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Fertility Services Distinguish Employers as Family Friendly

Nearly a fifth of large employers cover in-vitro fertilization treatments

A man and woman sitting at a table with a doctor.

Employers are offering family-friendly benefits like fertility services to recruit and keep younger employees. Traditional benefits that parents with young children hold in high regard, such as flexible work hours, also create a competitive advantage in hiring and engaging top talent.

A recent study by the nonprofit International Foundation of Employee Benefit Plans (IFEBP) in Brookfield, Wis., shows that among large employers (those with 500 or more employees):

  • Nearly a quarter (24 percent) now offer fertility services as part of their health care benefits.
  • 19 percent cover in-vitro fertilization (IVF) treatments.
  • 12 percent cover fertility medications.
  • 9 percent cover non-IVF fertility treatments.

Smaller numbers cover visits with counselors (genetic, surrogacy, etc.), at 6 percent, or egg harvesting/freezing services, at 4 percent.

The IFEBP report, Employee Benefits Survey 2016, analyzed responses received earlier this year from 577 HR and benefits professionals.

"Fertility services are a highly valued benefit for employees, often with a low cost impact for employers," said Julie Stich, IFEBP's director of research. "Employees who have access to fertility benefits can actually have overall lower health care costs because they are making decisions with their doctors based on medical best practice, not on personal financial concerns."

Fertility benefits can lower overall health costs.

Fertility services are more common among employers that have at least 500 employees, she noted. Only 4 percent of employers with fewer than 50 employees offer fertility services.

Employers with a self-funded health plan are also more likely to offer fertility services than those with insured plans.

Consistent with these findings, the 2016 Employee Benefits report by the Society for Human Resource Management, based on a random sampling of SHRM members, showed that IVF coverage was provided by 26 percent of respondents. Egg freezing for nonmedical reasons was provided by 3 percent of organizations.

Currently, 15 states require individual and group insurers to offer fertility coverage but benefits and exceptions vary.

Earlier this year, Mercer, an HR consultancy, announced it was partnering with fertility services firm Progyny to provide employers with reproductive assistance benefits, including egg freezing, IVF treatment, non-IVF fertility treatments and medications. The fertility benefits, which include neonatal care and counseling, are also intended to help employers to reduce newborn intensive care unit (NICU) and associated high-risk maternity-related costs.

"Fertility benefits are becoming a key topic for employers and employees alike," said David Kaplan, leader of Mercer Health Innovation LABS. "This interest is not only being driven by talent and retention-related issues, but also by the high cost for employers who, whether they offer infertility benefits or not, are still incurring much of the NICU and associated high-risk maternity-related expenses."

Fertility and neonatal benefits are "helping both employers and their employees better manage the financial and emotional burden of infertility," he noted.

"We're seeing companies interested in adding [fertility benefits] because they know how valuable it is for employee retention and overall wellbeing," said Karin Ajmani, president of healthcare services at New York City-based Progyny. "Employees who struggle with infertility face higher rates of depression and absenteeism in the workplace, as well as turnover," she noted. "The employees who need to utilize their fertility benefit is small, less than 1 percent per year, but they're disproportionately more vocal and proactive in their quest to obtain coverage through their employers. In the end, HR and benefits executives are recognizing that providing coverage is the right thing to do from both a cultural and cost perspective." 

The most significant return on investment is related to medical cost avoidance, Ajmani explained. "If an employee doesn't have fertility coverage, or has limited coverage, they'll choose less expensive, less effective treatment options, such as fertility meds and artificial insemination, that have the highest chance of producing twins or multiples." That can result in higher costs for prenatal care and delivery, often including C-sections, pre-term births and NICU services—medical expenses covered through an employer's insurance.

"Those downstream expenses far outweigh having a comprehensive fertility benefits plan [that would include] counseling to guide employees through the opaque maze of fertility options and coverage for the latest technologies," Ajmani said.

Flexible Work Schedules

Among other efforts to woo workers who are starting new families or have young children, IFEBP found that among employers of all sizes—from less than 50 to more than 10,000 employees:

  • More than one-third (37 percent) offer paid maternity leave.
  • Nearly one quarter (24 percent) offer paid paternity leave.
  • 19 percent offer paid leave for adoption.

Employers are also offering leave to attend a child's activities—9 percent provide paid leave, and 21 percent offer unpaid leave.

"Employers are striving to create a workplace culture that is family-friendly," said Stich. "Offering paid leave and flexible schedules help employees strike a better work/life balance. It also allows employees to remain at their most focused and productive while at the office."

To that end, IFEBP found that 47 percent of employers offer flexible work hours or compressed workweeks, while 9 percent offer job sharing (where two or more part-time workers share one full-time job).

Other family-friendly perks offered by employers include:

  • Dependent care flexible spending accounts (69 percent).
  • Resource and referral services for child care (22 percent).
  • Resource and referral services for adopted children (14 percent).
  • Take Your Child to Work Day (17 percent).
  • Financial assistance for adoption (16 percent).
  • Emergency/sick child care (10 percent).
  • Onsite or near-site child care (8 percent).

Less common were the following family benefits:

  • Child care subsidies (3 percent).
  • Special needs child care (1 percent).
  • Bringing babies to work (1 percent).
  • Shipping breast milk for new mothers who travel (1 percent).

Related SHRM Articles:

How to Weigh the Value of Paid Parental Leave, SHRM Online Benefits, April 2016

Leading-Edge Reproductive Benefits Raise Cost Concerns, SHRM Online Benefits, November 2015

Egg-Freezing Benefit from Facebook, Apple Raises Workplace Questions, SHRM Online Diversity, October 2014


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