Dear Human Resources,

For the record, my boss is freakin awesome! Really, truly, awesome.

I drafted up this letter, based on the sample that RESOLVE offers, and she sent it off to HR. She is one of the big bosses, so maybe something will actually come of this... The RESOLVE website says 65% of employers who provide infertility coverage said they do so because they were asked by an employee.

Dear Human Resources:

I have been contacted by a Company employee who is suffering with the disease of infertility. An estimated 1 in 8 couples have similar difficulties, so I know that this couple is not alone. On behalf of this couple, and all other Company employees who are silently struggling to overcome infertility, I would like to request that you advise me as to the action necessary to include coverage for infertility treatment with the Company health benefit package. I imagine that this might be a larger issue that requires some attention from Corporate and would appreciate your guidance about who in that organization might be most appropriate to contact.

I have been informed that insurance coverage for diagnosis and treatment of infertility is currently excluded from the Company health insurance plan. I have also been informed that California Insurance Code requires insurers to offer coverage of certain infertility treatments (see reference below), which I assume gives the Company an option about whether or not to include infertility as a covered benefit.

I want to be sure that we are providing comprehensive coverage options that both make sense for our employees as well as our fiscal bottom line. A 2003 Harris Interactive Poll indicates that there is broad public support for infertility coverage; 80% of the general population believes infertility treatment should be covered by insurance. Because of this, I believe that offering this comprehensive health benefit will support our hiring and retention strategies.

Often employers believe that adding an infertility coverage benefit will increase health care costs. However, recent studies indicate that including comprehensive infertility coverage in a health benefit package may actually reduce costs and improve outcomes.

For example, a recent employer survey conducted by the consulting firm William M. Mercer found that 91 percent of respondents offering infertility treatment have not experienced an increase in their medical costs as a result of providing this coverage. In fact, the cost of infertility services as a percent of the total health premiums went down after the 1987 Massachusetts mandate. (Study by Griffin and Panak, Fertility & Sterility, 1998). 

According to the American Society of Reproductive Medicine (ASRM), 85%-90% of infertility cases can be treated with conventional medications. In vitro fertilization accounts for less than 3% of infertility services.

Often patients select treatment based on what is covered in their health benefit plan rather than what is most appropriate treatment. Comprehensive infertility coverage may actually reduce premium expense by as much as $1 per member/per month by allowing employees to choose the most appropriate and effective treatment, rather than more expensive less effective procedures that are covered by insurance.

Medical outcomes are also better for couples whose health insurance includes infertility coverage. The rate of multiple births, which often result in high-risk pregnancies, delivery complications, and extended stays in the NICU, is lower in states that have mandated infertility insurance. Furthermore, the improved mental health and general productivity of employees who are able to access timely and appropriate infertility treatment cannot be underestimated.

I would like to be sure that our Company health insurance plan is as cost effective and comprehensive as possible to meet our staff’s needs as well as our own for a healthy, motivated, productive workforce. Please let me know if you would like any additional information on this issue. I look forward to your reply.


Sincerely,
Foxy's Super Awesome Boss


cc: RESOLVE – The National Infertility Association, 1760 Old Meadow Rd., Suite 500, McLean, VA 22102

Cal. Health & Safety Code § 1374.55 requires health care service plan contracts that cover hospital, medical or surgical expenses on a group basis to offer coverage for the treatment of infertility, except in vitro fertilization. The law requires every plan to communicate the availability of coverage to policyholders. The law defines infertility, treatment for infertility and in vitro fertilization. The law clarifies that religious employers are not required to offer coverage for forms of treatment that are inconsistent with the organization's religious and ethical principles.

Cal. Insurance Code § 10119.6 (1989) requires insurers to offer coverage of infertility treatments, except in vitro fertilization. Infertility, in this case, may be a result of a medical condition or may refer to the inability to carry a pregnancy to term during a one-year or more period of time. Infertility treatment refers to diagnosis, diagnostic tests, medication, surgery and gamete intrafallopian transfer.