Proposed Fertility Benefit Rule Changes Could Reshape Employee Benefits Plans

The employee benefits world is changing rapidly, and one of the newest developments employers, HR teams, and insurance professionals are watching closely involves fertility benefits and IVF coverage.

Proposed federal rule changes may give employers more flexibility to offer fertility and family-building benefits separately from traditional major medical health plans.

While these rules are still proposed and not finalized, they could significantly impact how employers structure group benefits in the future.

Why Fertility Benefits Are Becoming a Bigger Workplace Discussion

Years ago, fertility benefits were rarely discussed in employee benefits meetings. Today, many employers are actively exploring ways to support employees with:

• IVF coverage
• Fertility treatment assistance
• Egg freezing benefits
• Adoption assistance
• Surrogacy support
• Family-building reimbursement programs

This shift is happening for several reasons:

• Employees are asking for more personalized benefits
• Employers are competing for talent
• Younger workforces value family-planning support
• Companies are looking for more inclusive benefit options

For many businesses, employee benefits are no longer just about medical, dental, and vision coverage. Benefits packages are increasingly being used as recruiting and retention tools.

What Is Being Proposed?

The proposed guidance would potentially allow fertility benefits to be offered as an “excepted benefit.”

In simple terms, excepted benefits are benefits that can exist separately from the main group health plan. Examples already include:

• Dental insurance
• Vision insurance
• Accident coverage
• Critical illness insurance
• Hospital indemnity plans

If fertility benefits are eventually treated similarly, employers may be able to offer fertility reimbursement programs or fertility assistance separately from the core medical plan.

Why Employers and Brokers Are Paying Attention

Adding fertility coverage directly into a traditional group health insurance plan can create compliance and cost challenges.

These can include concerns involving:

• ACA regulations
• HIPAA requirements
• COBRA administration
• Nondiscrimination testing
• Mental health parity rules
• Overall group plan costs

By allowing fertility-related benefits to potentially exist outside the major medical plan structure, employers may gain additional flexibility in how they support employees.

This could make fertility benefits more accessible for some employers who previously avoided offering them due to cost or complexity.

How This Could Impact Small Businesses

Small business owners often want to provide competitive employee benefits but may struggle with affordability.

If separate fertility benefit programs become easier to implement, smaller employers may eventually have additional options to:

• Customize benefits packages
• Improve employee retention
• Stay competitive in hiring
• Offer meaningful family-building support without redesigning the entire health plan

This may become especially important in industries competing for younger professionals and specialized talent.

Fertility Benefits and Inclusive Employee Benefits Strategies

Another major discussion surrounding fertility benefits involves inclusivity.

Traditional infertility definitions within some health plans may unintentionally exclude:

• LGBTQ+ individuals and couples
• Single parents by choice
• Employees pursuing alternative family-building methods

Separate fertility benefit programs may allow employers more flexibility in creating inclusive family-building support strategies for diverse workforces.

What Employers Should Know Right Now

These are still proposed rules and guidance. Employers should not implement fertility reimbursement programs or fertility carve-out strategies without speaking with experienced benefits professionals and compliance experts.

Every employer’s situation is different, and there are still important considerations involving taxation, ERISA, HIPAA, ACA compliance, and plan administration.

However, this is absolutely an area worth monitoring because fertility and family-building benefits are becoming one of the fastest-growing trends in the employee benefits space.

How Mere Helps Employers With Group Benefits

At Mere, we help employers and small businesses navigate group benefits strategy, employee benefit options, compliance considerations, and creative solutions that support both the company and its employees.

As employee benefits continue evolving, many businesses are looking for ways to remain competitive while still managing costs responsibly.

Whether you are reviewing your current employee benefits package or exploring new benefit offerings for your team, our office can help you evaluate available options and strategies.

Frequently Asked Questions About Fertility Benefits and Group Health Plans

What are fertility benefits in employee benefits plans?

Fertility benefits are benefits designed to help employees with family-building expenses and services. These may include IVF coverage, fertility treatments, egg freezing, surrogacy assistance, adoption assistance, and fertility medication support.

What is IVF coverage?

IVF stands for in vitro fertilization, a fertility treatment where eggs are fertilized outside the body and implanted to assist with pregnancy. IVF treatment can be expensive, which is why some employers are exploring fertility benefit options.

What is an excepted benefit?

An excepted benefit is a type of insurance or benefit that can operate separately from the main health insurance plan under certain federal rules. Examples often include dental, vision, accident, and hospital indemnity coverage.

Could small businesses offer fertility benefits?

Potentially, yes. If proposed rules move forward, some small employers may have additional flexibility to offer fertility assistance or reimbursement programs separately from traditional medical plans.

Are fertility benefits required under employer health plans?

In most cases, fertility benefits are not currently required under standard employer-sponsored health plans, although certain state mandates may apply depending on location and plan structure.

Why are employers offering fertility benefits?

Many employers view fertility benefits as a way to support employees, improve retention, remain competitive in hiring, and provide more modern and inclusive employee benefits packages.

Should employers review compliance before offering fertility benefits?

Absolutely. Employers should work with experienced employee benefits professionals and compliance advisors before implementing fertility reimbursement or fertility assistance programs.