What to Ask HR About Fertility Benefits This Year

You opened the benefits PDF, saw the words "fertility coverage," and felt a small flicker of relief. Then you read the fine print.

Maybe it's a $5,000 lifetime max that wouldn't cover one round of IVF. Maybe it's "infertility services" with no mention of whether that includes medication, genetic testing, or anything for single parents or same-sex couples. Maybe there's no number at all, just a vague promise that something is "available."

This is the moment most of us shrug and click through. Don't. Right now — late summer through fall — is when employers are finalizing their 2027 benefits. Decisions about what your plan will cover next year are being made in conference rooms this quarter.¹ After enrollment closes, the window slams shut for another twelve months.

Here's how to use it.

Why your voice matters more than you think

Employers are paying closer attention to fertility benefits than they have in years. RESOLVE's Corporate Council — a group of companies engaging on family-building policy — is now the largest it's ever been.² HR teams are increasingly being told that auto-renewing a fertility vendor without reviewing outcomes isn't good enough.¹

That shift creates an opening. HR leaders who are already being pushed to evaluate their vendors are more receptive to employee feedback than they used to be. One specific, well-framed request from an employee can land on a desk where someone is actively asking the same questions.

You don't need to be an HR expert. You just need to ask the right things.

Before you talk to HR: read what you have

Pull your current Summary Plan Description and look for four things:

1. A dollar cap or cycle cap. Is there a lifetime maximum? Does it cover a number of cycles, or a dollar amount? A $25,000 lifetime cap sounds generous until you price one IVF cycle with medication.
2. What "infertility" means in your plan. Some plans still require a medical diagnosis of infertility based on a year of unprotected heterosexual intercourse — which by definition excludes single people and same-sex couples from coverage.
3. Medication coverage. Fertility drugs can run several thousand dollars per cycle and are often carved out separately under pharmacy benefits. A plan that covers IVF but not the meds is half a plan.
4. Adjacent paths. Does it mention egg freezing, donor gametes, surrogacy, adoption assistance, or mental health support tied to family building?

If any of those are missing or unclear, those are your questions.

Questions to ask HR (that they should be able to answer)

Frame these as an employee trying to plan, not as a complaint. You're being a good consumer of your own benefits.

• "Who is our fertility benefits vendor, and when was the contract last reviewed?" If the answer is "we just auto-renew," that tells you something. Vendor accountability — meaning, are the outcomes actually good — is exactly what benefits consultants are pushing employers to examine right now.¹
• "What are the clinical outcomes for employees who've used this benefit?" Good vendors track live birth rates, single embryo transfer rates, and multiple birth rates. A vendor that can't or won't share these is a red flag.
• "Is coverage based on a medical infertility diagnosis, or is it available regardless of marital status, sexual orientation, or partner status?" This is the single most important question if you're LGBTQ+, single by choice, or a couple who can't meet the traditional diagnostic definition.
• "Are fertility medications covered, and under which part of the plan?"
• "What's covered beyond IVF — egg freezing, donor gametes, gestational carrier costs, adoption assistance, pregnancy loss support?"
• "Is there a mental health benefit specifically connected to family building?"
• "What's the appeals process if something is denied?"

Write the answers down. If HR doesn't know, ask who does.

Red flags that a plan is more checkbox than real

• Coverage exists on paper but requires step therapy that forces you through treatments unlikely to work for your situation before approving what your doctor actually recommended.
• A lifetime maximum so low it covers diagnostics but not treatment.
• "Infertility" defined in a way that excludes you.
• No coverage for medications, or medications capped separately at a low amount.
• No mention of LGBTQ+ family building, single parents by choice, or third-party reproduction.
• A vendor your HR team can't name, or whose outcomes they've never seen.

How to make a personal case without oversharing

You do not owe your employer your medical history. You can advocate for better coverage without telling anyone you're in treatment.

A few approaches that work:

• Submit feedback through the benefits survey if one exists. Specific requests ("expand the definition of infertility to be inclusive of all family structures," "add coverage for fertility preservation," "include a mental health benefit for pregnancy loss") carry more weight than general dissatisfaction.
• Ask if there's an employee resource group for parents, caregivers, or LGBTQ+ employees. Collective requests move HR faster than individual ones.
• Point to peers. If you know companies in your industry offer stronger coverage, name them. HR teams benchmark constantly.
• Frame it as retention. Family-building benefits are increasingly cited as a reason employees stay or leave. You don't have to say it's about you.

One thing to watch this cycle

The regulatory environment around employer-sponsored fertility coverage is shifting. A proposed federal rule could change how employers structure family-building benefits, and advocacy organizations have raised concerns about whether it would expand or narrow access.³ You don't need to track every policy detail. But if your HR team mentions changes coming from federal guidance, it's fair to ask: will our coverage get better or worse under this?

What to take with you

The people designing your benefits next year are making decisions right now based on what they hear from employees and what their consultants tell them. Most employees say nothing. The ones who ask specific questions — calmly, in writing, during the window when decisions are still open — are the ones who get heard.

You don't have to fix the whole system. You just have to ask one question this month that you didn't ask last year.

Start with this one: Can you show me exactly what our fertility benefit covers, and who decided that was enough?