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NewsNewsCalifornia SB 729 now requires insured large employers to provide comprehensive coverage for infertility and IVF starting from 2026, significantly increasing workplace benefits.
California SB 729 marks a major expansion of fertility insurance coverage, requiring fully insured large group health plans to cover infertility diagnosis and treatment, including in vitro fertilization (IVF). Signed into law by Governor Gavin Newsom on September 29, 2024, the mandate takes effect January 1, 2026, reshaping employer-sponsored reproductive healthcare across the state. Under California SB 729, fully insured health plans covering 101 or more employees must provide comprehensive infertility benefits, closing long-standing coverage gaps and modernizing access to fertility care.
A key provision of California SB 729 is the expansion of the legal definition of infertility. The law now includes individuals who are unable to reproduce without medical intervention, whether alone or with a partner. Coverage eligibility extends to same-sex couples, single parents by choice, individuals with medical infertility, and those experiencing recurrent pregnancy loss. A diagnosis by a licensed physician based on medical, sexual, or reproductive history establishes eligibility.
For applicable large group policies, California SB 729 requires coverage for both the diagnosis and treatment of infertility. Mandated benefits include:
The law enforces cost-sharing parity, requiring infertility services to be subject to the same deductibles, copayments, and coinsurance as other covered medical benefits. Insurers may not impose more restrictive limits or exclusions on infertility care, nor discriminate based on gender, marital or relationship status, sexual orientation, or family structure.
While California SB 729 does not mandate infertility coverage across all small group plans, carriers offering policies to employers with 100 or fewer employees must provide at least one plan option that includes comprehensive infertility benefits. Employers electing such coverage must comply with the same benefit and cost-sharing standards applied to large group plans.
The mandate does not apply to self-funded or level-funded health plans, which remain governed by federal ERISA regulations. Additional exemptions include religious employers, specialized health plans, Medi-Cal, and certain state and CalPERS contracts, with some exemptions extending until July 1, 2027.
Importantly, California SB 729 applies to fully insured plans covering California employees, regardless of whether the policy is issued inside or outside the state.
Employers with fully insured large group health plans should review their benefits and confirm compliance with California SB 729. Organizations offering separate fertility benefit programs may need to assess potential overlap with the new mandate. Although self-funded employers are exempt, the law is expected to influence evolving market standards and employee expectations around fertility coverage.
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