Having a family-building benefit is now considered a necessity for employees. Companies across different industries are utilizing a managed fertility benefit as part of their toolkit to recruit and retain top talent. When it comes to designing a managed fertility benefits plan, there are 4 main things to consider.
1. How much the program will cost
As the sponsor of the fertility plan, your company has a fiduciary responsibility to make it worthwhile and valuable to your employees. It’s also critical to be aligned with the provider when it comes to costs. How efficiently is the fertility benefits provider spending on medication, recommending the most effective treatments and referring patients to in-person clinical appointments? There is no reason to overpay.
Your fertility program manager must make a dedicated effort to provide oversight in how care is administered. This helps ensure quality of outcomes for your employees and promote efficiency in spending. The best way to improve outcomes is to educate the patient. Are they choosing a doctor who has experience overcoming the challenges the patient and partner face? Choosing to not work with a qualified reproductive endocrinologist in the first place can add to the cost to both employers and patients.
Cost is the most important element to ensuring your fertility benefits program is sustainable. Purchasing fertility care and related pharmaceuticals can be fraught with inefficiencies, so be sure all costs are presented transparently.
2. Corporate culture
Define how the fertility benefit program fits into your corporate culture. Put simply, why are you offering this to your employees? Is its primary purpose to attract quality employees and retain your existing talent? To increase employee productivity? To promote diversity, equity and inclusion?
Your program manager needs to be well-versed in supporting people of all ethnic backgrounds, financial positions and geographical locations. What is the standard of fertility care in your immediate region? A good program manager will help patients gain access to the best care, even when it is not in their immediate area.
Keep in mind that standard health plans can’t be counted on to meet all the needs of a patient being treated for infertility. A separate provider is needed from the major health systems in your area.
3. Program management
In an unmanaged fertility benefit, a patient can spend to a predetermined limit (dollars or cycle) at his or her own discretion. But this approach can be fraught with inefficiencies. Intended parents need advocacy, guidance and clinical support.
In a managed fertility benefit, a clinician (preferably and trained RN) is available during every step of the process to advocate for patients: helping them to understand their benefit, finding the doctors they need, understanding their personal medical history and diagnosis, navigating medication, catering to their emotional and behavioral support needs.
A clinically trained advocate is sensitive to the diversity of patient situations ? anything from postpartum to male-factor behavioral support and testing ? and can be an essential advocate for each of them. This saves the patient time and stress, and saves employers money by eliminating potentially wasteful spending on doctor’s visits and unnecessary medication.
4. Family re-investment
Traditionally, employers have viewed an employee walking through the office door as the beginning of their relationship. It’s increasingly worthwhile to think about helping the employee outside the workplace as well.
The idea of an employer providing additional financial assistance from pre-conception through the fertility journey, then back to work and parenting, is gaining popularity. Effective management of a fertility program offers an opportunity to re-invest in broader family services.
Say a managed fertility benefit program is able to save a company $1,000 in per-employee spending. The company might choose to reinvest those savings in, for example, family coaching or at-home male factor testing for its employees.
The concept of family services is driven by the need for employers to support their employees with family-building more broadly than they have in the past. By designing a useful fertility benefits plan, the company can directly impact employees’ lives in a profoundly meaningful way.
Peter Nieves serves as the chief commercial officer for WINFertility. He is responsible for the profitable growth, product strategy and expansion at WIN. Peter has over 25 years of experience in the benefits consulting and P&C industry.
