CHAIR

NEW YORK STATE ASSEMBLY Committee on Ethics and Guidance

CO-CHAIR
DISTRICT OFFICE: Commission on Legislative Ethics
24-08 32nd Street, Suite 1002A, Astoria, NY 11102
COMMITTEES
(718) 545-3889 ● FAX (718) 545-3607 Energy
Insurance
ALBANY OFFICE: Judiciary
ARAVELLA SIMOTAS
Ways and Means
Assemblymember – 36th District Legislative Office Building, Room 652, Albany, NY 12248
Queens County (518) 455-5014 ● FAX (518) 455-4044

April 12, 2019

Superintendent Linda Lacewell
NYS Department of Financial Services
1 State St,
New York NY, 10004

Dear Superintendent Lacewell,

In the coming months, New York State will be selecting a new benchmark plan in order
to define the essential health benefits that individual and small group plans must provide
insureds. To stay consistent with our state’s expressed interest in the 2019-2020 budget, the
benchmark plan must provide its citizens with access to the optimum standard of care for
infertility.
As you know the process outlined by the CMS for the 2020 EHB-Benchmark Selection Plan,
I propose that New York State consider the following two options:

 Apply the Empire Plan Infertility benefits for New York State public employees as part
of its benchmark plan and convert the dollar cap to a cycle cap to match the three-cycle
limit in the 2020 State Budget, as dollar caps are not allowed on EHBs.

 Select the Infertility Benefits from another state’s benchmark plan, such as Massachusetts
or Rhode Island, whose IVF benefits were mandated well before December 2011 and are
in line with advances in medical technology.

Opting for a benchmark plan that includes In-Vitro Fertilization coverage, will further
strengthen New York State’s Women Agenda Initiatives without exposure to the potential risk of
incurring defrayal costs. It will also reduce the burden of paying out of pocket for IVF and will
help the one in eight couples that struggle with infertility.
I look forward to hearing from you and working together to help even more people struggling
to build their families in New York State.

Sincerely,

Assemblymember Aravella Simotas

New York State
36th District - Queens