West Case Update

Health Care Plan Need Not Provide Coverage for Infertility Treatment

Description Appeals court held that an employer's health care plan did not violate the Pregnancy Discrimination Act for not providing coverage of surgery to deal with infertility. The plan did not provide such benefits to either men or women, so the fact that certain procedures are only for women is irrelevant.

Topic Employment Discrimination

Key Words Pregnancy Discrimination Act; Medical Benefits

C A S E S U M M A R Y

Facts Saks was denied coverage for certain infertility procedures under her employee health benefits plan. She sued her employer, Franklin Covey, claiming that the denial of coverage violated the Pregnancy Discrimination Act (PDA). The trial court dismissed the action. Saks appealed.

Decision
Affirmed. For a condition to fall within the PDA's inclusion of pregnancy and "related medical conditions" as sex-based characteristics, that condition must be unique to women. Although the surgical procedure Saks requested is particular to women, the health plan did not provide surgical benefits to either men or women for infertility problems, so it was non-discriminatory.

Citation Saks v. Franklin Covey Co., --- F.3d --- (2003 WL 122396, 2nd Cir., 2003)

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Health Care Plan Need Not Provide Coverage for Infertility Treatment
Description	Appeals court held that an employer's health care plan did not violate the Pregnancy Discrimination Act for not providing coverage of surgery to deal with infertility. The plan did not provide such benefits to either men or women, so the fact that certain procedures are only for women is irrelevant.
Topic	Employment Discrimination
Key Words	Pregnancy Discrimination Act; Medical Benefits
C A S E S U M M A R Y
Facts	Saks was denied coverage for certain infertility procedures under her employee health benefits plan. She sued her employer, Franklin Covey, claiming that the denial of coverage violated the Pregnancy Discrimination Act (PDA). The trial court dismissed the action. Saks appealed.
Decision	Affirmed. For a condition to fall within the PDA's inclusion of pregnancy and "related medical conditions" as sex-based characteristics, that condition must be unique to women. Although the surgical procedure Saks requested is particular to women, the health plan did not provide surgical benefits to either men or women for infertility problems, so it was non-discriminatory.
Citation	Saks v. Franklin Covey Co., --- F.3d --- (2003 WL 122396, 2nd Cir., 2003)