Offering fertility benefits to your employees

Adding or improving fertility benefits at your organization can make a profound difference to your employees struggling to build their families. In 2022, 61% of employers with 500 or more employees offered some fertility insurance coverage¹. Additionally, 58% of benefits specialists believe not offering fertility benefits is discriminatory.

Small to medium-sized businesses can have difficulty providing health insurance, not to mention comprehensive fertility benefits. But, considering that fertility methods cost tens of thousands of dollars, it’s easy to see the appeal of a company of any size that’s willing to help foot the bill.

In this blog post, we’ll go over why you should offer fertility and pregnancy-related benefits, common fertility benefits that employees want, and how you can cover the cost with an integrated health reimbursement arrangement or a stipend.

Takeaways from this blog post:

• It’s more important than ever for employers to offer fertility benefits to attract and retain top talent and be a family-friendly organization. Many employees reported they would switch jobs to have fertility coverage.
• Infertility care is often not covered by health plans, leaving many individuals to pay high out-of-pocket costs for treatments. Providing fertility benefits can lead to long-term healthcare savings, improved employee morale and loyalty, and attract a more diverse pool of job candidates who value inclusive benefits.
• Offering a group coverage HRA or a health stipend is an affordable solution for employers looking to reduce their employees' financial burden when accessing fertility care and other pregnancy-related benefits.

Why you should offer fertility benefits

Offering comprehensive fertility benefits is critical for organizations striving to be more inclusive. After all, fertility isn’t just a women’s issue.

Family-planning benefits should meet the needs of employees of any orientation and gender identity to be genuinely inclusive, including same-sex couples, LGBTQ+ employees, and male staff members. This benefit should also extend to single parents, as an infertility diagnosis can affect any individual regardless of marital status.

Additionally, fertility benefits are becoming a top consideration in today’s job market. A Carrot Fertility study² found that 88% of employees said they would switch jobs to get fertility coverage. 61% of employees with fertility benefits also reported greater company loyalty and improved workplace culture.

With these stats, it’s easy to see that fertility coverage can help employers recruit and retain top talent.

Here are four advantages that come from offering fertility insurance:

1. Long-term healthcare savings by supporting early fertility care
2. Improved employee morale and company loyalty
3. Appeal to a more diverse pool of job candidates that value inclusive benefits
4. Enhanced reputation as a family-friendly organization

Offering family-forming benefits can also be a cost-effective way to increase productivity. An employer benefit that enables employees to access clinical oversight throughout their fertility journey increases the likelihood of a successful pregnancy while decreasing pharmacy costs, invasive treatments, premature infant care, and other health-related costs, leading to them being more present and motivated at work.

Common fertility benefits that employees want covered

Employees who experience an infertility diagnosis may look to their benefits package to see what treatment options their health insurance covers. That’s why some employers have started offering comprehensive coverage for fertility services as part of their health benefits.

According to the World Health Organization³, infertility impacts about 17.5% of adults worldwide, or one in six people. Even an otherwise healthy individual can require infertility care for a wide range of reasons.

Ensuring you’re offering the right fertility benefits that employees commonly ask for is an excellent place to start when designing your health benefits.

The six most commonly covered fertility treatments for employees are:

1. Fertility preservation procedures, including donor egg harvesting, sperm banking, embryo freezing, and donor sperm collection.
2. Intrauterine insemination.
3. Mental health counseling and employee resources for those struggling with fertility issues.
4. Non-in vitro fertilization (IVF) treatment.
5. Diagnostic testing, including genetic screening, imaging, and other examinations.
6. Medical treatment services, including infertility drugs, artificial insemination, and surgery.

Family benefits don’t have to be exclusive to medical conditions. Other popular family-friendly benefits include flexible work schedules, paid maternity and paternity leave, paid time off, adoption assistance, child care, and more.

Does health insurance cover IVF?

Most health insurance plans consider maternity and infant care essential health coverage, but they often don’t cover infertility care. About one in four married women⁴ in the U.S. aged 15 to 49 have trouble getting pregnant, making IVF a popular option. But even though demand grows, insurance companies continue to limit coverage for fertility care.

Access to top-notch reproductive technology is expensive. According to Forbes⁵, the average price of an IVF cycle can cost between $12,000 to $14,000. With fertility medication and other prescription drugs, the financial cost can rise to $30,000.

One insurance provider may cover IVF but not the injections that a covered person may also require. Other plans may only cover a limited number of retrievals per lifetime. Some health benefit plans don’t cover IVF—they may only cover diagnostic services.

