In February, the Alabama Supreme Court ruled that frozen embryos created through the in vitro fertilization process are humans, which could lead to liability for those who destroy unviable or unused embryos. The ruling prompted some providers to pause services and even drove the Republican legislature and governor of the state to advance a law aimed at protecting IVF providers. Coming nearly two years after the U.S. Supreme Court overturned Roe v. Wade, the Alabama decision cast further uncertainty on the direction of women’s reproductive and family-building rights, experts said—and highlighted the opportunity for employers to provide fertility benefits and support in the increasingly uncertain environment.
Employer-sponsored fertility benefits—which can include everything from financial assistance with IVF treatments, sperm and egg freezing, surrogacy and adoption to clinical guidance and coaching through these processes—were already on the rise before the Alabama ruling.
For instance, according to consultancy Mercer, about 45% of large employers offered IVF coverage to their employees last year, up 23 percentage points from 2019. When looking at employers of all sizes, the International Foundation of Employee Benefit Plans found that 40% covered IVF treatments in 2023, compared to 30% in 2020.
Such organizations are increasingly looking to fertility benefits as part of their employee value proposition: Job search engine Adzuna found a 109% increase in the number of companies promoting fertility benefits since 2023.
The shift suggests that employers are recognizing a well-managed fertility program can impact employee engagement, wellbeing and retention, says Shelly MacConnell, chief strategy officer at WINFertility, a provider of family-building benefits solutions.
“This is no longer about benefits design,” MacConnell says. “This is really a business imperative.”
Behind employers’ interest in fertility benefits
In the wake of the pandemic, workforces have become more vocal about the support they need from employers.
“Employees are becoming more comfortable talking about fertility challenges,” MacConnell says. “In doing so, they’re telling their employers they want these benefits. We’ve seen a lot of increased self-advocacy from employees.”
In part, the shift is driven by heightened discussions around employee financial wellness, as fertility treatments carry significant costs. For instance, one single IVF cycle may be upwards of $30,000, while a round of egg freezing can cost $8,000, with thousands more in medication costs.
“Given the expense of fertility treatments, employers may see this as a key factor to gaining a competitive edge in attracting and retaining top talent, especially up-and-coming talent of child-bearing age,” says Sadie Funk, national director at The Best Place for Working Parents®.
Some of these workers, MacConnell adds, are getting second and even third jobs just to be able to pay for fertility treatments on their own.
“People who are highest-paid may be most able to access this care if they need to pay for it themselves,” she notes. “So, providing this benefit does equalize the access to the care employees need to build a family.”
Today’s workers—especially in younger generations—MacConnell adds, are increasingly looking for employers to prioritize equity and inclusion and “demonstrate their values,” which is what she says fertility benefits can do.
Inclusion has been a driving factor in the fertility benefits trends WIN has seen recently, she adds.
While more employers are rolling out new fertility programs, many are also lessening eligibility for existing programs—such as removing the traditional requirement that granted access to fertility benefits only with a demonstrated medical necessity. This allows for coverage beyond medical infertility issues, expanding access to same-sex couples and transgender individuals, as well as to employees looking for fertility preservation.
“Employers are opening up these definitions to be more inclusive and cast a wider net,” she says, noting that, even if those needing fertility care are a minority of the workforce, employers are reconsidering the weight of such benefits.
“Rather than benefits that hit the largest number of people—like spreading peanut butter—we’re seeing a shift where employers want to offer something that’s the most meaningful to people, even if it’s a smaller number of people,” MacConnell says.
A ‘holistic’ approach to family-building support at Liberty Mutual
Insurance giant Liberty Mutual has long recognized how much family-building benefits can mean to employees, says Verlinda DiMarino, head of benefits.
“We know that every employee’s experience of starting and building a family is unique, and we want to offer a wide range of benefits, programs and resources that meet the needs of our employees at every stage of family expansion and care,” DiMarino says.
