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Part
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Ancillary Benefits
Among employers in the United States that offer IVF benefits, 76% to 100% of the IVF treatment cost is usually covered by the employer, while the remaining fraction is covered by the employee. While the portion of the egg freezing cost that is typically covered by employers offering egg freezing benefits is not readily available in the public domain, there is a good chance that the whole egg freezing cost is covered. This is because the cost of egg freezing is much lower than the cost of IVF treatment. Of the various ancillary benefits, dental insurance appears to be the most important. With a prevalence of close to 100%, it is the most prevalent of all ancillary benefits.
PERCENT OF COST COVERED BY EMPLOYER
IVF
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Based on data published by FertilityIQ, a provider of fertility-related services in the United States, it appears that employers that offer IVF benefits typically cover 76% to 100% of the IVF treatment cost. The remaining portion (0 to 24%) of the IVF treatment cost is then paid for by the employee.
According to FertilityIQ, of 200 IVF patients in 2017 that participated in its survey, 126 (63%) had no coverage, 10 (5%) had 1% to 25% coverage, 12 (6%) had 26% to 50% coverage, 14 (7%) had 51% to 75% coverage, and 38 (19%) had 76% to 100% coverage.
No coverage — 126 or 63% of 200
1% to 25% coverage — 10 or 5% of 200
26% to 50% coverage — 12 or 6% of 200
51% to 75% coverage — 14 or 7% of 200
76% to 100% coverage — 38 or 19% of 200
From these figures, it can be observed that of 200 IVF patients polled, 74 IVF patients were with coverage.
10 + 12 + 14 + 38 = 74
Of these 74 IVF patients with coverage, 51% had 76% to 100% coverage, 19% had 51% to 75% coverage, 16% had 26% to 50% coverage, and 14% had 1% to 25% coverage, as shown below. Over half of IVF patients with coverage had 76% to 100% coverage.
With coverage — 74
1% to 25% coverage — 14% or 10 out of 74
26% to 50% coverage — 16% or 12 out of 74
51% to 75% coverage — 19% or 14 out of 74
76% to 100% coverage — 51% or 38 out of 74
The sample these percentages were based on is small, but FertilityIQ's report is the only study in the public domain that provides the percentage of IVF treatment covered by employers. No other relevant information can be located even after a thorough search through reports on employee benefits and articles on IVF as an employee benefit.
Across eight major cities in the United States, the total IVF treatment cost ranges from $20,010 (Boston) to $25,883 (Los Angeles).
Employers that are considered most generous in terms of IVF coverage include Bain, BCG, Chanel, Bank of America, KKR, Ropes and Gray, Gates Foundation, Facebook, Pinterest, Spotify, Pyramid Hotel Group, City of Baltimore, Conair, Unilever, Johns Hopkins, LinkedIn, University of Maryland, News Corp, Google, and Salesforce. They offer either 3 to 4 IVF cycles + pre-implantation genetic screening (PGS), 5 to 6 IVF cycles, $100,000, or unlimited coverage.
Egg Freezing
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My searches through reports and articles on employee benefits and fertility treatments revealed that the portion of the egg freezing cost that is covered by employers is not available in the public domain. However, given that the cost of egg freezing, $10,000 to $15,000, is way lower than the cost of IVF treatment, and that many companies have begun extending the benefit to its employees since Facebook offered it in 2014, it is likely that employers that offer egg freezing benefits cover 100% of the egg freezing cost.
Tech companies that offer egg freezing benefits include Apple, eBay, Facebook, Google, Intel, LinkedIn, Netflix, Salesforce, Snapchat, Spotify, Time Warner, Uber, and Yahoo. Several of these companies, as noted in the section above, offer very generous IVF benefits. Spotify, for example, offers unlimited IVF coverage. Facebook, on the other hand, offers four IVF cycles plus one PGS. Considering that the cost of egg freezing is around half of the cost of one IVF cycle, the likelihood that there is full coverage of the egg freezing cost is high.
MOST IMPORTANT ANCILLARY BENEFIT
In answering this part of your request, I assumed that ancillary benefits refer to benefits that are "usually layered on top of medical coverage." Dental insurance and vision insurance are examples of ancillary benefits, according to Investopedia. While I was unable to find any source in the public domain that identifies the ancillary benefit that ranks the highest in terms of importance, I found a report by the Society for Human Resource Management (SHRM) that provides helpful insights.
According to Tables 3 and 4 of SHRM's report "2017 Employee Benefits," which presents the society's findings from its latest survey of 3,227 HR professionals in the United States, the prevalence of the following health-related benefits significantly increased during the period 2013-2017:
1. Health savings account (HSA) — from 42% to 55%
2. Employer contributions to HSAs — from 26% to 36%
3. Wholesale generic drug program for injectable drugs — from 20% to 31%
4. Vision insurance — from 82% to 88%
Based on Investopedia's definition of ancillary benefits, it appears #3 and #4 can be considered ancillary benefits. Given the statistically significant increases in the prevalence of these two benefits and the fact that over 300 employee benefits were covered in the report, it may be safe to assume that there is real demand from employees for these two benefits. Among the health-related benefits in the report that can be regarded as ancillary benefits, dental insurance, vision insurance, and prescription drug coverage had the highest prevalence in 2017. Their prevalence rates were 96%, 88%, and 95%, respectively. Since dental insurance had the highest prevalence, it may be safe to assume that it is the most important ancillary benefit. Its close-to-100% prevalence over the past five years signifies its importance to employees.
Since you are interested specifically in IVF and egg freezing, I would like to note that, according to SHRM's report, the prevalence of the following health-related benefits significantly decreased during the period 2013-2017:
1. Consumer-directed health care plans (CDHPs) — from 31% to 23%
2. Medical flexible spending accounts (FSAs) — from 72% to 65%
3. Long-term care insurance — from 31% to 22%
4. Mental health coverage — from 89% to 81%
5. Contraceptive coverage — from 82% to 75%
6. Infertility treatment coverage (excluding IVF) — from 34% to 26%
7. IVF coverage — from 30% to 24%
The prevalence of contraceptive coverage, infertility treatment coverage (excluding IVF), and IVF coverage decreased during the period 2013-2017. The prevalence of egg freezing for non-medical reasons, on the other hand, increased from 2% in 2015 to 3% in 2017.
According to fertility treatment provider WINFertility, however, 68% of employees would change jobs if they were offered fertility benefits. Also, according to a survey conducted by Willis Towers Watson PLC, the percentage of employers planning to offer fertility benefits will increase from 55% in 2017 to 66% by 2019.
CONCLUSION
Employers in the United States that offer IVF benefits mainly cover 76% to 100% of the total cost of IVF treatment, and employees take care of the rest. The portion of the egg freezing cost that is typically covered by employers is not publicly available, but it is likely that the whole cost is covered as the cost of egg freezing is way lower than the cost of an IVF cycle. At present, dental insurance emerges as the ancillary benefit with the highest importance. Its close-to-100% prevalence among employers is indicative of its usefulness among employees.