How employers can win the ‘talent war’ by providing employee infertility benefits in 2023

We have read many stories for couples experiencing infertility, of which one in seven, globally, seek treatment.

With growing competition in the job market, many women choose to delay motherhood until their careers are well established. Finally regretting that decision, their early 40s brings an emotionally and financially stressful process (the likelihood of needing fertility treatments increases with age, yet the success rate decreases, often resulting in lengthy treatments).

50% of women did not disclose treatment to their employer out of fear that they wouldn’t take them seriously and over 40% felt the same due to concerns about its negative effects on their career prospects (1).

Companies that are serious about diversity & inclusion and want to attract the talented Gen Z population have started to provide or discuss such employee infertility benefits publicly. Let’s have a close approach to these perks.

Could egg-freezing become the new norm for employee group benefits?

Egg freezing has existed for decades and was initially made for women undergoing medical treatment that threatened future fertility or for genetic reasons. Biologically, women should have children earlier, as their fertility declines during their early thirties. Many women are not in the right situation to start a family or have yet to find the right partner to settle down and start a family with.

As lifestyles change, you may find that egg freezing removes some of the pressure that surrounds important life choices, like education, career, or even finding the right partner.

Recently, egg freezing was rebranded as the ultimate act of self-care. Oocyte cryopreservation, the technical term for egg freezing, has become something of a makeover, thanks to a crop of fertility startups marketing it as essential for the everyday, liberated woman. According to Guardian (2), it has created a sense that egg freezing doesn’t have to be scary, or even a big deal, bringing it under the all-inclusive banner of self-care and wellness.

During the pandemic, fertility preservation procedures like egg freezing have dramatically increased as more women are delaying their plans to get pregnant or reducing the number of children they plan to have. Some countries like Greece raised the age limit to 52 years for women wishing to undergo assisted reproduction (especially for women who could not travel to Greece for IVF in the previous months).

The war for talent is the new normal

Many employers across the US and UK are now supporting employees on their path to parenthood by offering fertility benefits to support and retain top talent (3).

Silicon Valley companies like Facebook and Google now offer egg freezing as an employee benefit. The fierce competition for recruits has never been higher for companies in the era of ‘great resignation’. Many factors have contributed to this situation, including over 1 million foreign-born workers leaving the UK post-Brexit, which forced many employers to offer non-financial benefits like fertility preservation and make the company’s corporate social responsibility commitments more prominent (4).

Significant note: The success rates of egg freezing vary depending on the age of the woman.

A third (31%) of workers aged 18 to 34 believe that fertility benefits such as egg freezing or subsidized IVF should be offered by employers, mainly due to the high cost of private treatment. The costs on average vary from $15,000 to $20,000 a cycle, including medication, treatment, and storage, and the average patient undergoes two cycles. Other reasons included concerns about restricted NHS treatment (43%), the belief that this benefit would support career progression (26%), and that it would reduce time pressures around having children (24%) (5).

Regulations about egg freezing in the UK are restrictive, stipulating that eggs frozen for social reasons can only be stored for up to ten years (regulation is pending to change).

IVF as an Employee Benefit

While egg freezing, or sperm freezing, could be thought of as a more proactive healthcare choice, the same cannot be said when infertility knocks on your door. Infertility affects around 3.5 million people in the UK – around one in seven couples – according to the NHS. And of those undergoing in vitro fertilization (IVF) treatment, 58% are aged 35 or above and typically employed, finds the Human Fertilization and Embryology Authority (HFEA).

Over 7 million Americans are subject to such a diagnosis according to RESOLVE – the national infertility association. It affects 1 in 8 couples, making infertility a more prevalent condition than diabetes, asthma, or depression. (https://resolve.org)

More than ever, employees want options for pursuing parenthood. 50%+ of millennials consider fertility to be a core part of health coverage, 68% of adults say they’d switch jobs to gain fertility benefit, and 63% of LGBTQ+ people expect to use assisted reproductive technology, foster care, or adoption to become parents (6).

