On July 9, 2026, Gov. Green signed HB 1864, which requires insurers to cover fertility preservation services for individuals undergoing medically necessary treatments that may cause iatrogenic infertility, including surgery, chemotherapy, or radiation. The requirement applies to all policies, contracts, plans, and agreements issued or renewed after December 31, 2026. Hawaii is now the 22nd state to require coverage for fertility treatments for individuals at risk of iatrogenic infertility, a requirement intended to help patients with cancer access fertility preservation treatments.
Employers that sponsor fully insured group health plans in Hawaii should consult with their carriers and amend their plans as necessary to conform to the new legislation. Employers offering self-insured group health plans in Hawaii should consider whether to add fertility coverage to their plans. While self-insured group health plans ordinarily are exempt from state insurance laws, Hawaii’s Prepaid Health Care Act requires employers to receive approval from the state Department of Labor and Industrial Relations before offering a self-insured plan to employees in Hawaii.
For the full text of the legislation, please see HB 1864 enacted text.