What Are the Proposed Rules on Fertility Benefits?
A cross-agency proposal would amend regulations implementing the Employee Retirement Income Security Act of 1974 (ERISA), the Internal Revenue Code, and the Public Health Service Act to add fertility benefits as a category of “excepted” benefits that are exempt from certain requirements, for the purpose of expanding access to fertility treatments and services. This would allow employers to establish standalone fertility benefit plans, offering coverage for services like in-vitro fertilization (IVF), rather than having to integrate fertility coverage with their major medical plans.
When Would the Proposed Rules Take Effect, If Finalized?
Plan years beginning on or after January 1, 2027.
Are Employers Required to Offer a Fertility Benefit Plan Under the Proposed Rules?
No: offering an excepted fertility benefit would be entirely voluntary.
Under the Proposed Rules, Does a Fertility Benefit Plan Need to Be Integrated with an Employer’s Group Health Plan?
No; the proposed rules allow a fertility benefit plan to be structured as a standalone benefit, and participants are not required to enroll in a group health plan to access the benefits.
Are Employers Required to Contribute to the Cost of Fertility Benefits?
No; employers may charge participants premiums and impose cost-sharing, as with standalone dental and vision coverage.
What Is the Maximum Lifetime Benefit per Participant?
$120,000 (indexed for medical inflation for plan years beginning after December 31, 2027).
Do the Rules Resolve Whether Fertility Benefits Will Be Tax-Free to All Employees?
No. The tax treatment under Internal Revenue Code Sections 105, 106, and 213(d) is unchanged. Benefits for participants without a diagnosis of medical infertility (including same-sex couples and individuals seeking to have children on their own) cannot be provided on a tax-free basis.
When Does the Public Comment Period Close for the Proposed Rules?
July 13, 2026.
Where Can I Get More Information?
See our Insight or reach out to us or one of our colleagues.
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