There is no legislation or official guidance on IVF workplace rights, perhaps explaining why so few organizations have policies in place. The lack of employer coverage has a greater burden on Black, Indigenous, and employees of color, and LGBTQIA2S, single and low-income employees.

Coverage and Use of Fertility services – State Law and Private Insurance

Every country in the EU (except for Ireland) now has legislation governing assisted reproduction (ART) but patients may travel abroad for treatment, even if their ‘cross border reproductive care’ violates domestic legislation. The freedom of movement for treatment in Europe makes it easier to take a medical trip when conditions allow it. In the UK, for example, local CCGs cut NHS IVF funding as fertility treatment is a non-urgent service during a covid-19 era. A couple undergoing three cycles of IVF spent a little over 33,000 out of their pockets with no pregnancy guarantee.

To make their fertility treatment more affordable, many UK couples travel to Southern Europe where costs can be as low as 5,000. Here, they are provided with medicines and doctors who have performed extensive research and gained success in the field.

Even in Greece, a leading country in IVF, the latest techniques, including egg donation, surrogacy, ICSI, and preimplantation genetic diagnosis – with the most liberal legal frame-anonymity of egg and sperm donor and the high success rates with competitive prices in Europe (over 50%)- ις lagging in state allowances and benefits.

USA fertility services – State law, Employee benefits providers, and Insurance companies

Many larger company’s health insurance programs do cover some fertility benefits, and there are laws in 19 states that require certain group health insurance plans to offer some fertility treatments.

However, with no federal law to regulate ART and its reimbursement in the USA, only a few states require (by ‘mandate’) insurance * companies and employers to cover the cost, or part of the costs, of fertility treatment. But even in states where it’s required, coverage is limited, with lifetime maximums ranging from $15,000 to $100,000. Plus, you typically need to have demonstrated that you’re having trouble getting pregnant before fertility treatments will count as qualified medical expenses. That means coverage is often out of reach for LGBTQ couples and women who freeze their eggs for the possibility of using them in the future (7).

*Why is fertility treatment rarely covered by insurance?

Many fertility treatments are not considered “medically necessary” by insurance companies, so they rarely are covered by private insurance plans or Medicaid programs. When coverage is available, certain fertility services (e.g., testing) are more likely to be covered than others (IVF-IUI).

Otherwise, treatment is performed within a private market system which, in 2014, was estimated to cost an average of $12,400 per cycle. Critics of this private system complain that IVF in the USA is mostly treatment for those who can afford it (8).

Facing a tight and complicated labor market, employers are evolving their approach to traditional and voluntary benefits. Specifically, research finds that 71% of the nearly 4,000 employers surveyed see medical and pharmacy benefits as key assets to combat what Gallagher calls the “talent tsunami.” And 41% of surveyed employers said they’ve added more or different voluntary benefits to meet recruitment and retention objectives this year (9).

AON, the global employee health and wellbeing broker, states that if a firm wants to build a resilient workforce, it must invest in its financial and mental health support. Employee benefits such as Employee Assistance Programs and Private Medical Insurance could be valuable to manage the impact infertility can have on the employment relationship (10).

Companies That Offer Awesome Fertility Benefits

Many companies have recognized the importance and impact of these benefits. In a list of 47 companies that offer fertility benefits like IVF, egg freezing, surrogacy, and more, we can find those of Amazon, Apple, Bain & Company, Mass Mutual, Salesforce, and Tesla (11).

In the recent Mercer 2021 fertility benefits survey (12), we saw more employers responding to the requests of their employees and recognizing the importance of fertility benefits as part of a comprehensive program that seeks to support all aspects of employee health and well-being.

For many years, there was no discernible upward trend in coverage for infertility treatment in employer health plans. As more working women delay having families, fertility benefits have been shown to influence their employment decisions.

When coverage is not restricted to women and men in a heterosexual relationship, these benefits can also make an organization more attractive to LGBTQ+ employees.

