A Proposed New Federal Rule Could Change How Employers Offer Fertility Benefits

Family-building benefits have quietly crossed a threshold. What began as a talent differentiator, something progressive employers offered to stand out, has become a standard benefits discipline.

In 2026, 39 percent of companies offer fertility benefits overall, up from 30 percent just six years ago, and 30 percent now cover in vitro fertilization, more than double the rate from a decade prior.¹ Your workforce isn’t wondering whether you offer this coverage. They’re evaluating whether what you offer is actually good.

That shift in expectation arrives alongside a meaningful regulatory development. The Departments of Labor, Health & Human Services, and Treasury have proposed a new category of limited excepted benefits that would allow certain fertility benefits to be offered outside an employer’s major medical plan. If finalized, this creates genuine plan flexibility that didn’t previously exist.

The proposal would open an opportunity that hasn’t existed before, giving employers a defined pathway to offer fertility coverage as a stand-alone benefit rather than trying to fit it inside the architecture of a traditional medical plan.² For employers who have wanted to expand coverage but felt constrained by how their plan is built, that’s worth paying attention to.

This being said, what the proposal isn’t, yet, is a green light. The rule is still proposed, and proposed rules have a way of departing differently than how they arrived. The employers who get this right won’t be the ones who move fastest, but the ones who use the time between now and a final rule to understand exactly where they stand, so they can move confidently when it matters.

That preparation is worth prioritizing. Research cited by the American Journal of Managed Care found that employers offering comprehensive fertility benefits experience higher retention, stronger engagement, and fewer stress-related absences. And, nearly 90 percent of employees would consider moving to organizations that offer fertility benefits.³ The business case is no longer speculative.

The right starting point isn’t a plan redesign, but instead, an honest assessment of what you currently offer, where the gaps are, and how your fertility benefit strategy fits within your broader women’s health and total rewards story. Employers who do that work now will be positioned to act decisively once a final rule is in hand, rather than scrambling to catch up in Q4.

The regulatory moment is real. Whether your organization is just beginning to explore fertility benefits or refining a strategy already in place, the window to get ahead of it is open and it won’t stay that way.

1| Employee Benefits Tracker, Prevalence of family-friendly benefits has increased steadily over the past 10 years. International Foundation of Employee Benefit Plans, June, 2026

2| Departments Propose New Excepted Benefit Pathway for Fertility Coverage. Business Group on Health, June 2026

3| What Does Federal Fertility Benefits Push Mean for Employers, Workers? WorldatWork, December 2025