SB-62 • 2026

Health care coverage: essential health benefits.

Crime Education Healthcare

Enacted

This bill passed the Legislature and reached final enactment based on the latest official action.

Sponsor: Menjivar
Last action: 2025-10-13
Official status: Chaptered by Secretary of State. Chapter 739, Statutes of 2025.
Effective date: Not listed

Plain English Breakdown

The official source material does not provide specific details on updates to licensing and regulation, so this claim was removed.

Health Care Coverage: Essential Health Benefits

The law requires California to review and establish a new benchmark plan for essential health benefits starting in 2027, adding specific fertility services and durable medical equipment if approved by the federal government.

What This Bill Does

Requires the state to review and establish a new benchmark plan for essential health benefits starting in 2027.
Adds specific fertility services and durable medical equipment as required coverages if approved by the U.S. Department of Health and Human Services.

Who It Names or Affects

Health care service plan providers in California
People who have individual or small group health insurance contracts

Terms To Know

Essential Health Benefits: A set of health services that must be covered by most health plans under federal law.
Benchmark Plan: The specific plan used as a reference to determine the essential health benefits for other insurance plans.

Limits and Unknowns

It is not clear what exact fertility services and durable medical equipment will be covered.
The bill does not specify when or how often reviews of the benchmark plan will occur after 2027.

Bill History

2025-10-13 California Legislative Information
Chaptered by Secretary of State. Chapter 739, Statutes of 2025.
2025-10-13 California Legislative Information
Approved by the Governor.
2025-09-16 California Legislative Information
Enrolled and presented to the Governor at 3 p.m.
2025-09-08 California Legislative Information
Assembly amendments concurred in. (Ayes 39. Noes 0. Page 2604.) Ordered to engrossing and enrolling.
2025-09-03 California Legislative Information
In Senate. Concurrence in Assembly amendments pending.
2025-09-03 California Legislative Information
Read third time. Passed. (Ayes 76. Noes 0. Page 2873.) Ordered to the Senate.
2025-08-21 California Legislative Information
Read second time. Ordered to third reading.
2025-08-20 California Legislative Information
From committee: Do pass. (Ayes 15. Noes 0.) (August 20).
2025-07-16 California Legislative Information
From committee: Do pass and re-refer to Com. on APPR. (Ayes 16. Noes 0.) (July 15). Re-referred to Com. on APPR.
2025-07-01 California Legislative Information
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
2025-06-05 California Legislative Information
Referred to Com. on HEALTH.
2025-05-28 California Legislative Information
In Assembly. Read first time. Held at Desk.
2025-05-27 California Legislative Information
Read third time. Passed. (Ayes 39. Noes 0. Page 1251.) Ordered to the Assembly.
2025-05-23 California Legislative Information
Read second time. Ordered to third reading.
2025-05-23 California Legislative Information
From committee: Do pass. (Ayes 6. Noes 0. Page 1190.) (May 23).
2025-05-16 California Legislative Information
Set for hearing May 23.
2025-05-12 California Legislative Information
May 12 hearing: Placed on APPR. suspense file.
2025-05-02 California Legislative Information
Set for hearing May 12.
2025-05-01 California Legislative Information
From committee: Do pass and re-refer to Com. on APPR. (Ayes 11. Noes 0. Page 965.) (April 30). Re-referred to Com. on APPR.
2025-04-23 California Legislative Information
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
2025-04-11 California Legislative Information
Set for hearing April 30.
2025-01-29 California Legislative Information
Referred to Com. on HEALTH.
2025-01-10 California Legislative Information
From printer. May be acted upon on or after February 9.
2025-01-09 California Legislative Information
Introduced. Read first time. To Com. on RLS. for assignment. To print.

Official Summary Text

SB 62, Menjivar.
Health care coverage: essential health benefits.
Existing law, the Knox-Keene Health Care Service Plan Act of 1975, requires the Department of Managed Health Care to license and regulate health care service plans and makes a willful violation of the act a crime. Existing law requires an individual or small group health care service plan contract issued, amended, or renewed on or after January 1, 2017, to include, at a minimum, coverage for essential health benefits pursuant to the federal Patient Protection and Affordable Care Act. Existing law requires a health care service plan contract
to cover the same health benefits that the benchmark plan, the Kaiser Foundation Health Plan Small Group HMO 30 plan, offered during the first quarter of 2014, as specified.
This bill would express the intent of the Legislature to review California’s essential health benefits benchmark plan and establish a new benchmark plan for the 2027 plan year for health care service plans. The bill would require, commencing January 1, 2027, if the United States Department of Health and Human Services approves a new essential health benefits benchmark plan for the state, as specified, the benchmark plan for health care service plans to include certain additional
benefits, including coverage for specified fertility services and specified durable medical equipment. 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.
The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.
This bill would provide that no reimbursement is required by this act for a specified reason.

Current Bill Text

Read the full stored bill text

Download Bill PDF