Coverage of fertility benefits is growing, especially among the largest employers

	Employers >500 employees 2015	Employers >500 employees 2020	Employers >20.000 employees 2015	Employers >20.000 employees 2020
Evaluation by endocrinologist or infertility expert	54%	58%	70%	73%
Drug therapy	32%	33%	44%	53%
In-vivo-fertilization (intrauterine insemination)	23%	28%	34%	38%
In-vitro-fertilization	24%	27%	36%	42%
Egg freezing	5%	11%	6%	19%
No coverage provided	40%	39%	23%	23%

2021-Survey of fertility benefits-Mercer

Case 1

Cereals manufacturer Kellogg’s has announced it will provide more support to staff experiencing menopause, pregnancy loss, or fertility treatment.

The firm said about 1,500 workers at its factories in Trafford and Wrexham and its Salford headquarters would benefit from several new measures. They include extra paid leave for those undergoing fertility treatment or staff who suffers the loss of a pregnancy (13).

Evaluation by a reproductive endocrinologist or infertility specialist showed that IVF, drug therapy, egg freezing, and Vivo fertilization (intrauterine insemination) were the most prominent fertility benefits, especially among the largest employers.

LinkedIn, launched its fertility package for UK employees in 2019. According to the company, this has improved employee well-being, cultural cohesion, and its ability to attract and retain talent. LinkedIn began offering the benefits in response to a survey of 5,000 workers and HR professionals in the United Kingdom.

What kind of assistance do employees get?

Employees in the United Kingdom can claim money spent on adoption or fertility treatments through LinkedIn’s fertility and adoption assistance program, with a maximum claim of £7,000 per cycle and a lifetime limit of £21,000. In addition, the company provides them with a 24/7 confidential counselling service, webinars, and a database of family services (14).

When employers get asked about the outcomes of offering infertility benefits

The positive outcomes of offering infertility benefits for the majority of employers were classified as:

Ensuring employees have access to quality, cost-effective care
· Satisfying employee requests
· Staying competitive in attracting and retaining talent
· Recognition as a “family-friendly” employer
· Supporting Diversity, Inclusion, and Equity efforts
· Mitigating the risk of high-risk pregnancies Positive public relations

We do understand the concerns about the cost of IVF coverage remain a barrier, but these Survey results suggest that some employers may assume that the coverage costs more than it actually do.

Case 2

Salesforce, the American cloud-based software company offers a wide range of employee benefits for its employees and their families covering all aspects of health, wellbeing, and financial help. In a fully detailed EMPLOYEE ASSISTANCE PROGRAM employees and their partners can get reimbursed for fertility and adoption-related costs. This benefit covers up to €10,000 each 12-month rolling period to explore alternative options when starting a family. Reimbursement includes, but is not limited to, adoption agency and legal fees, IVF, acupuncture, and complementary medicine for infertility (15).

Employers should also consider lifelong fertility care in 2023. Menopause will affect an estimated 1.1 billion people worldwide by 2025, but this difficult stage of life is rarely discussed. 70% of those going through or who have gone through menopause considered changing jobs to better manage symptoms.

All employees must receive Inclusive support.

Employers must maintain commitments to diversity, equity, and inclusion (DEI) even in uncertain times, and fertility benefits can play a significant role in this. According to a Glassdoor survey, 67% of job seekers value a diverse workplace when deciding whether or not to accept a position. Employers will fall behind if they do not meet these needs. In fact, 58% of benefits managers said that not providing fertility benefits by 2025 would be discriminatory (16).

In the economy, change is unavoidable. Employee fertility health and family-forming goals should also be supported. Investing in fertility benefits allows your company to cut costs, maintain and expand its commitment to DEI, and attract top talent—even in uncertain times.

Are you a small or large-sized employer? Here are some customized solutions that our team can offer to your company:

Forming Families benefits (corporate discounts for Egg Freezing-IUI)
· Employee Care Advocate (guide employees to parenthood)
· Complimentary reimbursements of State allowances
· Refunding – Guarantee IVF programs
· Extend or design Group Medical Insurance to Fertility coverages –
· Selective Network of Fertility Specialists
· Lower Fertility treatment costs
· Fertility predictor toolkit

Get in contact See how RedOvum Team can transform your company.

References-Website links:

How employers can win the ‘talent war’ by providing employee infertility benefits in 2023

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