Review of Key Issues
for Informed Decision-Making
Introduction
Even though infertility is a medically recognized condition, there’s no consensus in the business community
about the sometimes confusing and sensitive issue of fertility benefits. Some employers are engaged
on the issue, and through a deliberate process, have designed a fertility benefit that is consistent with
their overall benefits philosophy and responsive to the unique benefits challenges posed by
infertility treatment. Conversely, other employers don’t consider employee infertility treatment their responsibility, or have shied away from fertility benefits because of its perceived
potential to be a black hole of spending.
The purpose of this employer guide is threefold. First, it is intended to provide
some basic “birds and bees” information about infertility and its treatment—
particularly female infertility. Second, it presents financial data about
the costs of infertility treatment and the costs of fertility benefits
to employers. Finally, this report explores key issues in fertility
treatment insurance coverage, issues about which many
employers have interest, but lack knowledge for
informed decision-making.
These medical and benefits
thought leaders contributed
to the content of this
employer guide…
34%
Howard W. Jones, Jr., MD
Ray Brusca
J. Brooks Watt, MD
Professor Emeritus,
Eastern Virginia Medical School,
Professor Emeritus,Johns Hopkins
University School of Medicine,
Honorary Chairman of the
Jones Institute Foundation
VP of Benefits
Black & Decker
Corporate Medical Director
Gillette Company
33%
33%
Þ Male reproductive problems
Þ Female reproductive problems
Source: RESOLVE: The National Infertility Association
1
What Is Infertility?
Infertility, which can be caused by many
diseases, is defined as the inability to
conceive after one year of unprotected
intercourse (six months if the woman
is over age 35).
Þ Male and female reproductive problems, or unexplained
Causes of Infertility
The major causes of infertility include the following:
Þ
Woman’s fallopian tubes may be blocked or damaged, making it difficult for the
egg to be fertilized or for an embryo to travel to the uterus.
Þ
Woman’s ovaries may not be maturing and passing eggs normally or egg quality
and number may have diminished with age; or the woman may have hormonal
conditions that adversely affect ovulation.
Þ
Disorders of the uterus or vagina that impair fertility.
Þ
Male sperm count may be low or there may be problems with sperm function.
Female Reproductive System
Source: JAMA patient page: infertility. JAMA.1999 Nov 17;282(19)1888.
Fertility Benefits Basics
62.1 million women
in U.S. age 15 to 44 years
9.32 million women
receive infertility treatment
How Common Is Female Infertility
and Its Treatment?
As depicted in this chart to the right, over 15%
of women of reproductive age in the U.S. have
received some level of infertility treatment.
15%
85%
No fertility
service
Sources: 2005 Population Estimates. U.S. Census Bureau; Infertility
Treatment as a Covered Health Insurance Benefit. Association
of Women’s Health, Obstetrics and Neonatal Nurses.
36%
Require
additional
treatment
64%
Require only basic
medical advice or
diagnostic tests
Fertility
service
How Is Female Infertility Treated?
The overwhelming majority of female infertility cases are treated with conventional drug therapy or surgical procedures. Since the
early 80s, assisted reproductive technology (ART) such as in vitro fertilization (IVF), gamete intrafallopian transfer (GIFT) and zygote
intrafallopian transfer (ZIFT) have also been used to overcome infertility. Fewer than 3% of infertility cases require ART, which is
defined as fertility treatments in which both eggs and sperm are handled in the laboratory for the purpose of establishing a
pregnancy. ART does not include ovarian stimulation utilizing medications such as clomiphene citrate tablets, USP and/or
gonadotropin to induce ovulation with (or without) intrauterine insemination.
A typical ART procedure begins when a woman starts taking drugs to stimulate egg production or begins having her ovaries
monitored with the intent of having embryos transferred. If eggs are produced, the procedure progresses to the egg-retrieval
stage. After the eggs are retrieved, they are combined with sperm in the laboratory (IVF), and if fertilization is successful, the
resulting embryos are selected for transfer. IVF accounts for over 99% of ART procedures.
