News

Senate Bill 729 (SB 729) is a California law that mandates certain health insurance plans to cover the diagnosis and treatment of infertility, including in vitro fertilization (IVF). It expands access to fertility coverage for fully insured employer groups, particularly in the small and large group lines of business. The bill aims to make fertility care more inclusive by broadening the definition of infertility to include nonmedical reasons, such as those related to same-sex relationships and single parenthood.

Implementation Timeline Updates:

• New SB 729 effective date: January 1, 2026
• Governor Newsom requested a delay to January 1, 2026, to allow time for regulatory guidance on IVF specifics like embryo storage and donor materials. Legislative trailer bill to finalize the delay has been signed.
• SB 729 coverage will start Jan 1, 2026, at the next plan renewal.

Key Takeaways for Employers & Employees: 

• Large-group fully insured plans (101+ employees): Once effective, must cover infertility treatments up to 3 egg retrievals and unlimited embryo transfers, with parity in cost sharing.
• Small-group fully insured plans (≤100 employees): Must offer such infertility coverage via riders; coverage is optional to include.
• SB 729 does not apply to self-funded or level-funded plans. These arrangements are governed by federal ERISA law only and are not subject to the state-mandated insurance requirements enforced by CDI and DMHC.
• Religious employers and certain groups (like Medi-Cal, CalPERS until 2027) are exempt.

What You Should Do: 

• Check your plan type: Large-group, fully insured: Expect automatic inclusion of infertility benefits at renewal.
• Small-group: Review plan options to include an infertility rider.
• Self-funded: SB 729 likely won’t apply; voluntary coverage remains an option.

Carrier Updates
 

Aetna	In SOBs plan names will include 'wINF', and updated ER application is coming January 1, 2026 .
Anthem Blue Cross	Will be releasing a new infertility rider in SOBs. Costs may change.
Blue Shield	LG: Any increase in plan premiums will take place in 2026 depending on the group’s population and specific plan designs. Groups that already renewed with a July 1, 2025, to December 31, 2025, effective date with originally mandated fertility benefits will see an adjusted rate. On July 1, 2025 ART riders were updated to comply with the requirements of SB 729, ensuring parity between medical and ART benefit cost shares. SG: Customers that chose to offer coverage under SB 729 will see coverage changes take effect upon new enrollment or renewal.
California Choice	See other carrier responses.
Covered California	If you offer infertility benefits to your employees, all health insurance plans available to your employees will include infertility benefits. If you choose not to offer infertility coverage to your employees, the health insurance plans available to your employees will not include infertility benefits. Previously, infertility coverage guidelines were based on the number of eligible employees and the selected product (HMO, PPO, etc.)
Health Net	Two SBCs per plan now available (one with infertility, one without). When the IVF/fertility rider is needed for small groups, it is added at a group level to all members/plans.
Kaiser Permanente	LG: Customers renewing between July and December 2025, the benefit will be included as part of the renewal.  As a contract renews and SB 729 coverage is included, this expanded benefit will act as a benefit reset. A covered member will be eligible for SB 729 services, regardless of whether the member has accessed or exhausted any previous supplemental fertility services coverage. SG: All existing employers and brokers with INF plans, both ACA-metal and grandfathered, will receive a one-time email notification informing them of the benefit enhancements at time of renewal, beginning mid-June (pending DHMC approval).
Medi Excel	Updates to be shared before new effective date of January 1, 2026.
Sharp Health	The ART C rider will no longer be offered. Plans will now be available with or without Infertility, built into the plan designs, available for all group sizes. New INF SOBs are available on carrier website
United Healthcare	Carrier is preparing to offer the mandated coverage to small group, new and renewing, effective January 1, 2026.

*For Key Implementation Details Click Here

If You Would Like More Information, Please Contact Your Dickerson Sales Representative.