Fertility services can be attractive benefit

In an effort to attract and retain top talent, employers are offering a variety of family-friendly benefits including fertility services, according to a new survey.

According to the Employee Benefits Survey 2016, conducted by the International Foundation of Employee Benefit Plans, a quarter of employers (24%) with 500 or more employees offer fertility services as part of their healthcare benefits. Nineteen percent cover in vitro fertilization (IVF) treatments, 12% cover fertility medications and 9% cover non-IVF fertility treatments. Smaller numbers cover visits with counselors (geneticists, surrogacy, etc.), at 6%, or egg harvesting/freezing services, at 4%.

Fertility experts Karin Ajmani, president of healthcare services at Progyny, and  Brian A. Levine, practice director, Colorado Center for Reproductive Medicine (CCRM), New York location, talk to Managed Healthcare Executive (MHE) about the details of fertility plans, including cost, implementation pros and cons, and coverage variability.

Q: MHE: What is a fertility benefits plan?

Ajmani

Ajmani: About 25% of employers offer some coverage for infertility treatments and that percentage is growing annually due to the recognition that infertility is a medical condition like any other (in 2015, the World Health Organization officially designated infertility as a disease). Typical infertility benefits are not comprehensive and only cover fertility medications or a very limited amount of infertility treatments. Most infertility benefits currently offer a defined dollar maximum, and do not cover all of the costs associated with the consultation, diagnostic testing, and latest infertility treatment technologies which drive success rates. Therefore, patients suffer longer, with higher rates of infertility treatment failures, higher miscarriage rates, and much higher out of pocket costs (the typical retail rate for one full IVF cycle including diagnostic testing and labs is as high as $20k per cycle). Since the average fertility benefit only covers $10k, and it takes about 3 IVF cycles to obtain a successful live birth, patients are forced to make difficult decisions about what treatments to pursue based on cost, not best practice. 

 

 

Levine

Levine: A fertility benefit plan is additional coverage for fertility and infertility benefits to an existing insurance policy. There are about 15 states where fertility and infertility benefits are ‘mandated’ by the state legislature. With that said, the breadth and depth of coverage can vary quite a bit.

 

Q: MHE: What is happening in the healthcare landscape that would make this attractive?

Ajmani: Employers are getting hit hard with medical costs related to high-risk pregnancies and NICU expenses as a result of employees seeking infertility treatments. And this trend is only going to increase, as the average age of women having children increases. Currently, one in five couples now have their first child at 35 years of age or older, let alone their second or third child. People struggling to get pregnant don’t stop if they don’t have a fertility benefit; they simply pay out of pocket and begin with less-expensive, less-effective technologies, such as fertility medications or intrauterine insemination (IUI), lending to the high rate of twins. It is widely known that pregnancies involving twins result in much higher prenatal, maternity and neonatal intensive care unit (NICU) expenses. Any employer looking to support their employees during the stressful and expensive journey of infertility will be interested in this benefit. Employees who struggle with infertility face higher rates of depression and absenteeism in the workplace, as well as turnover. The employees who need to utilize their fertility benefit is small, less than 1% 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 recognize that providing coverage is the right thing to do from both a cultural and cost perspective. By enrolling in this type of benefit, human resource directors are able to retain and attract employees, especially millennials. Sixty-eight (68%) percent of millennials take coverage for fertility preservation, such as egg freezing, and infertility coverage into consideration when choosing an employer.

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