What fertility benefits do employees really want?

Fertility benefits are a powerful tool for recruitment and retention — if employers provide the options employees need. In Carrot’s Fertility at Work survey, 45% of respondents had at least some fertility coverage at work — but only 14% of respondents felt like their company’s benefits were enough to meet their family-forming needs.

Part of what makes providing robust fertility benefits challenging is just how complex family-forming can be. To start, employers that provide fertility benefits through insurance usually only cover infertility — when a different-sex couple has been trying to get pregnant for six to twelve months without success. This definition typically applies only to different-sex couples trying to get pregnant through intercourse and leaves out same-sex couples and single-intending parents. And even when employees have access to fertility benefits that provide coverage outside this narrow diagnosis, knowing where to start or what step to take next can be confusing.

Figuring out what fertility, or perhaps more appropriately, family-forming benefits would help employees most starts with understanding the different journeys they may take, what many companies offer today, and what might be missing. Let’s review this more in depth.

What are the most common fertility benefits offered today?

Today, the 30% of employers that offer some fertility coverage are most likely to cover fertility medications (24%) and in vitro fertilization (IVF) treatments (24%). Even if your plan covers IVF regardless of diagnosis, though, that’s not the only path to parenthood your employees need support for. Health insurance rarely covers care related to donor-assisted reproduction, such as donor eggs, sperm, or embryos or gestational carrier (GC) services (commonly known as surrogacy).

Costs related to private adoption or adoption from foster care are also rarely included in insurance plans. Some employers provide supplemental support for paths to parenthood outside of IVF: of the 12% of respondents who had some fertility coverage, 19% had coverage for treatment using donor egg/sperm/embryos, 10% had coverage for GC services, and 24% had access to adoption support. While any fertility coverage can help at least some employees, it’s evident significant gaps exist between what employees need and what’s typically available.

The value of financial support

One of the most impactful ways to support employees pursuing family forming is financially. The average cost of one IVF cycle is $21,600 with prescription medications, and the average patient will undergo at least two IVF cycles to get pregnant. Surveys show that 70% of people using IVF will go into debt to do so. It’s not surprising, then, that 82% of respondents said that financial resources were the best way for employers to support them on their family-forming journey.

And medical care isn’t the only cost associated with family-forming journeys. Donor-assisted reproduction also includes costs for donor sperm or eggs and often involves legal fees. Adopting a child from foster care costs up to $5,000, while domestic private adoptions typically cost from $30,000 to $50,000. Providing financial support for paths beyond IVF helps make these family-forming options more possible for employees, including LGBTQ+ employees, who are more likely to plan to use donor-assisted reproduction or adoption to grow their families.

Financial support also helps employees who are interested in preserving their fertility or learning more about it. Only 11% of companies with 500 or more employees and 19% of employers with 20,000 or more employees provide coverage for egg freezing — and egg freezing is only one method of fertility preservation. Fertility preservation, which can also include sperm or embryo freezing, is a valuable option for those looking to grow their family later as they focus on their careers and those with certain medical conditions that may impact their fertility, such as cancer or endometriosis.

Why care navigation matters, too

For many fertility and family-forming journeys, care navigation is just as important as financial support. Without a knowledgeable guide, it can be difficult — and stressful — to know where to begin in the process or how to take the next step, especially since fertility benefits are a relatively new concept and employees may be unclear on what services are covered. In healthcare in general, 27% of people have avoided care because they were unsure of what their plan covered. While delays in any care can lead to higher costs down the road, this is particularly true in fertility — as people age, success rates for fertility treatment fall and the chances of high-risk pregnancies (in particular, multiples as a result of multiple embryo transfers) rise. The right clinical guidance and care navigation support can help employees understand their benefits and make the healthiest decisions possible — at the right time.

Family-forming paths that involve both medical and non-medical care can be difficult to navigate, as well. GC journeys, for example, are particularly complex, with legal considerations that vary by state. When a Carrot member is interested in pursuing a GC journey, Carrot Experts work closely with them to create a plan based on their unique situation and needs. Members also have access to Carrot’s vetted network of GC agencies and attorneys with experience creating GC agreements and birth orders so they’re supported each step of the way.

For many people, fertility and family forming needs go beyond coverage for a few doctors’ appointments. Providing guidance and financial support for each step of the way helps make family-forming possible for your employees. If you’re ready to offer employees fertility and family-forming benefits that meet all of their needs, get in touch with us.

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