Blogs

One in eight U.S. couples will have difficulty conceiving or carrying a pregnancy to term. The number increases when same-sex or single-by-choice parents are included. Fertility treatment encompasses a wide range of medical procedures for both men and women, from simple consultations with specialists to in vitro fertilization (IVF). Traditional employer-provided insurance often considers these procedures “elective” and offers minimal or no coverage. As a result, treatment is often out of pocket and an incredibly stressful financial event for many employees.

A single cycle of IVF can cost between $15,000 to $30,000, with medication costing an additional $5,000-$10,000. The average IVF patient completes three rounds. This cost is only the tip of the iceberg, with hopeful-future parents also paying for consultations, diagnostic testing, and the various treatments that lead up to IVF. Without coverage, employees are forced to take out loans, go deeply into debt, or look for new jobs with organizations that offer coverage.

Still, infertility coverage is often considered an “extra” or unattainable benefit, even though 97% of organizations that offer fertility coverage have not seen an increase in healthcare costs. In fact, offering fertility coverage can result in decreased healthcare costs. Employees without insurance are more likely to pursue less expensive but less effective treatments with a higher likelihood of a multiples birth. For example, an employee may transfer multiple embryos instead of just one, substantially increasing the possibility of twins or triplets. This can result in a high-risk pregnancy or premature birth, and subsequently, an extensive and expensive hospital visit—the cost covered by the employee’s insurance. In fact, research from the March of Dimes shows that employers pay 12 times as much in health care costs for premature babies as babies born without complications.

Offering fertility coverage does more than just help create families—it makes loyal, dedicated employees. A 2016 survey conducted by Resolve found that employees pursuing IVF with employer-provided IVF benefits had higher satisfaction than those without coverage. Covered employees were also less likely to miss time from work for treatments, psychological stress, depression, or other conditions related to infertility. They were more likely to recommend their employers as a place to work and felt their employers listened and met their needs. Similarly, a 2017 survey from FertilityIQ of patients who had undergone IVF found that employees with covered IVF were more likely to remain in their job for a long period (62%), more willing to overlook employer shortcomings (53%), and more likely to work harder (22%).

For many employers, offering fertility coverage is optional. However, seventeen states, including Texas and California, have passed mandatory fertility laws with varying required coverage levels. Colorado passed the Colorado Building Families Act, which was scheduled to go into effect on January 1, 2022, and would have mandated coverage for many (but far from all) in the state. However, the law was postponed in November 2021. Though a fix is in the works, the earliest the law will go into effect is July 1, 2022, or January 1, 2023. In the meantime, families counting on that coverage are stuck in a holding pattern, or in some cases, will look to work for organizations that offer coverage.

Employers interested in offering fertility coverage to their employees should reach out to their brokers to determine how to add it to their present health insurance offerings. Another option is partnering with organizations that offer fertility-only coverage that works with employer-provided insurance. With add-on coverage, employers have more flexibility with spending. Importantly, given the spectrum of fertility treatments, coverage should be inclusive and have a wide network covering various treatments.

All members can find more benefits information here. Members with consulting services, please contact Employers Council with questions.