Sources: Fast Facts About Infertility. RESOLVE: The National Infertility Association; 2004 Assisted Reproductive Technology Success Rates. CDC; Assisted Reproductive
Technology Surveillance—United States, 2003. CDC; 2004 Assisted Reproductive Technology (ART) Report: National Summary. CDC
Trends in Infertility Treatment
Growth in ART
The chart to the right illustrates how the use of
ART has increased significantly in the last decade.
From 1996 to 2004 the number of ART procedures
started almost doubled, from 64,681 to 127,977;
and the number of live births due to ART increased
more than 250%, from 14,507 to 36,760. In 2003,
approximately 1% of the infants born in the U.S.
were conceived through ART.
Sources: 2004 Assisted Reproductive Technology
Success Rates. CDC; Assisted Reproductive Technology
Surveillance—United States, 2003. CDC
140,000
127,977
120,000
100,000
ART Procedures
80,000
64,681
60,000
40,000
Infants Born*
36,760
20,000 20,840
0 14,507
49,458
Live Birth Deliveries
1996
1997
1998
1999
2000
2001
2002
2003
2004
* The number of infants born exceeds the number of live-birth deliveries because of multiple-infant births.
2
Why Has ART Utilization
Increased?
Employer Economics
ART utilization has increased because couples
are increasingly using it to overcome their
infertility, and it is indicated as the treatment
of choice for an increasing number of infertility
disorders. The increased use of ART combined
with higher ART success rates have resulted in
dramatic increases in the number of children
conceived through ART each year.
of Fertility Benefits
Another reason ART utilization has increased
is because of the growing trend for women to
wait later in life before having a child. Since
fertility progressively declines after age 30 in
women, they are at increased risk for having
a difficult time conceiving. Thus, delayed
childbearing is a key driver of ART.
Sources: Assisted Reproductive Technology Surveillance—
United States, 2003. CDC; Moultry et al. Formulary.
2005;40;329-41.
How Many Employers Provide Fertility Benefits?
Employer benefit coverage for infertility issues varies considerably.
Here are some examples.
59%
Infertility
Services
33%
37%
Drug
Therapy
In Vitro
Fertilization
25%
Þ Large Employers
Þ All Employers
19%
11%
Source: 2005 National Survey of Employer-Sponsored Health Plans. Mercer Health & Benefits LLC.
Risks of Infertility Treatment:
Multiple Births, Preterm Births and
Ovarian Hyperstimulation Syndrome
Patients who undergo ART treatments are
more likely to deliver multiple-birth infants
or preterm infants than women who conceive
naturally. Multiple births are associated with
increased risks for mothers and infants, such as
pregnancy complications, premature delivery,
low-birthweight infants and long-term disability
among infants. Another risk of ART is ovarian
hyperstimulation syndrome (OHSS), a condition
in which the patient’s ovaries become enlarged
and produce too many eggs. Patients with
OHSS need to be monitored closely by their
healthcare professional (HCP).
Progress on High Order
Multiple Pregnancies
First, it is important to note that IVF is not the
major cause of multiple and/or preterm births.
The majority of multiple births (60%) are a
consequence of drug-induced ovulation
combined with intrauterine insemination.
As to high order multiple pregnancies
associated with ART, their numbers have
continued to decrease over the past five years
as ART techniques have improved and the
number of embryos transferred decreased.
Sources: Assisted Reproductive Technology Surveillance—
United States, 2003. CDC; Fritz MA. Contemporary OB/GYN.
2002;9:65-92.
3
Approximately 1/3 of all employers cover
some type of fertility services—usually diagnosis and
surgical treatment. Assisted reproductive technologies,
such as IVF, are covered only 11% of the time.
Top Three Reasons Why Employers Do
or Don’t Provide Fertility Benefits
Here’s what the latest research survey findings tells us about the reasons for
employer coverage or noncoverage of infertility treatment.
