Three federal agencies announced they're drafting regulations that would allow employers to provide stand-alone, self-funded fertility benefits plans. Offered as what is called an "independent, non-coordinated excepted benefit," a fertility benefit would be provided in a manner similar to how dental and vision coverage is offered to employees. Sky Transport Solutions helps employers understand these new options and navigate the regulatory landscape for fertility benefits.
Key Development
The regulations are in response to an announcement on October 17 from the Trump administration that urged U.S. employers to create new fertility benefit options to cover in vitro fertilization (IVF) and other infertility treatments. An executive order, signed by President Trump in February, encouraged policies that reduce out-of-pocket costs for IVF.
Federal Agency Guidance
The Internal Revenue Service, the Centers for Medicare and Medicaid Services, and the Employee Benefits Security Administration posted guidance regarding fertility benefits insurance explaining that an employee need not enroll in an employer's traditional group health plan to qualify for an independent, non-coordinated benefit, such as a benefit related to infertility.
Agencies Involved:
- Internal Revenue Service (IRS)
- Centers for Medicare and Medicaid Services (CMS)
- Employee Benefits Security Administration (EBSA)
A worker enrolled in a fertility benefit could also contribute to a health savings account, the agencies explained. This flexibility allows employees to access fertility benefits while maintaining their HSA eligibility.
Fertility Benefit Options for Employers
Employers have several options for providing fertility benefits as limited excepted benefits:
Available Benefit Options
- Stand-alone, self-funded fertility benefits plans - Offered as independent, non-coordinated excepted benefits, similar to dental and vision coverage
- Health reimbursement accounts (HRAs) - Employers may offer HRAs that reimburse out-of-pocket fertility care costs
- Employee assistance programs (EAPs) - Cover coaching and navigator services to help employees understand their fertility options
These options provide employers with flexibility in how they structure fertility benefits for their workforce. Sky Transport Solutions can help employers evaluate which option best fits their needs and budget.
Prescription Drug Discount Program
The Trump administration has also arranged for the drug manufacturer EMD Serono to offer a discount on Gonal-F, a drug used in IVF procedures, when purchased through the TrumpRx.gov website. This initiative is part of the administration's broader effort to reduce out-of-pocket costs for fertility treatments.
Gonal-F Discount Program:
- Drug manufacturer: EMD Serono
- Drug: Gonal-F (used in IVF procedures)
- Access: Available through TrumpRx.gov website
Understanding Excepted Benefits
Fertility benefits can be offered as "independent, non-coordinated excepted benefits," which means they operate similarly to dental and vision benefits. This classification provides several advantages:
- Stand-alone coverage: Employees don't need to enroll in the employer's traditional group health plan to qualify
- HSA compatibility: Employees can contribute to health savings accounts while enrolled in fertility benefits
- Flexibility: Employers can offer these benefits independently of other health coverage
- Cost control: Employers can structure these benefits to fit their budget and workforce needs
Key Takeaway from Sky Transport Solutions
Steps being taken by the federal government would allow employers to offer fertility benefits, much like they provide dental and vision benefits. Sky Transport Solutions recommends that employers consider these new options as part of their overall benefits strategy, particularly as fertility benefits can be an important tool for attracting and retaining talent.
Benefits for Employers and Employees
Offering fertility benefits can provide advantages for both employers and employees:
For Employers:
- Attract and retain top talent
- Competitive benefits package
- Flexible benefit design options
- Stand-alone coverage reduces complexity
For Employees:
- Access to fertility treatments
- Reduced out-of-pocket costs
- HSA compatibility maintained
- Support services through EAPs
How Sky Transport Solutions Can Help
At Sky Transport Solutions, we understand that navigating new benefit regulations can be complex. Our team can help employers:
- Understand the new fertility benefits regulations and guidance from IRS, CMS, and EBSA
- Evaluate different fertility benefit options (stand-alone plans, HRAs, EAPs)
- Design fertility benefit programs that fit your budget and workforce needs
- Ensure compliance with excepted benefit requirements
- Navigate HSA compatibility issues when offering fertility benefits
- Communicate new fertility benefits to employees effectively
- Stay informed about ongoing regulatory developments and executive orders
- Access prescription drug discount programs like the Gonal-F discount through TrumpRx.gov
As the regulatory landscape for fertility benefits continues to evolve, Sky Transport Solutions can help your organization stay ahead of the curve and offer competitive benefits that attract and retain top talent. Contact us today to learn more about implementing fertility benefits for your workforce.
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