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Open Enrollment and the Fertility Benefits Conversation


Asking for Fertility Benefits

Most large employers have open enrollment for their health insurance plans in the fall each year, so their employees can select the type of plan and coverage they want for the coming year. If you’re thinking about getting pregnant next year or actively trying to conceive (TTC), open enrollment is a good time to investigate your company’s coverage of fertility treatment. And if they don’t cover fertility treatment, you can start building a case to get fertility benefits.

Start with Your Current Coverage

Find out what is available to you already, so you know what to ask for. Only 16 states require employers to cover at least part of the expense of fertility treatment, or to offer coverage for treatment, RESOLVE has found: Arkansas, California, Connecticut, Delaware, Hawaii, Illinois, Louisiana, Maryland, Massachusetts, Montana, New Jersey, New York, Ohio, Rhode Island, Texas and West Virginia. Texas and California only require that an employer offer coverage, i.e., the company doesn’t have to pay any of the expense. Coverage in the other states varies greatly.

Many companies offer high-deductible, traditional and HMO-type plans. Look carefully at the pros and cons of these for all your health insurance needs, and examine carefully what, if any, fertility benefits are covered. You may find big differences between the three types.  Look at not only your monthly benefit cost, but also at deductibles, size of network, and out-of-pocket costs. Most coverage does not include the cost of fertility medications, which are a major part of treatment cost.

Ask for Benefits Before You Start Treatment

Ask other employees if fertility benefits matter to them, and gain their support. Put your request in writing, and meet with the HR staff. They can advocate for you and the other employees with the benefits team. It helps if someone senior or especially valuable to the company is interested in coverage for fertility treatment. RESOLVE has a letter template on their website which you can copy and personalize.

Show How Coverage Benefits Your Company

Many high-tech companies and other companies in competitive fields are offering fertility benefits to their employees. These companies find this helps them recruit and retain talented, ambitious employees. Others offer fertility benefits because it fits with their family-friendly values. Infertility is on the rise as young people struggle to pay off massive student loans, pursue their careers, or take longer to find a partner. You can point out that almost one-third of couples over 35 will have fertility issues.