Why Employers Provide Infertility Treatment Benefits*
73% Ensure employee access to quality, cost-effective care
67% Be recognized as family friendly and attract employees
62% Increase morale and retain employees
Why Employers Don’t Provide Infertility Treatment Benefits*
64% Concern about cost
29% Not employer responsibility
29% Provide only basic coverage and infertility treatment doesn’t qualify
*Percentages do not total 100% because respondents could select more than one reason
for coverage or noncoverage.
Source: Employer Experience with, and Attitudes Toward, Coverage of Infertility Treatment.
May 2006. Mercer Heath & Benefit LLC.
How Much Does It Cost an Employer
to Provide Fertility Benefits?
Research has shown that when compared to total healthcare costs,
the cost of providing comprehensive infertility services is negligible.
Total Healthcare
Benefit Cost
Comprehensive Fertility
Benefit Cost
$591 PMPM1
$2.42 PMPM or 0.41% of total healthcare benefit cost2
2005 National Survey of Employer-Sponsored Health Plans. Mercer Health & Benefits LLC.
Griffin M, Panak W. Fertility and Sterility. 1998;70:22-9.
1
2
State Mandates for Infertility Treatment
Although there are no federal requirements pertaining to infertility treatment
insurance, 14 states require employers to provide some type of infertility insurance
coverage (the American Society for Reproductive Medicine (www.asrm.org) is a good
source of information on this topic). However, by virtue of ERISA, employers that are
self-insured are exempt from any state infertility treatment mandates.
What has been the impact of the mandates? One study3 found that in states that do
not require insurance coverage for IVF, more embryos were transferred per cycle, and
there were higher rates of multiple births. It also concluded that multiple births as a
percentage of total births might be expected to decrease with mandated IVF insurance coverage. The study further noted that the additional cost of covering IVF is likely to be only a small fraction of total health insurance costs. Another study pointed
out the unintended consequences of NOT having a mandate: “limiting the number of
ART attempts could motivate clinics to maintain policies of transferring numerous
embryos as a way of increasing success rates for couples who cannot afford numerous
ART attempts.” 4
Jain T, et al. New England Journal of Medicine. 2002;347:661-6.
Griffin M, Panak W. Fertility and Sterility. 1998;70:22-9.
3
4
Key Issue: Multiple Embryo Transfers
Multiple embryo transfers (the number of embryos transferred may exceed two,
but varies widely by patient and practitioner) is a common practice in the U.S.
The number of embryos transferred is largely unregulated in the U.S., although the
American Society for Reproductive Medicine has issued practice guidelines regarding
the number of embryos to transfer. In contrast, the number of embryos transferred is
limited by law or by insurance plans in some European countries.
FASTFACTS
for Employers
on Infertility
Treatment
Infertility treatment is determined
by the diagnosis and may include
the following:
Þ Oral or injectable medications
(ranging from $200 to $3,000
per cycle)
Þ Surgery (tubal surgery can
cost $10,000 to $15,000)
Þ Assisted reproduction
procedures (ranging from
$10,000 to $25,000
per cycle)
Þ A combination of these
treatments
Adapted from Benefit Manager Guide:
Assisted Reproductive Technologies.
National Business Group on Health.
August 2006.
Sources: Assisted Reproductive Technology Surveillance—United States, 2003. CDC;
Van Voorhis. New England Journal of Medicine. 2007;356:379-86.
4
Fertility Benefit Strategies of
Three Fortune 500 Companies
Benefits decision-makers may sometimes wonder: “How are other companies dealing
with infertility treatment? Is it a major issue for them? How much are they spending?”
Here are three “real world” answers to those questions.
Gillette
Black & Decker
J. Brooks Watt, MD, Corporate Medical
Director of the Gillette Company, says
that the company’s fertility benefit
philosophy is simple: “provide the
best/richest benefit that we can afford.”
