What You Need to Know to Support Equitable Family Building Benefits | Progyny

Equitable family building benefits depend on more than access alone; they also require plan design that works across different paths to parenthood. Employers can improve fairness by reducing exclusions, expanding eligibility, and making support easier to navigate.

The path to parenthood can look very different depending on one’s gender, race, sexual orientation, location, and even income. From available treatment coverage to the financial cost, access to fertility support in today’s benefit space is simply inequitable.   

In An Open Letter in Favor of Rational and Equitable Access to Fertility Care and Benefits, a group of prominent scholars, academics, and attorneys across the U.S. called for a better way to support growing families. Progyny recently convened a webinar to discuss the roadblocks currently in the way of family building equality and how health plans and employers can increase access to care for everyone. The powerful conversation produced three key takeaways for fostering more equitable, comprehensive access to family building support today.  

1. Starting (and continuing) this conversation is critical.  

Before progress can begin in earnest, benefits leaders should first understand the inequalities that diverse groups are facing. For example:  

• Fertility care is stigmatized: Healthcare coverage for other medical needs is treated differently than fertility. An employee won’t be told they have simply exhausted the allotted medical coverage for back pain or cancer and need to stop treatment. But individuals experiencing fertility issues are told every day that they’ve run out of coverage and can’t continue treatment. 
• Financial constraints: A woman early in her career may not have the financial resources to pursue fertility care, despite it being the best time to start that process. And let’s say she does have fertility coverage – if it’s a lifetime dollar max or “dollar cap” model, it still may not cover what she needs.  
• Identity-based requirements: A heterosexual, married woman may have easier access to infertility treatment than a same-sex couple or single parent with the same health benefits (because some benefits require a diagnosis of infertility that is defined by a year of heterosexual intercourse before fertility benefits can even be triggered).   
• Access gaps: There is disproportionate access to fertility treatment across racial and cultural lines. Black women, for instance, are twice as likely to suffer from infertility but are half as likely to access care than white women, even considering socioeconomic status.  

These factors and many others shouldn’t have a place in the decision to start a family, but they often do. Inequitable benefits and an outdated, arbitrary definition of infertility exclude people from needed medical care. A different path forward from both a policy and benefits perspective is required to ensure everyone has an equal opportunity to have a family.   

2. Benefits leaders must review gaps in their coverage and ask the hard questions.  

The first step for health plans and employers is to review what is currently being offered and identify any gaps, both in what their coverage entails and member access to coverage. Then, explore what supplemental coverage is available.  

It’s becoming more common for health plans and employers to enhance their offerings by carving them out to solutions, who can use their expertise to manage care, align access to specialists and provide unparalleled member support. In fact, research shows employers are 4x more likely to carve out fertility than in previous years. 

Not all coverage is equal – it’s important to thoroughly review the solutions available and make sure they can really serve the people you care for. Ask question like:  

• What types of services are available in the marketplace?   
• What can be integrated into existing coverage?   
• Does the benefit use language that excludes LGBTQ+ individuals and single parents by choice?  
• Is the provider network using best practices and providing positive outcomes? 

3. Fertility is a critical part of health benefits, but benefits leaders aren’t confident that their solutions are truly equitable.   

Progyny’s recent survey on the state of LGBTQ+ fertility and family building shows that 68% of individuals say they can’t access care because of heteronormative definitions of infertility, even when their employer offers a fertility benefit. Furthermore, 79% of respondents said they would be willing to take on a second (or even third) job to pay for their family building costs or would consider switching employers for more comprehensive benefits.   

While about 50% of benefits professionals participating in Progyny’s webinar said they believe fertility benefits are important and/or are something they’ve already implemented, 77% said they were somewhat confident or not confident at all that their benefits package was providing equitable coverage.  

So – what can be done today?   

According to the World Health Organization, 1 in 6 adults will experience infertility globally. However, these issues are incredibly difficult to talk about, so many benefits leaders and decision makers are left unaware of how hardships around fertility are affecting people in their organizations.  

We must create a way for people to talk about their needs, and benefits must be put in place that are truly equitable for any person who wants to build their family. When employers understand these issues and how people are affected, they can better facilitate these tough discussions and implement benefits solutions with an informed approach that meets the needs of their teams. It’s time for us to educate ourselves, to create space for people to express their needs, and to equalize access and coverage for everyone who wants to exercise their right to start a family. Learn more about what equitable fertility and family building benefits can mean for your members and employees.