California AB 2843 & SB 729 - Carriers Responses
Both Bills are effective July 1, 2025.
The charts 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 | Pending carrier response |
MediExcel | Pending carrier response |
Sharp Health Plan | EOCs will be amended, SOBs will not be impacted, plans will be in compliance with the law |
Sutter | Pending carrier response |
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. This has not yet been changed so we are documenting the carriers’ information as if the effective date is July 1, 2025 until we hear different.
- 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 | Pending carrier response |
Blue Shield | Waiting for DHMC to approve the new SOBs/SBCs |
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 | Pending carrier response |
Sharp Health Plan | Updated SOBs are available on our site |
Sutter | Pending carrier response |
UHC | Carrier is preparing to offer the mandated 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.