This translates into a fertility benefit that
Dr. Watt describes as “liberal,” which
means, for example, that there’s no dollar
limit on the medical portion of the fertility benefit. On the other hand, the benefit does have some boundaries. Lifetime
infertility treatment prescription drugs
are capped at $25,000. All IVF procedures require prior approval by the
company’s health plan and must be performed at one of seven approved facilities. There’s a limit of six attempted IVFs.
It bears noting that Gillette’s fertility
benefit benevolence is not because the
company is located in Massachusetts, a
state that mandates employers provide
fertility benefits. Because Gillette is a
self-insured company, it is exempt from
that mandate. The company’s fertility
benefit design reflects the desire of
Gillette to “do the right thing” for the
small number of its employees with
fertility issues. Dr. Watt points out that
by so doing Gillette provides a benefit
to employees that has incalculable value
for a relatively small cost.
According to Ray Brusca, VP of Benefits
at Black & Decker, “our company provides a generous but not unlimited fertility benefit.” Employees can utilize any
physician or healthcare facility provider
in their health plan’s network for infertility treatment. IVF is covered, and there’s
no limit on the number of IVF attempts.
However, there is a $25,000 lifetime limit
on the medical portion of the fertility
benefit. (Infertility treatment prescription drugs are managed through the
company’s drug benefit and have no
dollar limit.) Mr. Brusca has some telling
observations about employers and fertility benefits. “When you put the cost
of the benefit in perspective of how
much we spend on MRIs and CT scans,
for example, the cost of the fertility
benefit isn’t even a rounding error.”
Also, “employers who think there’s a lot
of cost involved in covering infertility are
mistaken. It’s not a cost driver. It’s an
employee relations issue that’s a winner
for all of us.”
5
Anonymous
Fortune 500 Company
Ms. Smith reports that her company currently does not offer any fertility benefits
to its workforce (with one exception).
Why not? One answer is that the benefit
has never been offered. Another answer
is that because the company is selfinsured, it’s exempt from any mandated
fertility coverages. And on top of that,
a significant portion of the workforce
is located in states without a fertility
benefit mandate. The previously noted
fertility benefits exception is the approximately 7% of workforce at company
headquarters who have access to one
HMO plan that provides infertility treatment coverage due to a state mandate.
This employee subpopulation is largely
professional, more challenging to
attract and retain, and the group from
which infertility coverage questions
have primarily originated. Finally,
Ms. Smith makes the point that although
her company does not currently provide
fertility benefits for the large majority
of its employees, “fertility benefits has
become a dynamic issue for us and
something we are evaluating.” This is in
part because the company’s workforce
is changing—becoming younger and
more female. Also, although the current
HMO arrangement for fertility solves the
problem for a small subset of employees, it contradicts the company’s overall
benefit strategy of moving away from
fully insured health plans.
Fortune 500
Company
J. Brooks Watt, MD
Ray Brusca
Mary Smith
Corporate Medical Director
Gillette Company
VP of Benefits
Black & Decker
Benefits VP
Fortune 500 Company
“We provide the best/
richest fertility benefit
that we can afford.”
“Our company provides a
generous but not unlimited
fertility benefit.”
“Fertility benefits has
become a dynamic issue
for us and something
we are evaluating.”
Comparison of Three Companies’ Fertility Benefits
Benefit Design Element
Description of benefit
Covered lives (employees + spouses + dependents)
Dollar limit on medical infertility treatment
Limitations on infertility treatment – provider or facilities?
Dollar limit on pharmacy infertility treatment
Infertility diagnostic tests covered
Gillette
“Liberal”
“Best benefit we can afford”
Black & Decker
Anonymous
Fortune 500 Company
“Generous but not unlimited” None for >90% of workforce
19,000
23,000
None
$25,000 lifetime
Provider: No Facilities: Yes
Provider: No Facilities: No
$25,000
None
Yes
Yes
Intrauterine artificial insemination covered?