If you provide traditional group health insurance, your employees aren’t necessarily guaranteed coverage. So, if IVF is a priority for many of your employees, you’ll want to provide them with a health insurance policy that offers as much coverage for these medical procedures as possible.

Remember, just because a medical professional says someone is a candidate for IVF doesn’t mean they’ll be automatically eligible for care—that’ll be up to the fertility benefits provider, insurance plan, and network providers.

How to confirm if your insurance covers IVF

If you already offer health insurance coverage, you can check your summary of benefits and coverage, summary plan description, or explanation of benefits page to find out if your insurance policy covers IVF. If you have employees asking about their infertility coverage, they can request the most recent copy from your HR department, benefits specialist, or health insurance company.

If you have little to no access to infertility services, there are ways your employees can advocate treatment for a successful pregnancy:

1. They can speak to their fertility specialist about potential IVF clinical trials.
2. They should keep copies of receipts showing they’ve spent money on fertility treatment, diagnostic testing, or other related care. Their financial advisor can determine if they can classify the expenses as “medical” during tax season.
3. If you offer a flexible spending account (FSA), health savings account (HSA), or health reimbursement arrangement (HRA), employees can use those funds towards IVF for that year.
4. They can research fertility financing options.

While it’s your employees’ responsibility to understand their health benefits, you should be able to point them in the right direction for clarification. Additionally, if a fertility doctor is already treating them, they may have access to an onsite financial advisor who can help.

How employers can cover the cost of fertility benefits

Despite a need for infertility services, fertility coverage is inaccessible to many because of the cost. Many insurance companies don’t fully cover most fertility assistance services.

Some employers get supplemental insurance coverage to fill in gaps in their traditional group insurance health plans to remedy this. But even so, a covered individual will most likely still pay high out-of-pocket costs for fertility treatment depending on the fertilization services needed to have a viable pregnancy.

Luckily, the two options we’ll explain below allow you to offer your employees personalized fertility coverage without exceeding your budget.

Integrated HRA

Your first option is an integrated HRA. An integrated HRA, or group coverage HRA (GCHRA), is a tax-free reimbursement arrangement between an employer and a covered individual to help them pay for out-of-pocket costs not fully paid for by their group medical plan.

With a GCHRA, you set a monthly allowance for your employees to use on healthcare. There are no minimum or maximum contribution restrictions with this type of HRA, so if you’re aiming for top fertility care and benefits, the sky's the limit on how much financial assistance you can give your employees.

Eligible expenses related to infertility treatment that are reimbursable with a GCHRA include the following:

1. Fertility and ovulation monitors
2. Visits to fertility clinics
3. Artificial insemination
4. IVF
5. Infertility diagnosis and treatment
6. Fertility preservation coverage
7. Pregnancy tests, medical treatment, and much more

Your staff can’t exceed their allowance, and any unused HRA funds stay with you when an employee leaves the organization, making a GCHRA an affordable solution to offering infertility benefits while increasing your employees' chances of having a successful pregnancy.

Health stipends

Another family-building benefit that can help your employees cover the price of fertility treatments is a health stipend. A health stipend is a fixed amount of money you can offer to employees to buy necessary medical services.

Just like an integrated HRA, there’s no dollar limit on how much you can offer your employees with a stipend. But unlike an HRA, stipend money is typically counted as taxable income, increasing your and your employees’ tax liability.

Health stipends can be easier to administer than HRAs and other health benefit plans. Because you can set up a stipend for anything, they are very flexible to whatever medical services your employees need, whether it’s family planning, IVF, adoption reimbursement, egg retrieval, gestational surrogacy assistance, or child care.

What’s more, when offering health stipends as a supplemental benefit to your existing group plan, they aren’t subject to the Affordable Care Act’s regulations.

However, you can’t require your employees to prove that they’re using their health stipend toward medical expenses, meaning there’s no accountability for whether they use their stipend allowances on fertility or family planning services.

Conclusion

Access to fertility care, IVF, and pregnancy-related benefits are no longer considered a nice-to-have insurance option—they’re a must-have benefit to support your employees and showcase your company as a family-friendly organization. Even in this tight labor market, you can offer top-notch fertility benefits to attract and retain top talent without breaking the bank.

An integrated HRA can provide an all-in-one solution to support a successful pregnancy and fertility benefits at an affordable price. If this personalized employee benefits suits your company, PeopleKeep can help!

Contact us today to see how a customized HRA can work for you and your employees.

This article was originally published on March 2, 2022. It was last updated on January 22, 2024.