California Fertility Insurance Coverage

IVF coverage required

Overview 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	No
Diagnosis coverage	Yes
Treatment coverage	Yes
IVF included	Yes
Fertility preservation included	Yes

Coverage Details

California's regime splits by market. For large-group plans, Health & Safety Code § 1374.55 as amended by SB 729 (Ch. 930/2024) is a mandate-to-cover: fully insured large-group plans issued or renewed on or after January 1, 2026 must cover infertility diagnosis and treatment, including IVF, with up to three completed oocyte retrievals and unlimited embryo transfers (AB 116 delayed the original July 1, 2025 date to January 1, 2026). Small-group coverage is offer-only under § 1374.55(a)(2). Standard fertility preservation for iatrogenic infertility is a covered basic health care service. CalPERS state-employee plans follow on July 1, 2027, religious-employer and plan-type exceptions may apply, and ERISA self-funded employer plans generally are not controlled by the state mandate.

Self-Funded Employer Plans (ERISA)

Self-funded employer health plans are generally governed by ERISA and may be exempt from state insurance mandates; verify benefits with the clinic and insurer.

Pending or Future Changes

SB 62 (Ch. 739/2025, signed October 13, 2025) adds fertility services to California's proposed 2027 essential health benefits benchmark, which would extend coverage to individual and small-group plans from January 1, 2027, contingent on pending federal HHS/CMS approval (still unresolved as of April 2026). For CalPERS state-employee plans, required coverage for infertility diagnosis and treatment, including up to three completed oocyte retrievals with unlimited embryo transfers, applies on or after July 1, 2027.

Source & Dates

Source:: State Government
Data as of:: 2026-06-10
Next review:: 2026-12-31
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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