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Federal regulators—specifically, the Departments of Labor, Health and Human Services, and the Treasury—issued joint guidance on October 16, 2025, making it significantly easier for employers to offer fertility benefits outside of their traditional group health plans.
This action was driven by an Executive Order focused on protecting in vitro fertilization (IVF) access and reducing the high out-of-pocket costs associated with fertility treatment. The guidance effectively creates compliant pathways for employers to offer fertility coverage as an excepted benefit.
Key Takeaways for Offering Fertility Coverage
The new guidance provides clear, compliant options for employers to offer fertility support:
- Standalone Excepted Benefit: Employers may offer fertility benefits through a separate, fully insured policy that is not coordinated with the main group health plan. This is a crucial distinction, as individuals enrolled in this separate coverage may still contribute to a Health Savings Account (HSA).
- Excepted Benefit HRA: Employers can use an Excepted Benefit Health Reimbursement Arrangement (HRA) to reimburse employees for out-of-pocket fertility expenses, provided the HRA meets all applicable regulatory standards.
- Limited EAP Services: Benefits for fertility coaching and navigator services (to help employees understand their options) can be offered under an Employee Assistance Program (EAP), as long as the EAP qualifies as a limited excepted benefit and does not offer significant medical care benefits.
What’s Next?
The Departments have indicated they plan to release future rulemaking to explore even more ways to offer fertility benefits as a limited excepted benefit, which could offer employers additional flexibility in the future.
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