California enacted SB 729 in 2024 with the goal of expanding access to fertility‑related medical care across the state. Signed on September 29 of that year, the legislation introduced a new coverage framework for infertility treatment and modernized the criteria used to determine eligibility. This represented a shift from the previous system, which did not require infertility or IVF benefits and relied on optional riders with narrow coverage.
The law’s requirements took effect on January 1, 2026. Fully insured large group plans with more than 100 employees must now provide coverage for infertility diagnosis and treatment, including IVF. SB 729 adopts an expanded definition of infertility that includes individuals or couples who cannot reproduce without medical intervention, same‑sex couples, single intended parents, individuals unable to conceive, and those who experience recurrent pregnancy loss. Eligibility may also be based on a physician’s assessment of medical, sexual, or reproductive history.
Small group plans follow a different structure. Carriers must offer at least one small group option containing comprehensive infertility benefits, although not every small group plan is required to include such coverage. The mandate does not apply to self‑funded or level‑funded plans, religious employers, certain specialized plans, Medi‑Cal, or specific state contracts that remain exempt until mid‑2027. Fully insured plans covering California employees must comply regardless of where the policy is issued.