Family planning and fertility benefits have historically been excluded from most employer-sponsored health care plans—but a new survey from Mercer suggests that lower treatment costs and employers' prioritization of diversity, equity, and inclusion (DEI) initiatives have made fertility services a rising workplace benefit.

More employers are offering fertility benefits

During the 2000s and early 2010s, Mercer's National Survey of Employer-Sponsored Health Plans found that less than 25% of large employers covered in vitro fertilization (IVF), one of the most widely used fertility services.

In recent years, Mercer's survey has measured significant growth in the number of employers who cover IVF treatments and other fertility services, such as elective egg freezing, surrogacy and adoption support, and reimbursement allowances.

The Mercer survey found that as of 2020, 58% of employers with 500 or more workers covered evaluations by reproductive doctors and 27% covered IVF treatments.

In addition, the survey discovered that 11% of U.S. employers with 500 employees or more covered egg freezing in 2020—a significant increase compared with just 5% in 2015. Among firms with 20,000 employees or more, 19% covered egg freezing in 2020.

"Earlier in my career, it was so rare for companies to offer this," said Alice Vichaita, head of global benefits at Pinterest, which covers fertility services for its workforce. "More and more companies are becoming aware that this is really an inadequacy in our health care system."

Many companies cite lower costs, DEI as reasons for fertility benefit expansion

Historically, many companies have not offered fertility benefits, largely due to concerns about the cost, Mercer reports. However, the increase in the number of fertility clinics, as well as the growing demand for their services, has driven down the price, said Gina Bartasi, founder and CEO of the fertility clinic Kindbody.

In fact, 97% of respondents in Mercer's Survey on Fertility Benefits said providing infertility coverage did not result in a significant increase in medical plan costs.

In addition, Mercer says the expansion of fertility services has largely been driven by the desire to attract and retain top talent, to be a family-friendly employer, a greater emphasis on DEI initiatives, and stricter quality guidelines for these treatments.

Employers are increasingly prioritizing DEI initiatives by offering more inclusive and comprehensive benefits packages. Among survey respondents, 40% said they offer coverage to support DEI efforts. 

Notably, respondents that added coverage over the last two years were more likely to have done so in support of DEI. In fact, 61% of respondents cited it as a primary objective, compared with 24% of respondents that offered coverage for over five years.

According to Bartasi, employers have the power to provide alternative options that can help their employees grow their families.

Tanner Brunsdale, senior manager of benefits and mobility at Lyft, which also offers these benefits, said fertility services are key from a DEI standpoint. In fact, Brunsdale said Lyft's benefits aim to help all employees, including LGBTQ+ couples and single parents, become parents through IVF, sperm and egg donation, and other services.

"Within the last five years, this has really taken off," Brunsdale said. "It's kind of table-stakes benefits at this point, especially at a tech company where you're trying to attract strong talent." (Dowling, Mercer US Health News, 5/6/2021; Pandey, Axios, 1/31)