Existing law imposes various requirements and restrictions on health care service plans and disability insurers, including a requirement that every group health care service plan contract or disability insurance policy issued, amended, or renewed on or after January 1, 1990 offer coverage for the treatment of infertility, except in vitro fertilization.
Senate Bill 729 (SB 729) requires large group health care service plan contracts and disability insurance policies issued, amended, or renewed on or after July 1, 2025 to offer coverage for the diagnosis and treatment of infertility and fertility service, including a maximum of three completed oocyte retrievals with unlimited embryo transfers. Small group (50 or fewer employees) health care service plan contracts and disability insurance policies must offer coverage for the diagnosis and treatment of infertility and fertility services, but are not required to provide it. A health care service plan shall include notice of such coverage in the plan’s evidence of coverage.
SB 729 also revises the definition of infertility, and removes the exclusion of in vitro fertilization from coverage. The law prohibits a health care service plan or disability insurer from placing different conditions or coverage limitations on fertility medications or services, or the diagnosis and treatment of infertility and fertility services, than apply to other conditions.
SB 729 does not apply to California Public Employees’ Retirement System (CalPERS) contracts pursuant to Public Employees’ Medical and Hospital Care Act (PEMHCA) until July 1, 2027.
(SB 729 repeals and replaces section 1374.55 of the Health and Safety Code and section 10119.6 of the Insurance Code.)