Yes – No limit on attempts
Yes – 6 attempts limit
In vitro fertilization covered?
Yes – 6 attempts limit
Yes – No limit on attempts
Use rate of fertility benefit? (claimants per covered lives)
0.18%
0.8%
Cost per fertility benefit claimant
$6,000
$6,100
Estimated PMPM cost of fertility benefit
$0.89
$4.04
30,000
NA for >90% of
workforce
Specific elements of
fertility benefits for
<10% of workforce with
coverage determined by
MCO in which they
are enrolled
6
Findings and Questions
from Employer Fertility Benefits Advisory Board
In June 2006, a Fertility Benefits Advisory Board was conducted with attendance by
representatives from ten Fortune 500 employers. The meeting started with the HR,
benefits and corporate medical executives attending the session describing their
companies’ fertility benefits. Then, invited speakers made presentations on clinical
and financial issues pertaining to infertility treatment and responded to participants’
comments and questions on the information that had been presented.
Major Findings of the Advisory Board
Þ
8 of 10 participants’ companies provided fertility benefits, but elements of coverage
varied widely. For companies that provided fertility benefits, the majority had
lifetime caps on both the medical and drug benefits, or the medical or drug benefit,
but not both. Some companies covered IVF, others did not, and for those that did,
the number of IVF cycles varied from one to unlimited.
Þ
The primary reasons participants’ companies provided fertility benefits were
because the benefit was consistent with their company’s overall benefits philosophy
and/or to retain employees and/or to remain competitive in their labor market.
Þ
9 of 10 participants said that their company was self-insured, and thus was exempt
from any state mandates for providing fertility benefits. This means that since 80%
of participants’ companies provided fertility benefits, most participants’ companies
were providing a benefit that they were not obligated to provide.
Þ
Participants’ companies were handicapped in their ability to make data-driven
fertility benefit decisions. Why? Their fertility benefit utilization and cost data were
hiding in plain sight amid aggregated benefits data.
Key Employer Questions
from Advisory Board
Þ
“How do we get a better understanding of infertility procedures and
medications to determine if controls
or guidelines need to be established?”
Þ
“Aren’t physicians abdicating their
ethical and professional responsibilities when they overuse fertility
drugs or implant excessive numbers
of embryos?”
Þ
“How can we ‘connect the dots’
between maternity costs and
fertility costs?”
Gaps in Knowledge and Data
Make Informed Fertility Benefits Decision-Making Difficult
Employers’ fertility benefits
status quo
7
What employers need for fertility benefits
decision-making
• Lack of knowledge about fertility issues
• Education about fertility clinical/financial issues
• Absent, minimal or confusing internal data
• Information on best practices in fertility benefits
• No external benchmarks
• Internal maternity and fertility-specific benefit data
• Fear of the unknown and cost control
• Integrated data
Creating a Contemporary
Infertility Treatment Benefit
Advice from an Infertility Treatment Founding Father
Howard W. Jones, Jr., MD
Professor Emeritus, Eastern Virginia Medical School, Professor Emeritus Johns Hopkins
University School of Medicine, Honorary Chairman of the Jones Institute Foundation
Dr. Jones and his wife were responsible for the
first successful IVF pregnancy in the United States.
Explaining why Howard W. Jones, Jr., MD, is a true luminary in the field of reproductive
medicine would take up most of this monograph. Suffice it to say that he has been
practicing in the field of reproductive medicine for over 60 years; he and his late wife,
Georgeanna Seegar Jones, MD, were responsible for the first successful IVF pregnancy
in the United States; he is an author of 284 scientific papers on reproductive medicine
issues; and the Jones Institute for Reproductive Medicine at the Eastern Virginia
Medical School (www.jonesinstitute.org ) is named in honor of Dr. Jones and his wife.
