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Appeals Court Upholds Infertility Treatment Exclusions
The US 2nd Circuit Court of Appeals said that even though the infertility treatments in the specific case were only performed on women, the “exclusion of surgical impregnation procedures disadvantages infertile male and female employees equally,” the National Law Journal reported. So the employer d id not run afoul of the federal Pregnancy Discrimination Act (PDA) by declining coverage for artificial insemination and other treatments, the appeals judges said.
The appeals court upheld a lower court’s decision in favor of the employer.
Sex Specifics
Chief Circuit Judge John Walker
said the proper question on review “is whether
sex-specific conditions exist, and if so, whether
exclusion of benefits for those conditions results in a
plan that provides inferior coverage to one sex.”
“Because reproductive capacity is
common to both men and women, we do not read the PDA as
introducing a completely new classification of prohibited
discrimination based solely on reproductive capacity,”
Walker wrote. “Rather, the PDA requires that pregnancy,
and related conditions, be properly recognized as
sex-based characteristics of women.”
“Artificial” Distinctions
Plaintiff
Rochelle Saks claimed that the
refusal of her self-insured health benefits plan to cover
infertility treatments was a violation of her
federally protected civil rights. While employees enrolled
in her health plan were allowed benefits for some
infertility products and procedures, the plan specifically
barred coverage for artificial insemination and other
surgical impregnation procedures, such as in-vitro
fertilization.
After Saks filed a federal suit in
the US District Court for the Southern District of New
York, US District Judge Colleen McMahon rejected her
claims, finding that the exclusions of surgical
impregnation procedures affected males and females equally.
McMahon also said the PDA was not violated because the plan
provides equal coverage for men and women.
The case is Saks v. Franklin Covey
Co
.
, 00-9598.