The enduring strength of family-building benefits in a shifting landscape

The past few years have been challenging for reproductive health in the United States. Significant legal changes, for example, around frozen embryos, have left many questioning the future of family building—especially for those who rely on assisted reproductive technologies (ART) like in vitro fertilization (IVF) to conceive. However, a powerful trend has emerged: Companies are expanding their family-building benefits.

Despite legal limitations, family-building benefits continue to trend upwards

Leading up to the Dobbs ruling, fertility and family-building benefits were already on the rise. 54% of large US employers covered IVF in 2022—up from 36% in 2015, reflecting the growing recognition of the diverse needs of today’s workforce and the desire to attract and retain top talent. The increasing prevalence of delayed childbearing, rising infertility rates, and advancements in fertility treatments all contribute to the growing demand for these benefits. Despite 21 states restricting reproductive care, there has been a remarkable response from companies across the country. This proactive stance, even with potential legal limitations, underscores the immense value employers place on family-building benefits for their employees’ family-building journeys. Companies understand that comprehensive family wellbeing benefits contribute to a happier, healthier, and more productive workforce.

A beacon of hope: Companies step up in uncertain times

Before the subsequent signing of SB159 into law, a bill aimed at providing immunity to fertility providers and patients, Alabama’s Supreme Court ruling on frozen embryos highlighted both the complexities surrounding reproductive health and the critical role employers can play when considering thoughtful benefit design for employees. When more than half of the clinics in Alabama ceased providing IVF services, it created significant implications for patients who were in the middle of a cycle and those who had stored embryos. Patients sought immediate support in finding care alternatives in neighboring states, as well as tissue transportation services.

Navigating a patchwork of regulations: The importance of expertise

Pre-Dobbs, there was a single national regulatory structure around reproductive health. Following Dobbs, it became a complex patchwork of state laws, regulations, and court-rulings governing reproductive care. This created a significant challenge for employers operating across multiple locations. Understanding the legal nuances in each state is critical to ensuring compliance and optimal care pathways for employees. Partnering with a trusted employee benefit provider with expertise in managed fertility benefits is essential to make sure that the partner is tailoring solutions to each patient’s journey, prioritizing their clinical needs and goals, and navigating specific state regulations to maximize access to quality care while maintaining legal compliance.

Beyond legal considerations, thoughtful benefit design is crucial. Companies should consider factors like:

• Flexible lifetime maximums and cycle caps: Sudden legal changes could disrupt ongoing cycles, forcing employees to restart and, potentially, exceed benefit limits. Flexible benefit plans with cycle restarts or extended coverage limits can ease the financial strain of changing reproductive health care regulations.
• Travel benefits: Varying and changing state regulations may necessitate travel to access care. Benefits that cover transportation and lodging costs associated with seeking treatment in neighboring states can significantly ease the burden on employees.
• Emotional and psychological support: A family-building journey can be emotionally taxing, especially when legal uncertainties add stress. Employers can expand their benefit coverage to include reproductive behavioral health resources and support programs to help employees navigate this challenging experience.

Related: 73% of workers would jump ship for better family benefits

Providing education, support, and advocacy, ensures patients can navigate their family-building journeys with confidence. An effective support program tailors care plans to individual needs and state regulations. This minimizes the time and effort required to start treatment, transfer care, if needed, and promotes efficient utilization of benefits. By empowering employees to make informed decisions, employers maximize the value of their reproductive health care plans. Without clinical advocates to guide patient journeys, uninformed decisions are made based solely on perceived short-term costs, which can lead to patients beginning with less expensive and less effective technologies that are either unsuccessful or lead to a higher rate of multiple births, compounding costs for both themselves and their employers.

Beyond benefits: The future of family building

Despite the recent legal challenges, the future of fertility care is promising because fertility and family-building benefits are here to stay.

• Rising demand: Demographic trends point to a continued increase in the need for ART. Delayed childbearing is a major factor, with birth rates for women aged 35-44 on the rise. Infertility rates are also climbing. With estimates suggesting one in six couples faces difficulty conceiving, it’s no surprise nearly half of Gen Z women report being worried about their fertility. 62.7% report family-building and maternity support as critical considerations when selecting a new position.
• Technological advancements: Medical advancements are making fertility treatments more successful and accessible. This not only increases success rates but also broadens the range of individuals who can benefit from ART—including same-sex couples, single parents, couples experiencing infertility, and women who are delaying motherhood.
• Employee demand for benefits: While organizations across all industries have taken steps to close the gap in fertility and family-building care, only 59% of employees acknowledge their current benefits align with their needs. A staggering 81% of women believe employer-provided fertility benefits and support, including egg and sperm freezing, are crucial for proactive reproductive health management.
• Employee retention and loyalty: Investing in employees’ wellbeing by offering family-building benefits fosters a sense of loyalty and appreciation. Employees who feel supported by their employers are more likely to stay engaged and productive, with 72% of employees saying they would stay at their company longer with access to fertility and family-building benefits.
• Employer recognition of value: Leading organizations understand the value of offering comprehensive family-building benefits. Over 50% of large US companies now offer such solutions, and this trend is likely to continue. Companies that prioritize family-building benefits position themselves as attractive employers who understand the evolving needs of their workforce. This is particularly true in today’s competitive talent market.

Investing in the future

Even as legal limitations surrounding reproductive health evolve, the future of family building appears promising. The demand for fertility care is undeniable, and advancements in technology are making these treatments more accessible. Companies are increasingly recognizing the value of offering comprehensive family-building benefits, not only to support employees but also to attract and retain top talent. As employers evaluate their current benefit strategies, it’s important to remember there’s no one-size-fits-all approach to family-building and family wellbeing. It’s important to find customized and inclusive, managed solutions that not only fit existing benefit ecosystems, but also address potential legal challenges and financial considerations, and promote optimal care pathways. These are all critical to ensure companies are well-positioned to support their employees’ family-building journeys—fostering a happier, healthier, more productive workforce.

Dr. Roger Shedlin has applied his training in medicine and law to become an early developer of the medical specialty benefit management industry and a leader of successful healthcare companies.  He is the founder, President, CEO and Chairman of WIN, the nation’s leading specialty benefit management company that is focused on fertility, family building and family wellbeing. WIN provides clinical, claims, network, financial and administrative services, which manage women’s and family healthcare for health plans, employers and consumers.  WIN’s comprehensive programs encompass pre-conception, family building, maternity, parenting support, healthy aging (meno – and andropause), care giving and pet advocacy and insurance. In its 27-year history, WIN has helped over 1,000,000 patients on their journey to parenthood.  

Dr. Shedlin served as CEO of the Medical Benefit Management group at Optum, one of the fastest growing business units within UnitedhealthGroup (NYSE: UNH), focusing on high cost, complex diseases and conditions including Orthopedics, Oncology, Cardiology, Transplant and Kidney. Dr. Shedlin was also the President, CEO and Chairman of OrthoNet, the nation’s largest musculoskeletal benefit management company.