Senate Bill 729: Understanding California’s New Fertility Coverage Law
California has enacted a major change to reproductive health benefits with the passage of Senate Bill 729 (SB 729), which takes effect on January 1, 2026. The law requires large and small group state-regulated health plans to cover fertility services, such as in vitro fertilization (IVF), and ensures that the diagnosis and treatment of infertility are covered regardless of the cause. It also strengthens protections by prohibiting discrimination based on sexual orientation, gender identity or marital status.
What the Law Requires
Expanded coverage
Health plans must cover the diagnosis and treatment of infertility, including services such as in vitro fertilization (IVF).Inclusive definition
The law broadens the definition of infertility to include those unable to conceive for nonmedical reasons, such as same-sex couples or single parents.Specific treatment requirements
Plans must cover up to three completed egg retrievals and unlimited embryo transfers when medically appropriate.Protections against discrimination
Coverage cannot be denied based on sexual orientation, gender identity or marital status.Equal cost-sharing
Fertility services must be treated like any other medical service, with no separate or higher deductibles, copays or cost-sharing levels.Effective date
The law applies to state-regulated health plans issued, amended or renewed on or after January 1, 2026.Exclusions
The mandate does not apply to self-funded (ERISA) plans or Medi-Cal managed care plans regulated by the Department of Health Care Services.
As fertility care becomes more accessible across California, employers should expect heightened interest from employees seeking clear information about coverage limitations, out-of-pocket expenses, referral requirements and medical-necessity criteria. Carriers are releasing updated benefit guidance throughout 2025 as they prepare for the 2026 effective date, making ongoing communication especially important.
For employees, SB 729 represents a meaningful expansion of reproductive-health access, particularly for those who previously faced financial or eligibility barriers. By including IVF and adopting a more inclusive definition of infertility, the law helps make family-building care more predictable, equitable and attainable for a wider range of households across the state.
Pacific Federal is a Zenith American company and subsidiary of Harbour Benefit Holdings, Inc.
