This bill amends the Employee Retirement Income Security Act of 1974 (ERISA) to require group health plans and health insurance issuers offering group coverage to provide comprehensive benefits for infertility and iatrogenic infertility treatments. This mandate applies to plans that already cover obstetrical services, ensuring that individuals facing challenges in conception receive necessary medical support. The bill defines infertility as the inability to achieve spontaneous pregnancy after a specified period or due to diagnosed conditions, and iatrogenic infertility as fertility impairment resulting from medical procedures like chemotherapy or radiation. The required coverage encompasses a broad range of treatments, including both those involving the handling of human egg, sperm, and embryo outside the body, such as in vitro fertilization (IVF) and cryopreservation, and those that do not, like ovulation induction and intrauterine insemination. Plans must apply coverage limits and cost-sharing requirements to these treatments no more restrictively than for other medical and surgical benefits. Furthermore, the legislation prohibits practices that discourage treatment, such as offering incentives not to receive care or penalizing providers for discussing or offering covered services. To ensure compliance, the bill introduces new requirements for utilization management tools applied to infertility benefits. For the first five plan years, plans must annually submit analyses to the Secretary demonstrating that these tools are consistent with clinical guidelines. The Secretary is empowered to assess civil penalties of up to $100 per day against issuers for failing to provide required coverage or submit these analyses. Additionally, the Secretary must report annually to Congress on compliance, identifying any non-compliant plans, and plans must notify participants about this coverage starting in the second plan year after enactment.