Colorado's Building Families Act (HB20-1158), signed April 1, 2020, requires state-regulated plans to cover infertility diagnosis, treatment including IVF, and fertility preservation, with no extra cost-sharing. A 2022 law, HB22-1008, made the requirement firm for large-employer plans; for individual and small-group plans it waits on a federal decision. In a 2025 state analysis, only 36% of individual and 25% of small-group enrollees had IVF coverage. Picture as of October 2026.
| Point | Colorado rule | Source |
|---|---|---|
| What must be covered | Infertility diagnosis, infertility treatment and fertility preservation | HB20-1158 (2020) |
| IVF scope | Up to 3 completed egg retrievals with unlimited embryo transfers, following ASRM guidelines | Triage Cancer, September 2025 |
| Cost-sharing | No deductibles, copays, coinsurance, benefit maximums, waiting periods or other limits that do not apply to other covered services; fertility drugs treated like other prescriptions | HB20-1158 |
| Religious employers | May request an exclusion if the coverage conflicts with bona fide religious beliefs | HB20-1158 |
| Large-employer plans | Required without waiting for a federal defrayal decision | HB22-1008, signed April 13, 2022 |
| Individual and small-group plans | Required only from January 1 of the year after federal HHS confirms the state does not have to pay for it | HB22-1008 |
HB20-1158 was written for plans issued or renewed on or after January 1, 2022; the 2025 Milliman analysis for the Colorado Division of Insurance says the large-group market has been subject to the mandate since 2023.
The Milliman analysis for the Colorado Division of Insurance (April 16, 2025) found that individual and small-group plans cover diagnosis and IUI/ICI through the state's essential health benefit benchmark, but IVF was patchy: in a November 2024 carrier survey, 36% of individual and 25% of small-group enrollees had IVF coverage. A 2024 bill to extend the large-group benefits to these plans, HB24-1025, was introduced but not passed. Whether individual and small-group IVF coverage has been required since then could not be confirmed.
If you have a fully insured large-employer plan, the Building Families Act should apply. If you buy your own plan or work for a small employer, you may have diagnosis and IUI covered but not IVF. And state mandates do not apply to self-insured employer plans, which cover 67% of US workers with employer coverage (healthinsurance.org, June 2026). Your plan documents or HR department can tell you which kind of plan you have.
Map to the Positive stresses that IVF success rates vary by age, so you should get the numbers for your own case. The approximate rates per transfer with your own embryo that the book gives:
| Age | Success rate per transfer |
|---|---|
| Under 35 | 40% to 55% |
| 35 to 37 | 30% to 40% |
| 38 to 40 | 20% to 30% |
| 41 to 42 | 10% to 15% |
| Over 43 | Less than 5% (donor eggs are frequently recommended) |
Approximate reference from Map to the Positive, Chapter 34. Not Colorado data.
With a set number of covered retrievals, ask your specialist how many attempts they suggest before revisiting the strategy.
These rates are from Chapter 34 of Map to the Positive, in Station IV, which lays out every treatment level from ovulation induction to IVF with donor eggs. The same station covers when to see a specialist, choosing a doctor and each phase of IVF.
Take 30 days. If it does not give you more clarity than everything you have read for free so far, ask for a refund and you get every cent back. We cannot promise you a pregnancy. We can promise you will not be guessing.
References: HB20-1158 Insurance Cover Infertility Diagnosis Treatment Preserve (Colorado General Assembly) (accessed 2026-10-30) · HB22-1008 (Colorado Capitol Watch bill record) (accessed 2026-10-30) · Fertility treatment coverage analysis, Milliman for the Colorado Division of Insurance (2025-04-16) · Health Insurance: Fertility Services (Triage Cancer state laws chart) (2025-09) · Q. Does the ACA require infertility treatment to be covered by health insurance? (healthinsurance.org) (2026-06-18)