age, who is diagnosed with cancer and whose medically necessary treatment may cause iatrogenic infertility.
9. Requires the health insurer to grant a requested exemption if the coverage conflicts with the employer's religious beliefs and requires a religious employer that obtains an exemption to provide written notice of the exemption to prospective insureds.
10. Specifies that the requirement to provide coverage for standard fertility preservation services does not prevent an insured from purchasing a supplemental insurance policy that covers standard fertility preservation services at the insured's own expense.
11. Defines terms.
12. Becomes effective on January 1, 2028.
Amendments Adopted by Committee
1. Specifies that the medically necessary treatment must be likely to cause iatrogenic infertility in order for the services to be covered.
2. Redefines religious employer.
3. Clarifies that standard fertility preservation services include storage for three plan years, rather than three years.
Amendments Adopted by Committee of the Whole
1. The committee amendment was withdrawn.
2. Requires standard fertility preservation services coverage to include at least three plan years of storage.
3. Stipulates that, if an insured changes insurance plans during the three-year storage period, the prior health insurer and the new health insurer are not responsible for the three plan years of storage.
4. Removes the prohibition against health insurers requiring prior authorization for standard fertility preservation services and instead requires a health insurer to process prior authorization requests for such services as urgent and to respond within 72 hours on request.
5. Specifies that the medically necessary treatment must be likely to cause iatrogenic infertility in order for the standard fertility preservation services to be covered.
6. Redefines religious employer and iatrogenic infertility.
7. Adds a delayed effective date of January 1, 2028.
Senate Action
FIN 2/16/26 DPA 4-1-2
Prepared by Senate Research
March 2, 2026
MG/hk