Benefit Flexibility
| Feb 17 2022

Family-Friendly Benefits Take Off

Samantha Purciello
Senior Associate, Mercer

Benefits to support fertility and family-building historically have been offered by only a small slice of employer-sponsored health care plans -- but that’s changing fast. When it comes to attracting and retaining employees in today’s tight labor market, family-friendly companies that support members on their various paths to parenthood have a distinct advantage.

For many years, there was no discernible upward trend in coverage for infertility treatment in employer health plans. Throughout the 2000s and early 2010s, Mercer’s National Survey of Employer-Sponsored Health Plans consistently found that fewer than a fourth of large employers (those with 500 or more employees) covered in vitro fertilization (IVF), one of the most widely used fertility services. But in 2020 that rose to 27% -- and then jumped to 36% in 2021. Among very large employers – those with 5,000 or more employees – 47% now provide this coverage.

Fertility benefits can demonstrate a commitment to inclusivity

Today, a growing number of companies see fertility benefits as central to their DEI objectives. Not only are employers focusing on providing services for members diagnosed with infertility, but they’re looking beyond to provide support that is relevant regardless of gender, sexual orientation, single or partnered status or medical condition. To that end, some companies are also adding financial support for employees whose path to parenthood is through adoption or surrogacy.

Coverage for elective egg freezing can be of help to women who may choose to delay childbearing to focus on their career or for other reasons. More employers are considering offering elective egg freezing in particular as a way to attract and retain female employees, but also as a part of their broader inclusion strategy. While this isn’t commonplace, we saw an increase from 5% of employers with 500 or more employees cover egg freezing in 2015 up to 15% in 2021. Among very large employers (5,000 or more employees), this reaches 21%.

Employers in the tech industry were at the forefront of expanded fertility benefits, and they still lead in some areas -- for example, of the 162 high-tech employers with 500 or more employees responding to the survey, 55% cover IVF and 30% cover egg freezing. However, we’re seeing growth in family building benefits in virtually all industry sectors as employers seek new levers to attract and retain key talent.

Nearly all employers report a negligible cost impact

The main concern for most employers who are hesitant to expand fertility and family-building benefits is the costs. However, in our recent in-depth survey on fertility benefits, respondents that covered infertility treatment were nearly unanimous in reporting that adding coverage did not result in a significant increase to medical plan costs (97%).  In fact, providing high-quality and cost-effective care can result in improved clinical outcomes, including reduction in high-risk pregnancies, improved birth outcomes, and reduction in costs due to complications or ineffective treatments. The financial security of having a fertility benefit allows members to follow best science and treatment protocols for their situation. Of the respondents with 500 or more employees that are not currently offering any fertility benefits, 37% say that employees have requested them, and 18% say they are now considering adding IVF coverage. 

Use specialty vendor to provide or administer fertility services

Some respondents (12%) use a specialty vendor to administer the benefit; examples include Carrot, Kindbody, Progyny, WIN Fertility, and Maven. Others, such as Cleo and Ovia, specialize in member-facing tools and resources. Overall, the specialty vendors tend to have more flexibility in the administration of the benefit compared to traditional medical carriers, provide enhanced coaching/member services, and are better equipped to navigate members to high quality resources, ultimately improving outcomes. Use of a specialty vendor is more common among larger employers: 21% of respondents with 5,000 or more employees use a specialty vendor, compared to 14% of those with 500 or more employees (and just 2% of those with 10-499 employees).

Choosing to offer these benefits will not only help your company stay competitive in the market but will create a family-friendly culture and enable more people to enter and remain in the workforce. But it’s important to remember that family-friendly policies are only beneficial if employees feel comfortable using the options available to them.  This also means helping employees navigate access to cost-effective and quality treatment.  Not only does this results in a more positive experience for the employee, but it can improve the clinical outcomes and decrease downstream costs for employers. Just as importantly, leadership can set an example by using the benefits, having open conversations about family matters with their team members, and supporting a family-friendly company culture.

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