California AB 2843 and SB 729 effective July 1, 2025 - Updated Carrier Responses Chart
California AB 2843 and SB 729 effective July 1, 2025 - Updated Carrier Responses Chart
7/1/2025
Both bills are effective July 1, 2025.
The charts below provide carrier specific information as to how each will be communicating the requirements.
AB 2843
- Effective July 1, 2025
- Applies to individual, small, and large group fully insured plans in California
- Requirement of a health care service plan or health insurance policy that is issued, amended, renewed, or delivered on or after July 1, 2025
- Must provide coverage without cost sharing for emergency room medical care and follow up health care treatment following rape or sexual assault for the first 9 months after enrollee initiates treatment
- The bill prohibits the plan or insurer from requiring, as a condition of providing coverage:
- An enrollee or insured to file a police report
- Charges to be brought against an assailant
- Or an assailant to be convicted of rape or sexual assault
| Carrier | AB 2843 |
|---|---|
| Aetna | Carrier states this is being administered through the claims processing for members |
| Anthem | Pending carrier response |
| Blue Shield | Currently under implementation, EOCs and SOBs will be updated |
| Health Net | No changes to SOBs, will depend on diagnosis code on submitted claim |
| Kaiser | Will be in compliance by July 1, 2025 |
| MediExcel | Will be revising EOC and other documents for DMHC review - expected to have approval mid-June. |
| Sharp Health Plan | Plans will be in compliance with the benefit taking place through claims processing. EOCs will be amended but SOBs will not. |
| Sutter | Language will be added to EOCs effective July 1, 2025 regarding Emergency Services and Urgent Care. |
| UHC | Pending carrier response |
| WHA | Pending carrier response |
SB 729
NOTE: The Governor of California did request that the effective date for SB 729 be moved to January 1, 2026. Still waiting to hear if California Legislation that includes this extension has been enacted.
- Effective July 1, 2025
- Requires fully insured large group health plans in California to cover infertility benefits (large group = 101+ employees)
- Fully insured small group health plans in California can offer infertility benefits but are not required to do so
- Benefit must cover diagnosis and treatment of infertility and fertility services
- The bill requires coverage for a maximum of 3 completed oocyte retrievals and unlimited embryo transfers
- Limits cost sharing to the same structure as for other benefits (parity)
- The bill revises the definition of infertility and removes the exclusion of in vitro fertilization from coverage
| Carrier | SB 729 |
|---|---|
| Aetna | Plan names will include 'wINF', updated ER application is coming for July 1, 2025 effective plan years |
| Anthem | New infertility rider available in SOBs. Delaying the implementation of SB 729 for Large Group until January 1, 2026, |
| Blue Shield | 18 new infertility riders added to SOB documents. 3Q25 rates for plans with Infertility benefits remain as previously released. |
| Health Net | Updated SBCs are available on our site, Carrier created two SBCs for each plan (one including infertility and one without) |
| Kaiser | Pending carrier response |
| MediExcel | SB 729 not applicable |
| Sharp Health Plan | The ART C rider will no longer be offered. Plans will now be available with or without Infertility, built into the plan designs, available for all group sizes. New INF SOBs are available on our website |
| Sutter | Will imbed coverage for all large group employers with new or renewing plans effective on or after July 1, 2025 - Amwins Connect Article |
| UHC | Carrier has prepared EOC language and applicable changes for INF coverage to small group, new and renewing, effective July 1, 2025. |
| WHA | Pending carrier response |
The charts will be updated as carriers provide the latest information regarding their implementation of the requirements.
While every effort has been taken in compiling this information to ensure that its contents are totally accurate, neither the publisher nor the author can accept liability for any inaccuracies or changed circumstances of any information herein or for the consequences of any reliance placed upon it. This publication is distributed on the understanding that the publisher is not engaged in rendering legal, accounting, or other professional advice or services. Readers should always seek professional advice before entering into any commitments.
