Trump administration's proposed rule could make fertility benefits more accessible

• Key Insight: Learn how reclassifying fertility as a "limited excepted benefit" could alter employer coverage.
• What's at Stake: Employers face compliance shifts, benefit design trade-offs, and recruitment competitiveness risks.
• Forward Look: Monitor rulemaking—adoption is voluntary now, but market dynamics could change if finalized.
  Source: Bullets generated by AI with editorial review

The Trump administration proposed a new rule that could help organizations' efforts to make fertility benefits accessible. 

On May 10, the U.S. Departments of Labor, Health and Human Services and Treasury proposed a new rule aimed at making fertility treatments — including IVF — more accessible and affordable through employer-sponsored benefits. If finalized, the proposal would make fertility treatment a type of "limited excepted benefit," similar to standalone dental or vision plans, potentially expanding coverage and access. However, there's still a lot for HR and benefits leaders to understand beforehand.  

"As a society, we have kind of grouped all of our benefits together," said Sarah Peterson Herr, an HR legal expert at global HR data, analytics, and compliance company Brightmine. "In simpler terms, this would be like being able to buy fertility benefits directly." 

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Right now, most fertility coverage has to be included within a company's main medical plan, which means it must comply with a long list of Affordable Care Act and HIPAA requirements. However, because fertility treatments are expensive, many employers either offer very limited coverage or none at all. By making fertility plans separate, employers could, in theory, offer fertility coverage with fewer regulatory requirements and more flexibility in how they structure it, and employees could potentially enroll in those benefits even if they don't use the employer's main health plan. 

"The proposed rules aren't very clear on what the implications will be yet on employers," Herr said. "But I would call this a first step into making fertility benefits even more mainstream."

Obstacles remain in place

Despite the perceived benefits, Herr still warned that the proposed fertility benefits rule may not significantly change anything yet. Many large employers already offer some form of fertility coverage and the proposal has no mandate attached to it yet. As of now, participation would remain voluntary, meaning that benefits leaders and HR professionals should not feel immediate pressure to add new fertility coverage or worry about major compliance changes. 

The proposal also does not yet provide strong financial incentives for organizations to want to strategize their current plan, nor does it have a limit on how expensive coverage could still be for workers. This remains a problem when IVF treatment can cost up to $50,000 per cycle depending on a person's medical needs, meaning that the $120,000 lifetime cap may not go very far for some individuals and families struggling with infertility.

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"Everybody is feeling the effects of a potential economic downturn and the rising costs of everything so it might not be in employers' financial ability to even provide these benefits," Herr said. "So I can't say for sure that this is going to expand access a ton."

Still, Herr encouraged leaders to do routine temperature checks on their employees as the proposal process runs its course to gauge whether a different fertility coverage or strategy is something that employees would be interested in. 

"Like any proposed rule, it is a very long process to get approved," Herr said. "Stay up to date on what's happening and make sure you always know what's important to employees because things can change super fast."