California Fertility Insurance Coverage
Mandate to cover / offerOverview of state insurance mandates and fertility coverage requirements for California. Applies to fully-insured health plans regulated by the state.
Coverage Summary
| Benefit | Required by State |
|---|---|
| Mandate to offer fertility coverage | Yes |
| Diagnosis coverage | Yes |
| Treatment coverage | Yes |
| IVF included | Yes |
| Fertility preservation included | Yes |
Coverage Details
California has moved from a mandate-to-offer model to a large-group mandate-to-cover. SB 729 amended Health & Safety Code ? 1374.55 and Insurance Code ? 10119.6 so fully insured large-group plans issued or renewed in 2026 must cover infertility diagnosis and treatment, including IVF, with up to three completed oocyte retrievals and unlimited embryo transfers; small-group coverage remains an offer/rider context. Health & Safety Code ? 1374.551 separately treats standard fertility preservation for iatrogenic infertility as a covered basic health care service. Religious-employer and plan-type exceptions may apply, CalPERS timing is later, and ERISA self-funded employer plans generally are not controlled by the state mandate.
Self-Funded Employer Plans (ERISA)
Pending or Future Changes
Source & Dates
- Source:
- KFF State Health Facts
- Data as of:
- 2025-11-30
- Next review:
- 2026-08-09
- Effective date:
- 2026-01-01
Disclaimer
This is not legal or insurance advice. Verify coverage directly with your insurer and HR benefits team. Self-funded employer plans (ERISA) are generally exempt from state mandates. Information reflects the reviewed source as of the date noted above and may not reflect recent legislative or regulatory changes.
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