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California Fertility Insurance Coverage

Mandate to cover / offer

Overview of state insurance mandates and fertility coverage requirements for California. Applies to fully-insured health plans regulated by the state.

Coverage Summary

BenefitRequired by State
Mandate to offer fertility coverageYes
Diagnosis coverageYes
Treatment coverageYes
IVF includedYes
Fertility preservation includedYes

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)

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

For CalPERS state employee plans on or after July 1, 2027, KFF notes required coverage for infertility diagnosis and treatment and fertility services, including up to three completed oocyte retrievals with unlimited embryo transfers.

Source & Dates

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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