In today’s tight labor market, US employers are having to work harder to attract and retain talent, not just by offering more pay and benefits, but also by targeting their employee value proposition to fit the needs of their candidates and current employees. As millennials take on the burden of caring for their aging parents while starting families of their own, and as progressive organizations strive to make sure motherhood doesn’t derail the career of their women employees, many of the latest benefit trends are family-focused: paid parental leave, flexibility for working parents, returnship programs for parents returning from career breaks, and so forth.
Another increasingly popular family benefit is health insurance coverage for fertility treatments, to help employees who want to start families but struggle with infertility. In vitro fertilization, the most effective of these treatments, is increasingly common as women start families later, but is often prohibitively expensive, costing over $12,000 for just one round, whereas several rounds are sometimes required to result in a successful pregnancy.
Despite the cost, we’ve seen several large employers add fertility benefits to their rewards packages in the past year, including Cisco, Estée Lauder, and MassMutual. In a recent feature at the New York Times, Vanessa Grigoriadis takes a look at what’s driving this trend, pointing to a recent Mercer study that found the percentage of large employers (of 20,000 employees or more) had increased from 37 percent to 44 percent from 2017 to 2018:
These days, I.V.F. coverage is “escaping” the sectors that have traditionally offered it, meaning tech, banking and media, said Jake Anderson, a former partner at Sequoia Capital and a founder of Fertility IQ, a website that assesses doctors, procedures and clinics. General Mills, Chobani, the Cooper Companies and Designer Shoe Warehouse have either introduced coverage or greatly increased dollar amounts for 2019. Procter & Gamble Company offered only $5,000 in fertility benefits until this year, when it increased the benefit to $40,000.
Many organizations are falling short, however, when it comes to communicating this benefit to employees and job seekers, Grigoriadis points out:
Some corporate silence may exist to discourage what some employees have started doing: fertility shopping. Though these benefits could help employers recruit the best candidates in a tight job market, the price tag could be high if lots of employees actually, you know, use the benefits. …
Employers also don’t match expectations equally. At some companies, both heterosexual and same-sex couples, as well as singles, can access benefits. But at others, coverage isn’t triggered until an employee has had unprotected sex of the baby-making kind for six or 12 months.
“Fertility shopping” might sound like an odd way to approach a job search, but it actually makes sense given what we know about the attractive power of benefits, which can be even stronger than the pull of cash compensation. To a candidate with fertility issues who hopes to start a family in the next five years, an employer that offers this benefit is absolutely more attractive than one that doesn’t, especially when you consider the message it sends about the workplace culture and the level of support working parents can expect to receive at the organization.
(To get a sense of how your organization’s family and other benefits stack up against the competition, Gartner Total Rewards Leadership Council clients can peruse our Benefits Plan Design Benchmarks and Trends for 2019. Clients can also learn more about how to communicate benefits in job advertisements to better attract talent, based on an analysis of 1 million job postings collected by Gartner Talent Neuron.)
FertilityIQ recently released its Family Builder Workplace Index for 2019-2020, which ranks employers in terms of the generosity of their fertility benefits. Around 23 percent of organizations included in FertiltyIQ’s index introduced or substantially enhanced their benefit in 2018, compared to 10 percent who had done so in the preceding year. The index shows that fertility benefits are becoming more common in a wider range of industries and that many employers with existing policies are making their benefits more generous and easier to access:
Fields like consumer product and retail, insurance, healthcare and industrial manufacturing drove nearly all of the above-mentioned gains in 2019. Fortune 100 companies like ExxonMobil (70,000 employees), Procter & Gamble (95,000 employees), AT&T (273,000 employees) and Liberty Mutual (50,000 employees) instituted new or enhanced benefits that resemble what’s been offered in the technology and consulting industries for years in terms of size, and accessibility. …
Companies are beginning to remove “pre-authorization” requirements that historically prevented employees from accessing subsidized care quickly, or in the case of lesbian, gay or unpartnered employees, subsidized care at all. Noteworthy examples of companies mitigating, or altogether removing such pre-authorizations include Morgan Stanley (a rarity amongst investment banks), Sony Corporation, and S.C. Johnson.
In a survey of patients who received full IVF coverage through their employers, FertilityIQ found that 73 percent felt more gratitude toward their employer because of this benefit, 61 percent said it made them feel more loyal, and 53 percent said it influenced them to stayed with a particular employer longer.
At the same time, however, pregnancy still remains stigmatized in the workplace to a troubling degree. Many working women are still afraid to tell their boss they are expecting: 21 percent, according to Bright Horizons’ 2018 Modern Family Index. That study also shed light on the “motherhood penalty” faced by working women who start families, finding that 41 percent of professionals think working mothers are less dedicated to their jobs, compared to 75 percent who said working fathers were more dedicated. That explains why 78 percent of working mothers surveyed by Bright Horizons said they felt they had to work harder than their peers to get ahead in their careers.
So US employers may not want to pat themselves on the back just yet. Pregnant women and mothers still face a number of unfair challenges in the workplace. Meanwhile, most organizations still don’t offer fertility benefits; in fact, our research shows that 28 percent of US employers offer no family benefits at all, and only 60 percent offer paid maternity leave, the most common of these benefits. As suggested by the lack of communication around these benefits, corporate America still isn’t all that comfortable talking about fertility, and isn’t dealing with it nearly as well as it could, Katherine Goldstein wrote recently in an in-depth discussion of the issue at Slate:
One of the biggest misconceptions about infertility is that it’s a niche issue. It’s not. Michelle Obama, upon the release of her memoir in late 2018, became arguably the most famous person to publicly reveal her fertility issues: namely, that she and her husband Barack Obama had used IVF to conceive their daughters. One in 8 women of reproductive age may face problems when trying to conceive a child, which makes infertility about as common as breast cancer and more common than Type 2 diabetes. In 2015, 73,000 babies were born using assisted reproductive technologies, a number that has doubled in the last decade; the most common of these technologies is in vitro fertilization.
Despite the fact that infertility was officially designated a disease by the American Medical Association in 2017, full fertility treatments are still not a standard part of most company health insurance plans, and are not viewed under current health care laws as an essential benefit. While there has been much public debate about whether employers have the right to limit women’s access to contraception through their health plans, there has been little discussion about whether employers should be required to provide benefits that help a woman get access to prescribed, medically necessary treatments when she is struggling to start a family. If you need medical help to have a child, adequate insurance coverage for such treatment is largely viewed as an employment “perk.” Only 16 states currently require that insurance companies provide or offer some coverage, but even those benefits can have loopholes, and often fail to cover the large costs associated with effective treatment.