Apr 08, 2025
Two California Bills - Both Effective July 1, 2025
California SB 729
Passed September 29, 2024 - Effective on or after July 1, 2025
This bill would require large and small group health care service plan contracts and disability insurance policies issued, amended, or renewed on or after July 1, 2025, to provide coverage for the diagnosis and treatment of infertility and fertility services.
With respect to large group health care service plan contracts and disability insurance policies, the bill would require coverage for a maximum of 3 completed oocyte retrievals, as specified. The bill would revise the definition of infertility and would remove the exclusion of in vitro fertilization from coverage.
The bill would also delete a requirement that a health care service plan contract and disability insurance policy provide infertility treatment under agreed-upon terms that are communicated to all group contract holders and policyholders.
The bill would prohibit a health care service plan or disability insurer from placing different conditions or coverage limitations on fertility medications or services, or the diagnosis and treatment of infertility and fertility services, than would apply to other conditions, as specified.
The bill would make these requirements inapplicable to a religious employer, as defined, and specified contracts, and policies.
Because the violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program.
Resources
From CALMatters - SB 729: Health care coverage: treatment for infertility and fertility services
Bill Text - SB-729 Health care coverage: treatment for infertility and fertility services
Letter from Governor Newsom dated September 29, 2024 requesting the July 1, 2025 effective date be moved to January 1, 2026 to allow an evaluation of the costs and benefit design in the bill. To date there has not been an extension of the effective date.
California AB 2843
Passed September 29, 2024 - Effective on or after July 1, 2025
Existing law requires a victim of sexual assault who seeks a medical evidentiary examination to be provided with one, as specified.
Existing law prohibits costs incurred by a qualified health care professional, hospital, clinic, sexual assault forensic examination team, or other emergency medical facility for the medical evidentiary examination portion of the examination of the victim of a sexual assault, as described in a specified protocol, when the examination is performed as specified, from being charged directly or indirectly to the victim of the assault.
This bill would require a health care service plan or health insurance policy that is issued, amended, renewed, or delivered on or after July 1, 2025, to provide coverage without cost sharing for emergency room medical care and follow-up health care treatment for an enrollee or insured who is treated following a rape or sexual assault for the first 9 months after the enrollee initiates treatment, as specified.
The bill would prohibit a health care service plan or health 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.
Because a violation of the bill by a health care service plan would be a crime, the bill would impose a state-mandated local program.
Resources
Bill Text: CA AB2843
Summary of the Bill from California Health Benefits Review Program
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