Understanding California’s SB 729 Fertility Coverage Law
What It Means for Your Family-Building Journey — From Life IVF Center

California’s Senate Bill 729 (SB 729) represents a major expansion of fertility care coverage for many people across the state. As this law begins to take effect, Life IVF Center wants you to understand what it does, who it affects, and how to navigate insurance coverage as you pursue fertility treatment. Bill Text – SB-729 Health care coverage: treatment for infertility and fertility services.

What is SB 729?

SB 729 is a state law signed by Governor Gavin Newsom that mandates certain health insurance plans cover the diagnosis and treatment of infertility, including in vitro fertilization (IVF). The law broadens the definition of infertility to be more inclusive of different family structures and reproductive needs.

For many Californians, this means that fertility care services previously excluded or optional may now be covered under their health plan. Coverage becomes mandatory for applicable plans beginning January 1, 2026, although some employer groups and state plans may roll benefits out as late as January 1, 2027. National Law Review+1

Who Is Covered

SB 729 applies to fully insured large-group health plans. These are health insurance policies that employers purchase directly from an insurer, and they cover at least 101 employees. If you are enrolled in one of these plans in California and your policy is issued, amended or renewed on or after the effective date, you should see fertility benefits added. National Law Review+1

Clarifying Misconceptions About Insurance Coverage

It’s important to understand that not all employer health plans are subject to SB 729. A common misunderstanding is that all large employers must provide fertility coverage. In reality:

• Fully Insured Plans are governed by state insurance law. These plans must comply with SB 729’s coverage requirements.

• Self-Funded Plans are governed by federal ERISA law and are not subject to state mandates like SB 729. Many large employers are self-funded, which means the employer itself assumes financial risk for health claims and simply contracts with a third party to administer benefits. If your employer’s plan is self-funded, SB 729 generally does not require fertility coverage.

• Other plans, including small group, Medi-Cal, or plans not regulated by the state’s Department of Managed Health Care, may also be exempt.

Because of these distinctions, it is not accurate to assume all large employers are required to fully cover fertility benefits under SB 729. Instead, plan type and funding structure determine whether the law applies.

What Services Are Covered Under SB 729

For plans regulated by SB 729, the law requires coverage for infertility diagnosis and treatment, including IVF. Some requirements include coverage for:

• Infertility evaluation and procedures

• IVF treatments (often up to three retrieval cycles)

• Embryo transfers under established clinical guidelines

However, not all fertility-related services are guaranteed under every plan. Coverage for adjunctive or add-on services such as:

• ICSI (intracytoplasmic sperm injection)

• PGT (preimplantation genetic testing)

• Genetic carrier screening

• Elective egg freezing or preservation not linked to medical necessity

are dependent on your specific insurance plan’s benefit design and the insurer’s interpretation of medical necessity. These services may be covered, partially covered, or excluded entirely depending on your policy.

Next Steps for Patients

To determine how SB 729 affects your coverage and out-of-pocket costs:

1. Contact Your HR or Benefits Team
   Ask whether your plan is fully insured or self-funded. This distinction determines whether SB 729 benefits apply.

2. Review Your Insurance Documents
   Request and review your Summary of Benefits, Evidence of Coverage (EOC), and Explanation of Benefits (EOB) for fertility services to see what is covered and what isn’t.

3. Speak With Your Insurer
   Verify the specific fertility services covered, any clinical criteria, cost shares (copays, coinsurance, deductibles), and prior authorization requirements.

4. Consult Your Life IVF Center Team
   Our financial counseling team can help interpret benefit details and guide you through insurance authorization, eligibility checks, and anticipated costs.

Life IVF Center’s Commitment to Your Care

At Life IVF Center, we understand that navigating fertility benefits can be complex and stressful. Our team is committed to helping you pursue effective and accessible fertility care. Whether your plan is impacted by SB 729 or not, we are here to support you with clear guidance, benefit support, and personalized treatment options grounded in the latest reproductive medicine.

If you have questions about how SB 729 may impact your care, or if you would like assistance reviewing your benefits, please contact our patient support team.