May 29, 2025
California Senate Bill 729 (SB 729) was signed by Governor Newsom in 2024 and provides coverage for medically necessary diagnosis and treatment of infertility. It covers both men and women with certain group coverage and includes fertility services such as office visits, labs, imaging, drugs, and procedures, including In Vitro Fertilization (IVF).
Kaiser Permanente is awaiting final regulatory approval from the DMHC for our benefit offerings and implementation timing. There is a possibility that implementation may be delayed from July 1, 2025, to January 1, 2026. We will release an update if any changes are required from the DMHC.
Large Group Update:
Access to fertility care will be expanded because of the new California Senate Bill 729. With a current effective date of July 1, 2025, as contracts renew, Kaiser Permanente will provide coverage for the diagnosis and treatment of infertility/fertility treatments.
Coverage details are currently being reviewed by the Department of Managed Health Care (DMHC). Once the DMHC approves Kaiser Permanente's implementation approach, plan documents such as EOCs will be updated accordingly for all fully insured large employer groups that offer fertility service in accordance with SB 729.
Kaiser Permanente will continue to provide additional information as it becomes available. In the meantime, you can review the coverage details below (pending DMHC approval). Please share the coverage details with your employees who will receive the expanded fertility benefits.
SB 729 offers coverage for the following fertility treatments and procedures, including:
- Diagnosis and treatment of infertility
- Artificial insemination (IUI)
- In Vitro Fertilization (IVF)
*If the lifetime maximum for egg retrievals is reached, Kaiser Permanente will not cover any future services related to egg retrievals including prescription drugs.
Cost share and accumulations for fertility services will match the plan's cost sharing that applies to non-fertility medical services (e.g., plan’s cost share for the same type of service, lab, imaging, etc.). Fertility drugs will be covered, equal to plan’s generic/brand /specialty cost share.
For large group customers renewing between July and December 2025, the benefit will be included as part of the renewal. As a contract renews and SB 729 coverage is included, this expanded benefit will act as a benefit reset. A covered member will be eligible for SB 729 services, regardless of whether the member has accessed or exhausted any previous supplemental fertility services coverage.
Small Group Update:
All existing employers and brokers with INF plans, both ACA-metal and grandfathered, will receive a one-time email notification informing them of the benefit enhancements at time of renewal, beginning mid-June (pending DHMC approval). I’ll be sure to forward this update to you, our GA partner.
How will a member be informed of SB 729 fertility coverage?
Kaiser Permanente will provide information about fertility benefit coverage and how to access care to your employees who are members. Kaiser Permanente members can always reach out to the Member Services at kp.org/supportcenter or call 1-800-464-4000, 711 TTY available 24/7 for most services and more than 150 languages using interpreter services.
Kaiser Permanente’s Member Services representatives will be able to respond to any member questions about SB 729. If a member has any questions or wants more information about these changes, they can contact member services at kp.org/supportcenter or call 1-800-464-4000, 711 TTY available 24/7 for most services, offering more than 150 languages using interpreter services.
Where can a Kaiser Permanente member receive fertility services?
In Northern California, Kaiser Permanente provides comprehensive fertility care at our Kaiser Permanente’s Centers for Reproductive Health (CRH) - California Fertility Clinic (Bay Area) | Kaiser Permanente Centers for Reproductive Health.
In Southern California, the Southern California Permanente Medical Group (SCPMG) REI physicians provide IVF care in a variety of high-quality, conveniently located non-KP IVF centers within the Southern California region. All covered patients are seen at a Kaiser facility by an SCPMG REI physician who coordinates their care. Intrauterine Insemination (IUI) procedures are performed at a Kaiser facility and In-vitro Fertilization (IVF) services are performed by KP physicians at contracted facilities.
Where can members find more information about fertility care and local services at Kaiser Permanente fertility?
Members can ask their ob-gyn and visit the following pages to obtain clinic specific information along with fertility services:
- kpivf.com (Northern California)
- fertilitycare-southerncalifornia.kaiserpermanente.org (Southern California)
To learn more about Kaiser Permanente reach out to your Amwins Connect Regional Sales Manager.
