- On October 21, 2025
The United States Department of Labor, United States Department of Health and Human Services, and United States Department of the Treasury have issued new guidance clarifying how employers can use excepted benefits to offer or expand fertility coverage.
This action follows Executive Order 14216, which directed the Domestic Policy Council to develop strategies to improve access to in vitro fertilization (IVF) and reduce costs for patients and health plans.
Key Options for Employers
- Stand-Alone Fertility Coverage: Employers may offer fertility benefits as an independent excepted benefit if the coverage:
- Is provided under a separate insurance policy or contract (not self-funded),
- Is not coordinated with other group health plans, and
- Pays benefits regardless of other coverage.
Individuals enrolled in this type of 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 fertility-related out-of-pocket costs, provided the HRA meets existing regulatory requirements.
- EAP Support Services: Coaching or navigation services may be offered through an employee assistance program (EAP) that qualifies as a limited excepted benefit. To qualify:
- No cost sharing, premiums, or coordination with other health plans is allowed, and
- The EAP cannot provide direct medical care benefits.
What’s Next
The Departments indicated plans to propose additional regulations to expand further how fertility coverage can qualify as an excepted benefit. They are also evaluating potential updates to rules governing supplemental health insurance.
Action Steps for Employers
- Review current benefit offerings to determine if adding fertility coverage through an excepted benefit structure makes sense.
- Coordinate with carriers or third-party administrators to ensure compliance with regulatory requirements.
- Monitor forthcoming rulemaking for additional flexibility and options.