Recently, Liberty Mutual enhanced its offerings, boosting coverage for fertility treatments to $50,000 and pharmacy costs to $25,000. The organization also reimburses employees for adoption and surrogacy expenses throughout the process.
DiMarino says the company has found enabling employees to meet their goals in their personal lives makes them more likely to excel professionally.
“Especially during periods of transition or change, it’s important that employees have the tools, resources and community to support their overall wellbeing,” she says.
That’s why Liberty Mutual takes a holistic approach to its support for family-building, looking beyond medical and financial assistance benefits. The organization offers eight weeks of parental leave—inclusive of adoption and foster care—and an additional eight weeks of short-term disability for employees who give birth. Liberty Mutual’s emphasis on workplace flexibility, DiMarino says, allows employees to invest the time and attention to growing and supporting their families.
Liberty Mutual is not alone in recognizing that workplace design aspects like flexibility can be viewed as part of a broader shift toward family-friendliness.
For instance, in its 2023 National Trends Report, more than 90% of The Best Place for Working Parents®-certified organizations report offering PTO, flexible hours, remote options and healthcare coverage for employees and their families. While just 11% have on-site childcare facilities, the number of surveyed organizations that offer such a site has grown 47% since 2019.
“Companies that prioritize these benefits experience a more motivated and loyal workforce, which ultimately leads to a more productive and successful business,” Funk says.
Listening to the needs of employees
Apart from family-friendly benefits and policies, Liberty Mutual employees have opportunities to have “meaningful connections and conversations” with colleagues who may have faced similar journeys, including through its parenting employee resource group, Pathways to Parenthood.
This group has been influential in bringing employee needs to leadership. As a result of the ERG’s conversations with employees about their family-building and parenting experiences, Liberty Mutual last year updated its bereavement policy to provide up to five days of paid time off for employees or partners who experience pregnancy loss. It also recently rolled out a fertility education tool, free to employees.
“We’ve seen tremendous outcomes when our employee resource groups are engaged in conversations surrounding employee support and the benefits an employee population might need most,” DiMarino says. “These meaningful and impactful benefits signal to our employees that, as a company, we see you and support you.”
Organizations considering expanding fertility and other supportive family benefits should ensure their strategies are informed by employee needs, adds Funk.
“A short employee survey,” she says, “can help determine where your employees are on the caregiving and family-planning continuum and which policies would be most beneficial. It’s important to determine your specific workforce’s priorities before implementing any policy to ensure maximized ROI.”
In addition to working with ERGs, Liberty Mutual leadership regularly leverages employee surveys and stays keyed into market trends and benchmarking data to understand how they can better support employee wellbeing.
“We know that employees and prospective talent want more than just a paycheck. They’re eager for job opportunities, flexibility and benefits that support them throughout all stages of their lives,” DiMarino says. “By providing benefits that support their overall wellbeing, employees feel valued and supported, which fuels engagement and fosters a sense of belonging.”
The future of fertility benefits
Beyond employee surveys and market data, employers may also need to keep an eye on the courts and state legislatures, as the Alabama ruling cast additional uncertainty over the already complex landscape of fertility treatment.
If legislatures or courts in other states follow suit in redefining embryonic personhood, MacConnell notes, it could drive changes to standard IVF practices. For instance, patients may have to go through repeated stimulations to secure fewer numbers of eggs, which could significantly prolong the treatment process, its physical toll and its cost.
Weeks after the Alabama ruling, Florida was the latest state to move toward further restricting abortion access, with the Supreme Court allowing a constitutional amendment to ban abortions after six weeks to appear on the ballot this fall. This volatile environment, MacConnell says, should emphasize to employers the value of a supportive fertility benefits program, as employees may need access and guidance more than ever.
“[Fertility benefits providers] help navigate people through this process, especially when the unexpected occurs like what happened in Alabama when people were scrambling to figure out what to do,” she says. “Uncertainty will continue and we’re here to support people through that. Having a resource to help employees navigate this journey is vital.”
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