A majority of large employers in the U.S. offer some family-forming benefits, but many still do not help workers pay for IVF, and transparency around the benefits is often a problem.
Jenna Pellicori-Curry spent around $40,000 out-of-pocket on medical treatments to conceive her first child, who is now 3 years old.
She had struggled for three years with infertility, and experienced ectopic pregnancy -- a dangerous condition in which a fertilized egg does not implant in the uterus, often staying in the fallopian tube.
Like many people, Pellicori-Curry at the time did not have fertility coverage through her employer's health benefits package.
"There were times throughout that journey that I didn't even think we would be able to keep going just because of the financial constraints, and the physical and mental anguish that just accompanies the process," said Pellicori-Curry, a pediatric audiologist at Nemours Children's Health in Deptford.
Nemours patient service representative Justine Haring and her husband went through two years of fertility treatments before she got pregnant. She bonded with Pellicori-Curry through the infertility process, which is at times "very lonely and isolating," Haring said.
"We work with children too, so it's in our face every day and it's so hard and it's something that you want so badly," Haring said. "And then you have this huge financial burden if you don't have the coverage" through an employer's health insurance offering.
Moved by their own experiences, and the knowledge that infertility affects roughly one-sixth of people according to the World Health Organization, Pellicori-Curry and Haring approached leadership at Nemours with an argument for providing fertility benefits to the company's workforce. The company's then-chief human resources officer, Peter Adebi made a point of coming to their office in Deptford for an in-person meeting.
In that first meeting he gave them an answer: no.
"I really do genuinely remember seeing the heartbreak on his face when he had to relay that news to us," Pellicori-Curry said, recalling that Adebi encouraged the pair to continue raising the issue. "I said, 'I'm gonna reach out year after year until there's a change.'"
But she didn't have to. One year later, as Pellicori-Curry was preparing to contact Adebi and make the case again, the company announced plans to begin offering infertility coverage in 2022. Numerous Nemours employees had expressed a desire for the benefit, so human resources found a third-party benefits provider to navigate the offering.
Over the next 2½ years, 65 babies were conceived by couples using Nemours' fertility benefits, according to the company.
One of them was Pellicori-Curry's second daughter.
The number of large companies offering this coverage seems to be increasing, and workers are increasingly seeking out these benefits when considering a job change. Still, experts say, employers may not be touting these benefits in the recruiting process, and transparency around using them is often lacking.
In a report examining 100 large U.S. employers, the nonprofit organization Reproductive & Maternal Health Compass found that the majority offer some family-formation benefits, which could include fertility treatments, surrogacy, and adoption. Fourteen of them cover at least $40,000 of family-formation expenses.
But only 41 of the 100 expressly cover in vitro fertilization or IVF -- a series of procedures in which mature eggs are collected and fertilized by sperm in a lab, then inserted into the uterus to implant and develop.
IVF accounts for 99% of assisted reproductive technology procedures, according to the U.S. Department of Health and Human Services (HHS).
In 2021, more than 3,100 babies in Pennsylvania were conceived using assisted reproductive technologies, accounting for 2.4% of infants conceived in the state. More than 5,100 in New Jersey were conceived using these technologies, accounting for 5% of infants conceived, according to HHS.
The RMH Compass report also identified common pitfalls for employers in providing these benefits. Top among them: lack of transparency. Employees don't know what is available to them.
Providing fertility coverage is a growing trend that began in large companies and has begun to trickle down to smaller workplaces, said Theresa Stenger, a benefits consulting practice leader at Marsh McLennan in Conshohocken.
Historically, she said, employer benefit plans "would cover diagnosis of infertility" but nothing beyond that. In the past eight years or so, that's changed, Stenger said.
"We're seeing significant interest from an attraction and retention standpoint to say we have fertility benefits," Stenger said. It's hard to put the recruiting and retention impact into numbers, she said, but it's a topic that comes up in satisfaction surveys and exit interviews.
It's also a "financial wellness" consideration, said Tyler Zalucki, a benefits consultant at Marsh McLennan, noting that financial assistance with expensive fertility treatments may become more common as employers look to alleviate financial stress that commonly distracts people from their work.
Nemours ultimately invested in fertility coverage because of associate feedback, said Lisa Meddock, a member of Nemour's benefits team. About 50% of the company's workforce was at a stage where family-forming was top-of-mind, she said.
Her team researched the options available for coverage and aimed to create an "inclusive" policy, ultimately picking one that would cover 21 different methods of treatment. Through third-party benefits provider Progyny, Nemours covers a predetermined amount of treatment, which includes all services and tests, so users don't have to track the cost and coverage of each step dollar by dollar.
While fertility benefits are becoming more prevalent among employers, and more in-demand among workers, it's not a benefit local employers are commonly listing outright in their job postings.
"We're not seeing companies using it so much as a tool to attract talent," said Christine Endres, a senior regional director at staffing firm Robert Half. But "it could be a huge way to attract certain talent, to retain certain talent."
Endres said some recruiters on her team have seen an uptick in job candidates inquiring about fertility coverage. Jobseekers should feel empowered to ask these questions during the interview process, she said, as they seek information about a company's entire benefits package.
If you're "asking these things early on in the interview process, a company should be proud to discuss with you what they offer," Endres said. "It's not just about money -- [that's] a big part of it. But your career growth and well-being are equally important to the longevity you'll spend at an organization."
For Haring, becoming a parent has also given her a stronger connection to her job at Nemours, helping pediatric patients coordinate their care, she said. "I just want to support our families as best as I possibly can."
Pellicori-Curry was, at one time, one of those people on the job market hoping a new employer might help cover her fertility treatments. She ended up staying at Nemours, eventually seeing that hope come to life there.
"I just always would encourage people to -- honestly, it sounds a little cliché -- but to never give up, and to fight for the things you believe in and advocate for yourself," Pellicori-Curry said. "I didn't think my voice would honestly hold much power ... but here we are."