Fertility and adoption services can cost thousands. More and more companies are stepping up to help.

Tuition reimbursement, paid volunteer days, even in-office kegs – the list of perks companies are offering to keep workers happy these days is long. Benefits to support fertility and help employees start a family have historically been offered by only a small slice of employer-sponsored health care plans, but that’s changing.

A Five on Your Side investigation found many of the largest employers in the Triangle are expanding their benefits in this arena. It's part of a strategic business decision to retain and attract workers in a moment where demand far outweighs supply.

In 2020, just over a quarter of large employers covered in-vitro fertilization. That number jumped to 36 percent in 2021, according to data collected by asset management firm Mercer.

“This is not for charity. If you’re a company that says ‘we offer medical and dental’ good-luck getting the best talent,” Pendo Chief People Officer Kelli Dragovich said.

Pendo offers its employees $2,500 that can be used for fertility treatment, prescriptions, gestational carriers, adoption and more.

“The silver lining of the pandemic, in my mind, is it really accelerated the need and responsibility for companies to pay attention to this,” Dragovich said.

Carrot Fertility works with companies globally, but its chief human resources officer Leslie Neitzel is based in the Triangle.

“It’s our mission to make fertility care accessible and affordable regardless of age, race, sex, sexual orientation, gender-identity and geography,” Neitzel explained. “So we customize a fertility benefit for employers that can include financial, medical and emotional support as individuals or families pursue parenthood.”

Neitzel explained that while many put the responsibility and focus of fertility on women, the matter is really one of global health that impacts anyone who wants a family.

“Historically, the misconception is that infertility is something that only impacts a cisgender female, but the reality is forty percent of our members are male and one third of all fertility cases are actually due to male-factor infertility,” Neitzel said.

Carrot Fertility began in 2016 and has seen a big increase in interest and partnerships with businesses since the pandemic.

“It’s sort of an expectation to have this coverage now,” she said. “We all have unique needs, and the fact is that many of us may be working from home now. The lines between work and personal life are very blurred now so the expectations are shifting dramatically.”

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Neitzel adds that for a long time this kind of coverage was only happening in the tech sector, but now they work with companies in retail, entertainment, hospitality, business and governmental agencies.

Duke Health and Duke University recently added more time off for working fathers. Both employers have offered fertility treatment coverage such as in-vitro fertilization for decades.

Those benefits have helped hundreds of employees start families according to Joyce Williams the associate vice president for Total Rewards, Duke’s benefits program.

Ashley Acken is a chaplain at Duke University Hospital. For a long time, she didn’t think that motherhood was possible for her due to long-term health issues including a blood disorder.

“I knew from a fairly young age that there were likely going to be issues with getting pregnant,” she said.

During the pandemic, she decided she wanted to have a baby. Her doctor said it was possible with fertility help. So she underwent intrauterine insemination or IUI. She was able to get pregnant and now has a beautiful 8-month-old baby boy.

“He’s my little miracle,” she said. “He’s the happiest baby.”

Acken admits that fertility treatment may not have been possible without coverage through work.

“I had friends who paid $30,000, $40,000, $50,0000 for one attempt at getting pregnant,” she said. “We did not pay more than $500 to conceive our child. It’s absolutely incredible.”

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Acken tells Five on Your Side that the coverage provided through her work made her a better employee.

“I can work harder and be there for families at some of the most difficult moments in their life because I have my family to come home to,” she said.

Other companies in the area see the benefit of providing this type of coverage as well.

IBM offers $20,000 for eligible adoption or surrogacy expenses. Software developer-SAS offers qualified adoption expenses per child and paid maternity leave for birth mothers, fathers, domestic partners and adoptive parents.

However, the reality is many companies still do not cover treatments to grow or start a family.

Here’s how to talk to about getting this kind of coverage from your employer:

Since the onset of COVID, IBM understood that for employees responsible for the health and wellbeing of others – in their role as parents and/or caring for family members – has been particularly difficult and overwhelming. In 2020, HR benefits design changed from an annual November launch to a rolling evaluation of need, based on employee input.

IBM also introduced four additional weeks of flexible, paid emergency leave that can be used in increments of hours or days, or in a single, monthlong stretch. It began offering emergency backup offering employees use of a daycare center or in-home assistance when usual child or elder care arrangements fall through.

These benefits were in addition to:

Here is a list of many family-forming support benefits SAS offers to all employees and their family members enrolled in our benefits plan:

Adoption assistance for qualified adoption expenses per child. (This has been in place since at least 1990.)

Infertility services for certain services related to the diagnosis, treatment and correction of any underlying causes of infertility for members enrolled in the health care plan (except dependent children), including in-vitro fertilization. In 2021, this was updated to remove the requirement for a diagnosis of infertility.

Paid parental leave for birth mothers, fathers, domestic partners and adoptive parents.

Free Family Support offered by our internal Work/Life team provides free access for all employees to in-person and/or virtual resources on family-related issues, including:

Paid and unlimited family sick days.

Free SAS Healthcare Center services for new parents (who are enrolled in the SAS health care plan):

Breast milk shipping when traveling for work.

On-site daycare and child care subsidy program for full-time employees.

Employee Assistance Program (EAP) provides free counseling sessions for employees and family members. Support services include resources for:

Family Support Services

And of course, the above-mentioned SAS Health Care Center is completely free to employees and their dependents enrolled in the SAS health care plan for all primary care needs.

Family planning support through the company’s medical plan:

Parental leave – Fully paid parental leave, totaling up to six weeks, available to mothers and fathers. A qualifying employee can start the six-week paid leave any time within the first 16 weeks after the birth, adoption or foster care placement of a child. (A birth mother can take up to at least 12 weeks' paid time off: at least six weeks through the company's pregnancy-related short-term disability benefit, followed by up to six additional weeks of parental leave pay).

Adoption expenses reimbursement – Up to $5,000 for covered costs associated with adopting a child.

Sick and family care pay – Paid time off for certain personal circumstances that require time off from work, such as for an employee’s own illness, injury or condition, or to care for a family member’s medical needs. Generally, employees have at least 80 hours available that can be used annually.

Time off in support of education, communities and inclusion – Up to 12 hours of paid time off each year to volunteer for academic-related activities, or activities with a 501(c)3 nonprofit organization in support of qualified diversity and inclusion events.

Financial coaching – Employees and their families can receive company-paid financial checkups and a personalized financial plan from an experienced financial coach.

Through the company’s employee assistance program, employees have access to:

Employee discounts – Childcare discounts are available from the company’s employee discount vendor.

Yes, UNC Health does offer employees fertility coverage. Some of the benefits vary by hospital – we’re not all on the exact same benefits package. Generally, UNC Health pays all claims to restore natural fertility, or pays for any fertility related procedure or prescription.

Also, UNC Health late last year began offering paid parental leave for all employees (four weeks). That was an important benefit that employees had requested. We also offer adoption assistance.

It’s possible we will be reviewing options for adoption assistance and infertility services in the future, but here is what Wake County Government currently offers employees related to your questions:

Wake offers 8 weeks of paid parental leave (to both male and female) in the 12 months following:

There are also Wake County buildings offering dedicated lactation rooms.

WakeMed’s employee health plan does cover fertility testing and diagnosis for men and women as well treatment for underlying conditions that may cause infertility – for example, endometriosis, pelvic inflammatory disease, hypothyroidism, low testosterone, blocked fallopian tubes or sperm ducts, etc. Our current health benefits for staff do not include fertility treatments or reproductive assistance such as in vitro fertilization (IVF), intrauterine insemination (IUI), and intracytoplasmic sperm injection (ICSI).