Corporations are constantly looking for new ways to attract talent. The latest strategy? Make it easier to plan for a baby by offering fertility perks.
Actually, it should be termed “infertility perks,” because mostly this trend means companies will cover employees trying desperately to get pregnant. Or, employees putting off getting pregnant by freezing eggs and sperm. And, most of the time, this means funding expensive treatments like In-Vitro-Fertilization (IVF).
The Incredible Cost of IVF
The use of IVF is definitely on the rise. According to the Centers for Disease Control and Prevention (CDC), infertility affects about one in seven Americans. The World Health Organization (WHO) considers infertility a disease with multiple causes and treatments. It’s historically been a disease that’s underinsured. IVF has had a steady climb since the recession in 2008 (stress can cause infertility issues) and reached an all-time high of 15% annual growth for 2018.
IVF is invasive, particularly for the woman. It requires hormone shots for egg production, which equals side effects. It’s structured in rounds of egg fertilization, embryo testing and implantation.
Fertility IQ tracks treatment costs, and found that “in 2018, we estimate the average fertility patient paid over $22,000 per “cycle,” with over 10,000 IVF patients reporting. This cost figure represents a 7% increase over 2017 and nearly a 15% increase since we began tracking the metric in 2015.”
Keep in mind, though, that cost is per cycle. Fertility IQ found more than half of all IVF patients (read: the woman), must undergo a second round, and nearly a third go for three. The total cost, of over $50,000 for three cycles, is almost the same as the average annual US household income of $51,000.
And, even with companies covering all or part of IVF, most patients still pay out of pocket for some or all of the costs.
Which Companies Offer the Best Coverage
The enormous cost of infertility treatment means companies that cover them hope to attract better, and more loyal, talent to their ranks.
There’s even a company, Progyny, that provides infertility treatment coverage for companies hoping to use these benefits as recruitment leverage.
“As workplaces change to become more inclusive, they are providing more robust benefit packages that empower employees to balance successful careers and family building,” Progyny Chief of Strategic Development Karin Ajmani tells Parentology. “ In order to attract and retain talent (especially millennials), companies need to address employees’ needs. Fertility benefits are one of many ways they are investing in the well-being of their workforce.”
According to Ajmani, the ultimate fertility coverage is possible.
“Often with traditional coverage, procedures will not be authorized until less invasive treatments such as fertility medications and/or IUIs are utilized first,” Ajmani says. “Most coverage plans have a dollar maximum, like a $15,000 lifetime maximum towards fertility treatments.”
“One of the biggest problems with this type of coverage is, most patients will exhaust their dollar maximums (and waste time) on treatment that isn’t as effective,” Ajmani continues. “By the time IVF is even in play, they most likely would’ve maxed out on their coverage and be forced to pay for the IVF cycle out of pocket.”
This scenario can play out badly.
“ One of the biggest problems with this type of coverage is that patients are subjected to unnecessary procedures and drugs that aren’t the most effective treatment for them. They will also exhaust their dollar maximums (and waste time),” Ajmani explains.
The best coverage, Ajmani counsels, is all-inclusive.
“Additionally, many conventional carriers have pre-authorizations that need a diagnosis of infertility for treatment to be covered. This excludes LGBTQ members and single parents by choice from accessing the benefit. It’s important for companies to add family building benefits that don’t have barriers to care,” Ajmani said.
The site Glass Door offers a pretty comprehensive list of companies that offer excellent infertility coverage. Some of the companies are pretty big ones; Bank of America, for instance, provides unlimited IVF coverage after an infertility diagnosis. Pinterest covers up to four rounds of IVF, plus up to $20,000 of coverage for parents working with a surrogate, and even $5,000 for those who wish to adopt.
Starbuck’s is a standout because it has a $20,000 IVF benefit for every employee who wants it, even for its part-time baristas. Other companies, such as Unilever and Viacom, cover not only IVF and surrogacy expenses, but also egg freezing.
These are not small perks if you happen to be someone who needs these benefits.
These Perks Are Great, But Are They Fair?
If you haven’t noticed, most of the companies offering these extraordinarily generous infertility benefits are high-end, and many are in Silicon Valley. The employee populations of these companies are generally affluent, educated and skew caucasian.
According to the American Medical Association (AMA) Journal of Ethics, infertility treatment is harder to come by for certain populations, even though infertility is categorized as a disease, complete with diagnosis codes (of note: the Affordable Care Act (ACA) does not include coverage for infertility).
“Infertility has multiple associated billing codes in use, as determined by the International Statistical Classification of Diseases and Related Health Problems. However, the often-prohibitive costs associated with infertility treatment, coupled with the lack of universal insurance coverage mandates, contribute to health care inequity, particularly along racial and socioeconomic lines,” reported a 2018 article in the Journal of Ethics.
The article went on to explain the inequity further.
“Minority patients face substantial barriers in seeking treatment for infertility. There is evidence that African American, Chinese, and Hispanic patients are much less likely to seek care than white patients and that African American and Hispanic women, despite having higher rates of infertility, are underrepresented in the infertility clinic population,” the Journal stated.
Another concern is that some companies, like Intel, offer IVF coverage to employees without an infertility diagnosis. While it might sound crazy to subject oneself to IVF when one could conceive naturally, it’s becoming more common. Wealthier prospective parents don’t want to leave anything — gender, possible IQ, and even eye color — to chance. Through polygenic screening, IVF allows them to cherry-pick the embryos that best fit the parents’ criteria for a perfect baby. And now, at least at Intel, they can do at least the lion’s share of it on the company’s insurance dime.
Fertility coverage specialists like Progyny do try to steer companies toward broader benefits not just the infertile, or genetic engineering minded, but all parents. It’s a process.
“As companies grow to become more innovative, their benefits packages will become more inclusive,” Ajmani says.” In addition to fertility coverage, companies are also thinking more extensive maternity and paternity leave, work flexibility, on-site childcare services, etc. With a focus on empowering all populations in the workforce, there is a stronger emphasis on equal access family benefits across the board.”