Family-forming for everyone: Rethinking fertility benefits at work

More than one in 10 Americans have known fertility issues. Supporting employees through fertility challenges can improve morale, reduce stress, and boost productivity. Comprehensive fertility benefits reflect a progressive, employee-centered culture and provide a competitive edge in today’s workforce.

According to the International Foundation of Employee Benefits Plans 2024 Benefits Survey, 42% of U.S. organizations currently offer fertility benefits (an increase from 40% in 2022). While this shows an increase in offerings, more than half (58%) of employers still do not offer any fertility benefits. Moreover, depending on the plan many participants may seek fertility treatment and be ineligible based on the plan’s definition of “infertility.”

LGBTQ+ couples and single individuals not in a relationship often face obstacles when they seek fertility assistance for family forming. Significant disparities in access to infertility services (both diagnostic and treatment) exist across the U.S., based on an individual’s state of residence, insurance plan, sexual orientation, gender identity and other factors.

In October 2023, the American Society for Reproductive Medicine (ASRM) Practice Committee redefined infertility as a disease, condition or status characterized by any of the following:

• The inability to achieve a successful pregnancy, based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing or any combination of those factors.
• The need for medical intervention, including, but not limited to, the use of donor gametes or donor embryos to achieve a successful pregnancy either as an individual or with a partner.
• In patients having regular, unprotected intercourse and without any known etiology for either partner suggestive of impaired reproductive ability, evaluation should be initiated at 12 months when the female partner is under 35 years of age and at six months when the female partner is 35 years of age or older.

The ASRM goes on to specify, “[n]othing in this definition shall be used to deny or delay treatment to any individual, regardless of relationship status or sexual orientation.”

The case for inclusivity

Fertility benefits have quickly become a key pillar of modern employee benefits packages. They are a clear demonstration of a company’s commitment to inclusivity and support for different family structures. Providing fertility benefits increases employee satisfaction by furthering personal and family planning objectives. In turn, this alignment helps create a more engaged and motivated workforce. Employers can save on employee retention by offering strong fertility benefits, which have been shown to increase employee loyalty and lead to lower turnover costs. Fertility benefits help to foster a supportive and inclusive workplace culture. They support diversity and equity by addressing the reproductive health needs of a diverse workforce and improving employee well-being overall.

Inclusive fertility benefits aren’t just good for employees – they also help reduce legal risk. Several lawsuits have challenged insurance policies that define infertility in ways that disadvantage LGBTQ+ individuals. In one case, a policy required heterosexual couples to try conceiving for 6-12 months before coverage, while LGBTQ+ individuals had to pay out of pocket for a year before qualifying. Though the insurer denied wrongdoing, it settled by updating its plan to cover artificial insemination regardless of sexual orientation, reimbursing past expenses, and revising clinical policies. Similar discrimination cases are still pending.

Truly inclusive fertility benefits

It’s easy to claim to want to have truly inclusive fertility benefits, but it can be difficult to understand what that means. At a minimum inclusive fertility benefits should include:

Getting started

First, you need to understand your current plan offerings. Evaluate the current plan by asking some of these questions:

• Do they allow for equitable access and coverage for LGBTQIA+ individuals, couples, and single parents?
• What offerings do you have to support adoption, surrogacy, or fertility treatments?
• Does your plan require a diagnosis of infertility for coverage?
• How does that requirement impact same-sex couples’ access?
• Does it provide domestic partner benefits as well?

You may want to consider partnering with a vendor that focuses on providing inclusive benefits.

Ask your employees about their experiences with your existing healthcare benefits and policies, wellness benefits, resources and other internal programs to identify gaps. Consider utilizing your employee resource groups (ERGs) to solicit employee feedback on how to improve or expand your benefits offerings to meet diversity and inclusion needs.

Once you have determined where there may be gaps in coverage, work with benefit providers to provide inclusive employee benefits that support LGBTQIA+ individuals throughout their family journey. Strive to ensure your family benefits offer personalized and affirming care.

Lastly and most importantly, make sure to clearly communicate eligibility requirements. Clear, inclusive, and proactive communication is essential when rolling out or updating fertility benefits.

As fertility challenges become more visible and diverse family-building needs grow, fertility coverage is no longer a niche perk; it’s a core part of modern employee benefits. From shifting demographics to rising expectations, the demand for inclusive, supportive fertility care is shaping how employees choose where to work, how long they stay, and how engaged they feel. For employers, the business case has never been clearer.