With infertility affecting 1 in 8 individuals in the U.S., many Americans wish to remove the stigmas and barriers that stand in the way of building families. In recognition of National Infertility Awareness week, April 18th through April 24th, I would like to share some insight into how employers can be a part of the solution by considering the range of options in offering supportive fertility benefits to their workforce.
High Cost To Employees
Today, the cost of fertility treatments is primarily borne by your employees today. The therapies are expensive and include vitro fertilization (IVF), artificial insemination, egg freezing, surrogacy, adoption, genetic testing, or a combination of them. The average spend for IVF in the U.S. ranges from $40,000 to $60,000. Egg freezing costs between $6,000 to $10,000, with an on-going expense of $500 per year. The average cost for adoption is roughly $43,000. These are high price tags, with no guarantee of success. The emotional and psychological toll of multiple rounds of treatments and fertility drugs can also have a significant impact on employees. As a result, many are turning to their employers for guidance and support. According to Fertility IQ, more than 32% of employees have indicated that they would stay with a company longer if they offered a fertility benefit. This is why a fertility benefit could be a valuable addition to an employer’s retention and recruitment strategies. For the most part, health plans do not cover fertility services. They generally offer a narrow definition of coverage. This might include the office visit to test for a medical diagnosis of infertility, or limited coverage to treat the underlying health condition. Beyond that, most infertility treatments and some prescription drugs are typically excluded. That means employees have to shoulder these large, out-of-pocket expenses.
Key Considerations
There are several options for employers to consider in order to support their employees’ fertility journey:
1. Add a Rider to the Health Plan: Since most health plans exclude, or limit, infertility benefits, a rider could be added to your health plan. This would be a specified service, such as IVF or other embryo transfer procedures, artificial insemination, ovulation induction and/or egg freezing. They typically include a benefit cap, or a maximum number of cycles. A rider typically adds 5-7% to the overall health plan costs, and it could also drive up medical and pharmacy claims. A rider also comes with administrative burdens, including on-going approvals, and the need for a responsive doctor’s office that is willing to work with the insurance company. Finally, employers should recognize that fertility treatments are not an inclusive benefit. An individual must have a medical diagnosis of infertility to qualify for the coverage, which could exclude same-sex couples.
2. Build a Reimbursement Benefit: Similar to a reimbursable business expense, some employers are offering additional benefits and perks through a variety of platforms. For adoption assistance and surrogacy benefits, some have decided to move the benefit in-house and have employees submit requests for reimbursement. With this option, there are a variety of compliance implications, such as writing a plan document, updating the employee handbook, and understanding any tax implications.
3. Direct-to-Consumer Approach: There are many point solutions on the market that individuals can purchase. Most of them offer access and discounts to their network of high-quality, vetted fertility clinics. They also offer educational information and resources for individuals and couples.
4. Fertility Point Solution: Many employers are attracted to a fertility point solution. This approach offers the ability to tailor a custom benefit offering, it is inclusive, and it takes the administrative and compliance burdens off of the employer. Vendor solutions span the spectrum from low-cost mobile apps to robust services that provide personalized assistance throughout the process. Additionally, some vendors contract with international providers that must adhere to strict clinical and regulatory qualifications as they do in the U.S.
5. Promote the Pre-Paid Legal Plan: If an employee is considering adoption or surrogacy, legal services are an important part of the process. Many employer-sponsored legal plans help discount legal fees from attorneys who specialize in family law, including adoption and surrogacy.
6. Remind Employees to Leverage Their HSA: A Health Savings Account (HSA) offers many advantages to individuals, such as lowering their taxable income through pre-tax contributions, and building a medical safety net over time. It’s even better if the employer contributes to the account to aid in the long-term growth of an employee’s HSA balance.
7. Mental Health and Fertility: Studies show that 50% of women and 15% of men report that infertility was the most upsetting experience in their lives. Financial issues aside, the emotional swings throughout the fertility journey can lead to depression and anxiety. If a fertility benefit is not right for your organization at this time, a mental health solution might be the next best thing.
8. Revisit Your Flexible Working Policy: Individuals going through IVF, for example, are faced with many appointments that must be carefully planned. Flexibility during working hours can go a long way to demonstrate an employer’s support, at little to no cost to the organization.
Like any new offering, employers must first consider the demographics of their employee population. They should evaluate if a fertility benefit fits within the company’s strategic planning and priorities. A successful solution, supported by leadership, must also fit within the culture and values of the organization. Finally, employers must weigh the benefits and costs of implementing a new program.
If you are interested in designing a fertility benefit that supports the wellbeing of your employees and promotes long-term employee satisfaction, please contact our Employee Health & Benefits Consultants at Marsh & McLennan Agency. www.MarshMMA.com
Katie Jones is a Client Service Executive in MMA’s Employee Health & Benefits Division, providing world-class customer service and support to clients with enrollment, claims, and any other needs that arise. Katie has over 12 years of experience in the insurance industry and recently completed an Executive MBA with an emphasis on leadership, innovation and global business strategies at Loyola Marymount University.
