How does benefit plan design impact member experience

Employers are recognizing the need for fertility and family building coverage - last year, nearly a third of large employers said they were planning to add fertility and family building coverage to their benefits packages.¹

However, employers evaluating options for fertility benefits quickly find that it's difficult to compare solutions because of the variety of coverage models. How can employers understand whether a current or potential benefit will truly meet their employees' needs? How can they evaluate whether it will drive the outcomes they want - happy, healthy employees and effective cost containment?

To help benefit leaders answer these questions, Progyny surveyed more than 1,400 patients who used fertility coverage through dollar cap and traditional carrier in the last five years to find out what their experiences have been like.

The results uncovered a plan design ripe for change:

• 53% of employees had to compromise aspects of provider-recommended care due to cost

• 60% of employees spent money on wasted medication or ineffective treatment

• 1/3 of employees didn't have a care path option for their family building scenario

• 63% of employees said their work productivity suffered from increased stress due to inadequate support

It's clear that fertility benefits can be delivered differently. In fact, that's why Progyny was founded 8 years ago, and why we continue to innovate to fill gaps that other plans miss.

According to our members, the three things that help drive our +80 NPS score are:

• Full episodic coverage that empowers them to pursue the treatment recommended by their provider without having to worry about running out of money.
  • Why you care: The cycle-based approach results in less wasted medicine, less overall treatment, and more effective spend for employees and employers
• Clinically integrated, high-touch experience that connects members with patient support, covered Rx, and access to a nationwide network of thoroughly vetted providers - all in one platform
  • Why you care: Continuous support that streamlines care helps reduce fragmentation while mitigating gaps that lead to high-risk situations
• Coverage for all parenthood options with inclusive support available for single parents, couples, those adopting or using surrogacy, etc.
  • Why you care: When employees are locked out of access to benefits, everybody loses. Underserved populations don't feel valued or included, and organizations miss out on positive results like improved recruitment, retainment, and lower healthcare costs

Click here to download a full readout of the survey, learn more about how to close key gaps, and explore new data on why meeting employee needs is so critical to outcomes in fertility. Our expert team is also available to answer any questions you may have about fertility and family building benefits - get in touch here or reach out directly at [email protected].

1. Mercer, Health & Benefits Strategies for 2023 report

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