How an employer's perspective on and handling of fertility and family-planning benefits can help or hinder workplace culture
When understanding the true needs of an employee population, an employer must first accept that equity looks different for everyone. Although infertility affects one in six families, fertility treatment is often looked at as a nice-to-have, or an add-on to traditional coverage. Gallagher’s 2023 Benefits Strategy & Benchmarking Survey found that over 80 percent of 504 surveyed employers had a healthcare benefits plan because they wanted to provide their employees with access to the quality medical care they need. So when did fertility and family planning get left behind?
While insurers are starting to include fertility drugs in their benefit plans, fertility treatments are less likely to be covered, and take up the bulk of treatment cost. Some of the average costs for treatments include $20,000 for in-vitro fertilization, $8,000 for egg freezing, and $60,000 for surrogacy – and some families need multiple rounds before a successful pregnancy. Provincial coverages vary, wait times are lengthy, and, often, programs do not cover even half of the required funds. Of the Canadian employers covering fertility benefits, five percent cover the cost of treatments while 95 percent only cover the cost of drugs. In comparison, drug pipelines feature drugs costing upwards of $500,000 annually, with employers providing unlimited drug coverage – excluding fertility. The cost of fertility treatments exceeds most people’s means and can place a financial burden on employees and their families.
While larger employers may look to embed fertility coverage in their program, smaller employers may need a unique solution, such as a healthcare spending account carved out solely for fertility. This offers employees tax-free coverage for their fertility treatments, while not affecting experience-rated claims use in a traditional fully insured program. As a reminder, these treatments may be higher in cost, but are low frequency, and make a great impact on employees’ lives.
Beyond the financial constraints, employee mental health is greatly affected by the process. A supportive workplace can make all the difference for an employee going through this experience. Many employees who did not have financial support through their workplace noted that understanding and clear communication on internal policies from their leadership team would have positively shaped their experience. Having the autonomy to schedule appointments during the day and not having to use sick or vacation days but instead being able to make up the time is seen as a supportive measure. One employee even mentioned how higher coverage for acupuncture or naturopathic treatments may have helped support her as she chose to use these alternative methods to improve her fertility.
Poor mental health can quickly create absenteeism, presenteeism, and, ultimately, disability claims. While many Canadian employers are already struggling with rising disability cases due to mental health conditions, fertility issues could also greatly affect those costs. Many employees would also consider leaving their employers for jobs with greater benefits or a better perceived work-life balance. What is the true cost of replacing an employee?
Last, a very important note on grief and bereavement. While the fertility and family planning process may be lengthy and burdensome on an individual’s mental health, it is important to note that one in four pregnancies will end in a loss. These devastating impacts of grief and loss are not often talked about in the workplace or in society. Having a supportive workplace culture that encourages employees to bring their whole selves to work will positively influence the outcomes of these situations.
On a broader spectrum, employers can look to incorporate pregnancy and infant loss into their internal bereavement policies. Employers may also be able to amend their group contracts to remove outdated dependent life wordings such as from “live birth” or “14 days from live birth” to help support employees who have suffered a stillbirth. Other suggestions may include parental top-up programs and providing support groups for new parents or those who have recently suffered a loss to help ease them back into the workplace.
With most employers wanting to improve their diversity, equity, inclusion, and belonging (DEIB) initiatives, it is important first to look internally to see what policies and procedures exist in the workplace today. By broadening coverages or providing supportive and flexible programs and policies internally, employers can ensure that employees not only have a seat at the table, but have the seat they need.
Ellen Medeiros supports organizations with unique benefits solutions that affect the well-being of their people. Ellen volunteers at the Pregnancy and Infant Loss Network, supporting grieving families enduring the devastating impacts of loss.
