'I see family building being like mental health over the past five to 10 years,' says COO at Sprout Family
If plan sponsors want to set themselves apart from the pack, ensuring adequate fertility coverage just might be the silver bullet.
As Suzanne Mason recently highlighted at the Canadian Pension & Benefits Institute (CPBI)’s regional conference in Saskatchewan, organizations need to shift the narrative around fertility from a niche concern to a core business issue.
And based on the data Mason sees, it’s overdue. The problem isn’t always that benefits don’t exist, it’s that they’re often misaligned with the reality of what employees need.
“While I do want to recognize that this is a newer, more novel and maybe niche area benefits, it is extremely pervasive across organizations in the country. Over 20 per cent of Canadians will seek some type of support to build their families,” highlighted Mason, co-founder and COO at Sprout Family.
Fertility challenges touch nearly every workplace, yet benefits plans remain woefully out of sync with demand.
“Infertility leads to an impact on the employee’s ability to be productive and engaged at work,” she said, emphasizing that short-term disability, mental health claims, and even attrition can all stem from an unsupported family building journey.
“I honestly see family building being like what happened in mental health over the past five to 10 years, where maybe offering a big mental health budget would have been special and flashy. Now, it’s a bit of a miss if you don't have it in your plan,” asserted Mason.
And yet, the system remains fragmented. Despite the growing need, fertility care is significantly out of reach, asserted Mason, noting that a single round of IVF costs around $20,000, and most patients require multiple rounds to be successful.
Additionally, Canada’s public healthcare system, often assumed to be comprehensive, largely excludes fertility treatment, Mason noted.
“There is no federally mandated requirement for fertility treatments to be covered,” she said.
Indeed, provincial approaches varying wildly. While Saskatchewan now offers a 50 per cent tax credit up to $10,000, British Columbia recently introduced full coverage up to $19,000, Mason highlighted.
As for Ontario, one of the common restrictions among female workers is they can only use the benefits coverage after all provincial health care has been used, Mason explained, while acknowledging that female Canadians get one funded cycle of IVF.
“The wait list for those funded cycles are now between 18 months and two years, so they couldn’t tap into their benefits budget until they get their funded cycle. If they wait two years for their funded cycle and it’s not successful, then they will tap into their benefits for the next cycle. In that time, fertility is declining with age, so they're giving themselves less and less likelihood of success on that later paid cycle because they were waiting for the public cycle in between,” she explained.
This discrepancy directly affects employees’ out-of-pocket costs and should influence employer benefit design as she highlights many employers still assume fertility coverage begins and ends with prescription drugs.
“Just because you have fertility drugs doesn’t mean you have useful family building support,” she noted.
She emphasized the distinction repeatedly, particularly as the structural design of most plans leaves out LGBTQ+ families, individuals using egg or sperm donors, and those who need proactive services like genetic screening or egg freezing.
“Coverage outside of fertility drugs today is actually very minimal,” she said. “It's quite common to see fertility drugs as an opt in option in many carrier plans.”
The path forward, Mason argues, doesn’t require employers to rip and replace their benefits offerings. Instead, they need to optimize what’s already available by using public programs, flexible spending tools, and a smarter approach to education.
“Maybe you have a health spending account that’s a few hundred dollars and guess what? That’s enough to go get tested,” she said.
Employers could also look to include paramedical benefits.
“Working with a fertility-focused acupuncturist might actually be the best way to make sure that IVF cycle is successful,” added Mason.
She disagrees with the notion that family building requires massive new investments as she asserted, they’re “trying to lessen the cost burden.”
She also sees major cost savings in prevention. She pointed to at-home testing, which can offer actionable insights before someone even sets foot in a clinic.
For up to $100, plan members receive a kit that gives them “a very good picture of your reproductive health,” she said. That includes sperm testing through a $40 sperm analysis kit which she insists could spare months of fruitless attempts and accelerate diagnosis.
When employees and employers are equipped with data, they can avoid being pushed toward expensive, unnecessary procedures.
“We want you to be empowered with the right information at the lowest cost option so that we can keep [members] out of fertility clinics and save money, especially if employers are covering those costs,” said Mason.
She argues that what seems like a lifestyle choice is often a retention risk because “fertility is known as one of the most traumatic experiences that women go through in their life,” she said.
And employers who wait for a business case might miss the point.
“You have to have a really strong business plan to justify it,” she acknowledged. “But there’s a positive signal too. There's truly nothing more impactful than having benefits that will make such a concrete impact on someone's life, like having a baby.”
