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The New Jersey Family Building Act (a.k.a. the NJ mandate)

In 2001, the State of New Jersey joined a handful of states in mandating coverage of infertility testing and treatment by passing the New Jersey Family Building Act. This law requires NJ based employers to cover infertility related medical services including:

  • diagnostic testing 
  • intrauterine inseminations (unlimited)
  • ovulation induction
  • IVF up to and including 4 completed egg retrievals per lifetime
  • procedures related to IVF including ICSI, assisted hatching, GIFT and ZIFT
  • procedures performed on an egg donor or gestational carrier
  • medications even if not covered by prescription plan

There are a several exclusions where employers are not required to follow this mandate:

  • small employers (< 50 employees)
  • self-insured plans
  • organizations that oppose these treatments on religious/ethical grounds
  • couples who have a had a permanent elective sterilization procedure (tubal ligation or vasectomy)
  • companies not based in New Jersey
  • compensation paid to egg donors, surrogates or recruiting agencies

The Department of Banking and Insurance (DOBI) later clarified that coverage cannot be denied for:

  • same sex couples or single women who have failed 6 or more donor IUI cycles
  • counting any non-covered, self-pay cycles as one of the 4 lifetime cycles

While recent reforms in the US health care system has eroded much of this mandate, many couples continue to have coverage under the New Jersey Family Building Act. At Princeton IVF, we participate in most New Jersey health insurance plans.

For more information about your coverage under the NJ mandate or to make an appointment to see us, please contact our infertility benefits coordinator. Samantha@delvalogyn.com (609) 512-4031