Workplace fertility benefits for employee recruitment, retention

• Infertility is most important to many adults who have children later or with a same-sex partner.
• Startups like Carrot and Progyny offer fertility treatment coverage to fill gaps in your healthcare plan.
• This article is part of “Trends in Healthcare,” a series about innovations and industry leaders shaping patient care.

As Vernize Rios sat in the printing press of her office, she rested her hand on her swollen belly and took a deep breath.

In a few days, Rios would undergo a procedure to retrieve and freeze her eggs. She had saved for years to afford it, hoping to keep her dream of becoming a parent alive later in life. (The medical community often refers to pregnancy after age 35 as a “geriatric” pregnancy. The American College of Obstetricians and Gynecologists has said that pregnancy later in life could increase the risk of various complications, including preeclampsia.)

Rios, 36, said he grew up wanting to start a family of his own, but also saw the value in focusing on his career in his early 20s before becoming a parent. Rios said she hopes she will meet someone and get pregnant with him after settling into a stable career. But that wasn’t the case when Rios was 30, so she considered freezing her eggs.

Rios, who works as an office and facilities manager in New York City, said she anticipated the egg-freezing process would be a major financial investment and was willing to tap into her retirement savings to afford the treatment.

Rios said she was able to afford the nearly $15,000 egg-freezing procedure — which involved blood work, ovarian stimulation hormone injections and egg retrieval — because her employer, Chegg, covered upfront costs through the partnership its fertility benefits. startup Carrot.

Carrot is one of several fertility startups that have emerged in recent years to address the evolving landscape of family planning. As more people choose to have children later in life, fertility treatments such as IVF, hormone therapy and cryopreservation are more commonly sought after. And with more LGBTQ+ married couples interested in starting families, there has been greater interest in treatments such as surrogacy, egg donation and sperm donation. In a 2023 survey by the Pew Research Center, four in 10 adults said they knew someone who had used fertility treatments or had used the services themselves.

As interest in fertility care has grown, so has the number of U.S. workers asking their employers for health care benefits for specific fertility treatments — services that typically cost people tens of thousands of dollars. Enter startups like Carrot, Progyny, and Kindbody that partner with employers to help cover expensive fertility treatments when employees’ healthcare plans don’t have that coverage.

Many American workers want fertility benefits

In a March survey by Harris Poll and HR Brew, three out of five Americans said they want their workplace to offer fertility benefits.

This year, the US government began offering fertility benefits to federal employees through its Blue Cross Blue Shield health care plan. But a number of American workers do not have health care plans that cover the cost of fertility treatment.

Public and private insurance companies often do not consider fertility treatments to be medically necessary, which means that services to address infertility are usually not covered, even partially.

Because of these coverage restrictions, hopeful parents-to-be may want to carefully consider the jobs they apply for and accept. Some have chosen to work second jobs at Starbucks because fertility services are included in the company’s health insurance packages. Others consider positions only with companies that offer fertility benefits.

Dr. Asima Ahmad, co-founder and chief medical officer of Carrot, said it is common for adults who want children to exhaust all their options during family planning.

“I have patients who come in for a fertility consultation and they don’t have coverage,” Ahmad said. “Then I don’t see them for six months, 12 months or three years. But they come back, and it’s because they’ve found a new job or a new part-time job with fertility coverage.” . She added that many of Carrot’s employer partnerships begin after a company’s employee tells the human resources department they want the benefit.

That’s what Rios found himself doing in Chegg’s employee engagement surveys until January 2022, when the company announced it would offer Carrot to full-time employees. A few days later, Rios said, she signed up for a session with one of Morcov’s fertility consultants to begin the egg freezing process.

Fertility startups can fill gaps in employee health plans

Ahmad said he co-founded Carrot after seeing the need for more affordable and accessible fertility treatments during his medical training.

When an employer partners with Carrot, Progyny or another fertility benefits company, they commit a set amount of money to each employee who chooses to use fertility benefits. The employer’s investment translates into a menu of options for employees, such as one round of IVF or one round of egg freezing for each billing cycle.

Rios said the treatment funds were charged to her Carrot debit card at two separate times. She used the card to pay for treatments; Chegg later refunded her $14,291 in full to her bank account.

Although fertility startups may increase access to expensive services, many people still face challenges in seeking fertility treatments.

In online forums, some people have described experiencing long wait times and complicated paperwork to be reimbursed for out-of-pocket costs while using labor fertility benefits. Rios and others online said they had to pay taxes on covered fertility costs — something they didn’t anticipate, given that most employer-paid health care plan premiums are tax-free.

And because fertility coverage through these startups requires an employer to sign up, some employees may never gain access to such benefits.

An investment in employee satisfaction

Offering fertility benefits to workers can help employers attract talent and keep their employees happy for longer.

“While not many employers are offering it yet, you’re seeing a lot of signals in the market that there’s consideration and attention to how to offer it going forward, to signal that they’re some kind of future-ready company that has talent-aligned values the next generation,” Libby Rodney, chief strategy officer at Harris Poll, told HR Brew.

In 2022, as Rios waited for her sheets to be printed in the Chegg office, the company’s CEO, Dan Rosensweig, entered the room to sign papers. With the egg-freezing procedure nearing, Rios decided to tell Rosensweig how much she appreciated having access to fertility benefits, she said.

Rios said that after retrieving her eggs, she chose to freeze the viable ones to create an embryo, even though her doctor said there were fewer viable eggs than usual. Rios added that he would pay for another round of cryopreservation tomorrow if he could afford it. “I’d have to hit the lottery or another $15,000 in my lap, that’s what I’d definitely use it for,” Rios said.

She’s still at Chegg and has no plans to leave, saying the fertility benefits have contributed to her happiness as an employee.

“He set the bar really high,” Rios said.