In addition to his daily work with patients on the medical frontiers of reproductive
medicine, Dr. Jones has also been at the forefront of fertility benefits issues. He is
intimately knowledgeable about the clinical, emotional and financial consequences
of employer fertility benefits decisions. He knows how the behavior of patients
with infertility problems can be influenced by whether or not they have insurance
coverage. In that regard, here are two important infertility treatment issues about
which Dr. Jones believes employers are not fully informed.
Surreptitious Diagnostic Codes and Hidden Costs
Dr. Jones believes that infertility can be, and is, often unknowingly reimbursed by
health insurers under surreptitious diagnostic codes. That is, when treating a patient
without fertility benefits coverage, some physicians creatively mask their infertility
treatment services under reimbursement codes that they know will be reimbursed.
For example, a patient with infertility who at the same time has asymptomatic
endometriosis may be diagnosed and treated under endometriosis diagnostic and
treatment codes, despite the fact that the patient’s principal reason for seeking
treatment was infertility. Insurers and the health plan sponsors pay for infertility
treatment costs such as unrecognized or hidden costs when infertility treatment
is specifically excluded under the patient’s insurance coverage.
Obsolete Therapies
Dr. Jones also points out that “since IVF is frequently not covered by insurance, it can
create a dilemma for physicians who want to help patients who lack coverage but
are desperate to bear children.” Regrettably, these circumstances can cause certain
physicians to use inappropriate or obsolete therapies to treat infertility. They do so
because they know these less effective therapies are likely to be reimbursed by the
insurer. For example, a provider treating a patient who is a bona fide candidate for
IVF, but who lacks insurance coverage for IVF, may use ovary-stimulating drugs in
excess of clinical guidelines in order to increase the chance of the patient conceiving.
This practice increases the risk for multiple and/or preterm births, both of which
employers pay for, whether fertility treatment was a covered benefit or not.
“Jones Fertility
Benefit Model”
Based on his decades of experience,
Dr. Jones believes that if the diagnosis
and treatment of infertility were
covered by all employers, patient outcomes would be better and the cost
for treating patients kept the same or
reduced. This would be true because
such uniform coverage would eliminate or greatly reduce the perverse
financial incentives currently in the
system that can encourage multiple
embryo transfers and the resulting risk
of high order pregnancies and multiple
births. As Dr. Jones sees it, creating a
contemporary infertility benefit for
self-insured employers would be costeffective while making more effective
services financially accessible to
employees. Savings would be realized
by eliminating hidden infertility costs,
eliminating payments for ineffective
treatments, providing coverage for
effective contemporary treatments,
and reducing costs associated with
multiple pregnancies by reducing the
number of embryos transferred.
The key features of the “Jones Fertility
Benefit Model” are presented below.
Two of these features really stand out:
• Services must be provided
by certified infertility
treatment providers
AND
• The cost of infertility medical
procedures and medications
will be shared by the
employer and the employee
8
Key Features
of a Contemporary Infertility Treatment Benefit
As recommended by Howard W. Jones, Jr., MD, and Brian Allen*
Covered Services
Þ
Þ
Þ
Treatment only for documented
infertility of at least one year’s duration
Services must be authorized and
delivered according to determinations
of medical necessity
Þ
Facilities and providers must be
certified by the insurance plan
Þ
Providers must receive preauthorization for proposed services in advance
of treatment
Þ
Insurance plan will provide providers
with detailed instruction on coding
and billing issues
Example services include:
• Consultations
• Office visits, laboratory and/or
radiologic procedures
Non-Covered Services
Þ
Medically unnecessary services
such as those with less than 5%
chance of success for a live birth
Þ
Treatment to reverse voluntary
sterilization
• Embryo transfer (fresh or frozen)—
no cycle limit
Þ
Costs associated with gestational
carrier and surrogacy cycles
Example services requiring Reproductive
Endocrinologist guidance and criteria:
Þ
Experimental or investigational
infertility treatments
• Intracytoplasmic sperm injection (ICSI)
Þ
ZIFT and GIFT
• Standard evaluation per American
Society of Reproductive Medicine
• In vitro fertilization oocyte (unfertilized
egg cell) retrieval—limited to 6
stimulated cycles
Þ
• Cryopreservation of embryos and sperm
• Donor sperm and egg/embryo
• Pre-implantation genetic diagnosis (PGD)
Employer and Patient
Cost-Sharing
Þ
Facilities and Providers
Þ
Medical providers must be boardcertified reproductive endocrinologists
Þ
Covered services to be performed by
facilities that conform to the American
Society of Reproductive Medicine’s
current standards and guidelines
Appropriate cost management and
sharing strategies for deductibles,
copayments/coinsurance, out-ofpocket maximums, lifetime medical/
medication dollar or number of
cycle caps
* Brian D. Allen, Allen Consulting Incorporated. More information on fertility benefits guidelines
from Dr. Jones and Brian Allen is available from Brian Allen at [email protected].
