May 30, 2022
Dusan Baic

Offering Fertility Coverage To Employees Won't Break The Bank

May 30, 2022
Dusan Baic

Fertility has become a hot topic as of late and for good reason. In Canada, infertility affects 1 in 6 couples in child-bearing years. While pregnancy and childbirth are celebrated on Instagram feeds and company email threads, infertility is often suffered in silence. With limited employer support, the stress, missed work and high treatment costs all compound to bear heavy weight on both partners. This was one of the key reasons why we partnered with Fertility Benefits Matter back in March 2021 to make the business case for fertility benefits.

In addition to just talking about it, it was also important for us to act. In April 2021 we introduced an increase to our minimum health standard of benefits to all Beneplan members. This new health standard saw 6 new mandatory enhancements to all plans which included Fertility Drug Coverage at $2,500 per lifetime per employee. While this doesn't cover the entirety of treatment costs, we felt it was the first step in the right direction.

We received much praise for this. We got endless calls, emails and social media buzz for taking the initiative to support employees building their families. However, there were still some skeptics and we totally understand their concern - "you are just offloading this expensive benefit onto the employer's tab. Our premiums are going to take a hit!". Through our experience in facilitating fertility claims, we assured employers that offering this  benefit won't impact premiums in a significant way because its usage is low and very selective. With over a year since our enhancement has took effect, we wanted to share the preliminary data and examine the trends.

Total fertility drug claims May 1 2019 - April 30 2022

In 2019, fertility drug claims were hovering at a stable level of $32,042.81. This amount represents companies who voluntarily opted to offer fertility drug coverage for their employees. During 2020 we saw a drop in claims by 34% due to the extended COVID-19 lockdowns and restrictions that limited employees to access fertility health practitioners. Since we added the $2,500 fertility drug coverage per employee in April 2021, fertility claims increased by 65% to $52,894.25. This increase highlights a few key trends:

  1. Fertility drug coverage is actually needed and wanted
  2. Beneplan, advisors and employers have been successful in driving awareness of this newly added benefit
  3. The end of lockdowns has released pent up demand in fertility care from 2020 onto 2021

A total of 18 employers have accessed this benefit in 2021 (vs 10 in 2019). This shows a healthy increase of usage amongst our members but still a low utilization rate of 4.8% when looking at Beneplan’s total membership of 375 employers. While fertility treatment is often stigmatized as a lifestyle choice for office executives, we see an equal split of usage between industrial/trades and service oriented employers.

So while total claims have increased significantly in 2021 compared to previous years, offering fertility benefits will still not materially impact employer premiums. When looking at fertility drugs claims as a percentage of Beneplan’s total health and dental premiums (see chart below), we can see they only represent 0.19% of premiums in 2021. This benefit is not as cost intensive as initially perceived by some skeptics. Comprehensive reviews from Connecticut, Massachusetts, and Rhode Island, which have mandated infertility benefits since the 1980s, show that the cost of infertility coverage is less than 1% of the total premium cost (source). We predicted similar levels of cost at which we are still significantly far from reaching given today’s current levels. We will continue to monitor this trend.

Fertility claims as a percentage of total Beneplan premiums, 2019-2021

The business case for investing in fertility benefits is becoming clearer. Since we have mandated Fertility Drug Coverage as part of our new minimum health standard, we have seen greater requests, praise and usage of this benefit with very little impact to premiums. We encourage employers to continue spreading awareness of this benefit to their teams and help those that need support in building their family. 


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