HB 2649 — An Act amending the act of May 17, 1921 (P.L.682, No.284), known as The Insurance Company Law of 1921, in casualty insurance, providing for coverage for certain fertility preservation services.

CORRECTIVE REPRINT PRIOR PRINTER'S NOS.NO.

3663,3663 3752THE PRINTER'SGENERAL NO.ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

37532649 THE2026 GENERALINTRODUCED ASSEMBLYBY OFKOSIEROWSKI, PENNSYLVANIAMARCELL, HOUSEMAYES, BILLKHAN, SessionRIVERA, ofFLEMING, No.SHUSTERMAN, PROBST, HILL-EVANS, SANCHEZ, BOROWSKI, SCOTT, T.

2649DAVIS, 2026HOHENSTEIN, INTRODUCEDMADDEN, BYCEPEDA-FREYTIZ, KOSIEROWSKI,DONAHUE, MARCELL, MAYES, KHAN, RIVERA, ISAACSON, BRENNAN, MALAGARI, McNEILL, BURGOS, WAXMAN, FLEMING, SHUSTERMAN, PROBST, HILL-EVANS, SANCHEZ, BOROWSKI, INGLIS, DELLOSO, PASHINSKI, POWELL, GUZMAN, HANBIDGE, OTTEN,,OTTEN, J.

HARRIS, VENKAT, LABS, CIRESI, MULLINS, ABNEY, SAPPEY, MUNROE, CURRY,CURRY DELOZIER AND MADSEN,DELOZIER, JUNE 17, 2026 ASREFERRED AMENDEDTO COMMITTEE ON SECONDINSURANCE, CONSIDERATION,JUNE HOUSE22, OF REPRESENTATIVES, JULY 1, 2026 AN ACT Amending the act of May 17, 1921 (P.L.682, No.284), entitled "An act relating to insurance;

amending, revising, and consolidating the law providing for the incorporation of insurance companies, and the regulation, supervision, and protection of home and foreign insurance companies, Lloyds associations, reciprocal and inter-insurance exchanges, and fire insurance rating bureaus, and the regulation and supervision of insurance carried by such companies, associations, and exchanges, including insurance carried by the State Workmen's Insurance Fund;

The following shall apply to coverage under this ◄ section:

◄ (1) Coverage under this section shall include storage for ◄ not less than three years at an in-network facility.

(3) An insurer may impose a lifetime maximum benefit for coverage under this section if the lifetime maximum benefit is ◄ not less than one hundred thousand dollars ($100,000) for each covered person.

(4) An insurer may limit coverage under this section to a ◄ period that ends on the earlier of the following:

◄ (i) Three years after the date of the medically necessary treatment that may directly or indirectly cause iatrogenic infertility in the covered person.

(5) Coverage under this section shall be subject to all of ◄ the following:

(ii) The terms and conditions of the health insurance ◄ policy, including determinations of medical necessity and clinical review criteria used for utilization review of health 20260HB2649PN3753 - 2 - care services, copayment provisions, deductible provisions and 20260HB2649PN3663 - 2 - coinsurance provisions.

(6) Coverage under this section shall be administered in a ◄ similar manner to other health care services provided under the terms and conditions of the health insurance policy.

(b) A religious employer may submit a written request to an ◄ insurer for an exemption from the coverage required under subsection (a).

(c) A religious employer that obtains an exemption under ◄ subsection (b) shall provide written notice of the exemption to ◄ each prospective enrollee covered under the health insurance policy.

(d) Nothing in this section shall prohibit an enrollee ◄ covered under a health insurance policy provided by a religious employer from purchasing, at the enrollee's own expense, a supplemental insurance policy that covers fertility preservation services.

(e) As used in this section, the following words and phrases ◄ shall have the meanings given to them in this subsection unless the context clearly indicates otherwise:

"Fertility preservation service" means a procedure or service ◄ to preserve fertility in accordance with nationally recognized clinical or professional guidelines existing on the effective date of this section.

"Health care service" means a treatment, admission, procedure, medical supply, medical equipment or other service, including behavioral health, ordered or otherwise provided or 20260HB2649PN3753 - 3 - proposed to be provided by a health care provider to a patient 20260HB2649PN3663 - 3 - for the diagnosis, prevention, treatment, cure or relief of a health condition, illness, injury or disease.

The term includes an impairment of fertility caused ◄ directly or indirectly by surgery, chemotherapy, radiation or another medical treatment with a potential side effect of impaired fertility.,fertility. INCLUDING SURGERY, CHEMOTHERAPY, RADIATION ◄ 20260HB2649PN3753 - 4 - OR ANOTHER MEDICAL TREATMENT FOR CANCER WITH A POTENTIAL SIDE EFFECT OF IMPAIRED FERTILITY.

"Insurer" means an entity licensed by the Insurance 20260HB2649PN3663 - 4 - Department with accident and health authority to issue a health insurance policy that is offered or governed under any of the following:

"Religious employer" means an employer that is a church, ◄ convention or association of churches or an elementary or secondary school that is controlled, operated or principally supported by a church as defined in 26 U.S.C.

(2) For a health insurance policy for which neither rates nor forms are required to be filed with the Federal Government or the Insurance Department, the addition of section 635.11 of the act shall apply to a policy issued or 20260HB2649PN3753 - 5 - renewed on or after 180 days after the effective date of this paragraph.

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