9
Key Issues
for Informed Fertility Benefit Decision-Making
1. Over 15% of women of reproductive age in U.S., approximately 9.3 million,
have received some level of infertility treatment.
2. Approximately 1/3 of all employers cover some type of fertility services—usually
diagnosis and surgical treatment. Assisted reproductive technologies, such as IVF,
are covered only 11% of the time.
3. The cost of providing a comprehensive fertility benefit ($2.23 PMPM) is almost
inconsequential compared to the overall cost of health benefits ($591 PMPM).
4. Most employers’ ability to make informed decisions about fertility benefits is
hampered by lack of maternity and fertility-specific internal data and external
benchmarks and best practices.
5. According to a renowned infertility treatment specialist:
Þ
Due to the billing and clinical creativity of some physicians, employers sometimes pay for infertility treatments even when they are not a covered benefit,
and for outdated or ineffective infertility treatments.
Þ
Uniform coverage of infertility treatment by employers would improve
fertility outcomes for the same or reduced cost. This would be true because
such coverage would eliminate or greatly reduce the perverse financial
incentives currently in the system that can encourage multiple embryo
transfers and the resultant high order pregnancies and multiple births,
both of which can have huge cost consequences for employers.
Action Items
for Informed Fertility Benefit Decision-Making
Step 1: Document current coverages. What infertility treatment services are
covered? Which ones aren’t? What’s the history behind current fertility benefits?
Step 2: Run the numbers. Identify, collect and analyze company’s fertility-specific
data. How many fertility benefit claims are there? What’s the total and per claimant
cost? What’s the trend? What specific infertility treatments are being used?
Step 3: Get benchmarks. What comparative fertility benefit metrics can your
company’s benefits consultant or health plan(s) provide? How about fertility
benefit best practices examples?
Step 4: Ask the tough question. Once educated and updated on your
company’s current fertility benefit, ask: Is the company’s current fertility benefit
(or lack thereof ) appropriate? Is it consistent with the company’s corporate
culture? Is it based on a rational decision-making process? Is it up to date
considering the current workforce?
Step 5: Make informed decision. Based on the outcome of Steps 1-4, keep,
modify or update fertility benefit. Reevaluate company’s fertility benefit
annually to keep it up to date.
10
This report made possible by the financial support of Organon, a part of Schering-Plough.
About Schering-Plough
Schering-Plough Corporation is a global science-based health care company with leading
prescription, consumer and animal health products. Through internal research and
collaborations with partners, Schering-Plough discovers, develops, manufactures
and markets advanced drug therapies to meet important medical needs.
Schering-Plough's vision is to earn the trust of physicians, patients and
other customers. Following the acquisition in November 2007 of
Organon BioSciences (OBS), a Dutch human health (Organon) and
animal health (Intervet) company, Schering-Plough now has
approximately 50,000 colleagues around the world.
Our products reach patients and caregivers
in more than 120 countries.
Copyright © 2008 Schering Corporation, Kenilworth, NJ 07033. All rights reserved. Printed in USA
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