It's finally here: Senate Bill 729 (SB 729)! For California employees planning to start a family, here's what you need to know about this groundbreaking change.
Starting January 1, 2026, California is set to implement one of the most comprehensive fertility coverage laws in the nation. This law is a game-changer in making parenthood financially accessible for all, but especially those who have historically been excluded from coverage. Here is a summary of upcoming changes:
IVF is Now Mandated
Historically, California law required insurers to offer employers the option to add basic infertility coverage, and more often than not, this excluded In Vitro Fertilization (IVF), the most effective treatment.
As of January 1, 2026, IVF is mandated for fully-insured large group plans (typically 101 employees +)
For fully insured large-group plans, SB 729 now requires coverage for the diagnosis and treatment of infertility, which must include:
- IVF Treatment: Coverage for up to three completed oocyte (egg) retrievals.
- Unlimited Embryo Transfers: Once eggs are retrieved, there is no limit on the number of transfers, following established clinical guidelines.
- Fertility Preservation: Coverage for medically necessary procedures, such as egg or sperm freezing, before cancer treatments that could cause infertility.
This moves IVF from a high-cost, optional add-on to a standard, mandatory health benefit for many employees.
Removal of outdated and discriminatory rules.
Older definitions of infertility often required a heterosexual couple to try to conceive naturally for 6 to 12 months before qualifying for coverage.
SB 729 is bringing a new definition that reflects today's standards. The law explicitly prohibits discrimination in coverage based on age, sexual orientation, gender identity, or marital status. The term "infertility" has been broadened to include any individual or couple who cannot reproduce without medical intervention, based on a physician's findings, including:
- LGBTQ+ Couples: Same-sex couples and individuals are explicitly covered and no longer have to navigate bureaucratic hurdles to prove a medical "infertility" diagnosis.
- Single Parents by Choice: Unpartnered individuals seeking to build a family via donor services are now included. The law explicitly prohibits discrimination in coverage based on age, sexual orientation, gender identity, or marital status.
Who is covered?
| Fully-Insured Large Group | Companies with 101 or more employees that purchase their insurance from a state-regulated carrier (a fully insured plan) are the primary group covered by the mandate. |
| Fully-Insured Small Groups | Carriers must offer small employers (100 or fewer employees) the option to purchase this full infertility coverage, but the employer is not mandated to buy it. |
| Self-Insured Plans | These are exempt. Federal law (ERISA) preempts state mandates for self-insured companies, which include many of the largest national employers. |
Effective Date:
The law officially takes effect on January 1, 2026. However, your specific coverage may not begin until your employer's health plan is newly issued or renewed on or after that date. This means for some, coverage may not be available until later in the 2026 calendar year.
Your Next Steps
As HR leaders who are part of a fully insured large group, please be prepared to speak to California resident employees about your company's renewal date and promote this new mandate to your teams.
For a California resident employee looking to start a family, your next steps are:
- Consult a Specialist: Do not delay diagnostic testing. Understanding your fertility potential now is crucial for planning, regardless of the policy timeline.
- Review the Details: Once your 2026 plan documents are available, confirm the specifics, such as any copays or deductibles, which the law requires to be treated equally to other medical services.
If you'd like to learn more, please contact me at:
Heather Raskulinecz
Sr. Vice President, Employee Benefits
Hraskulinecz@venbrook.com
C:949.547.0227
