Fertility care is no longer a niche benefit — it’s a critical part of holistic healthcare. Today, 21 states and Washington D.C. require some level of fertility coverage, but mandates vary dramatically from state to state—and often leave key populations and procedures uncovered. For health plans, this is more than a compliance issue. It’s a strategic opportunity to engage more members and retain more groups.
Carrot helps health plans do just that—offering inclusive, clinically validated fertility, family-building, and hormonal healthcare benefits that go beyond the mandate to meet member and group needs. This drives better outcomes and member experience while minimizing risk and eliminating low-value spend.
The mandate landscape is growing — and so are expectations
Since Maryland created a mandate in 1984 specifically requiring coverage for IVF, 21 states and D.C. have followed, with more considering similar laws. In 2023 alone, at least 16 states introduced related bills. However, these mandates vary and often exclude LGBTQ+ individuals, single-intending parents, and those undergoing treatments like chemotherapy. Meanwhile, self-insured and other employers are voluntarily expanding benefits—42% now offer fertility coverage, up from 30% a few years ago. And importantly, 97% of employers report that adding fertility coverage did not significantly increase medical costs
As infertility and delayed parenthood rise, access to fertility care is increasingly essential. While mandates raise awareness, employers are moving faster to offer more inclusive and comprehensive benefits. And, they’re looking first to their health plan for coverage.
Meet the demand of employer groups
Fertility coverage isn’t just a benefit — it’s a business driver. Employer groups are looking for health plan partners that can help them attract and retain talent and manage fertility care costs effectively. If a plan doesn’t offer robust fertility benefits, groups will look elsewhere.
According to Mercer, 12% of employers now use a specialized fertility vendor like Carrot — a number that jumps to 50% among companies with 5,000 or more employees. Their goals include:
- Providing inclusive support for all paths to parenthood.
- Responding to growing employee demand for fertility benefits.
- Reducing absenteeism in the workplace.
- Improving health outcomes during pregnancy, birth, and postpartum.
More than IVF: A comprehensive member experience
Family-building journeys are deeply personal and often complex. Without proper support, navigating options like IUI, IVF, preservation, or donor-assisted reproduction can be overwhelming. At Carrot, the most common question our Care Team receives is: “Where do I start?”
State mandates do not require adjacent support for fertility coverage. Meaning many members left to search the internet or turn to friends and family for guidance on whether IVF is appropriate, which provider to choose, and how many embryos to transfer—advice that may not align with their personal needs or clinical best practices. Plus, state regulations vary dramatically–from limited “opt-in” mandates in Texas and California to fully inclusive requirements in places like Illinois and New York–employer groups are often left to juggle inconsistent coverage across regions.
Carrot helps health plans deliver a consistent, scalable fertility benefit that can adapt to local requirements. Unlike disjointed third-party add-ons, a fertility benefit integrated into the health plan ensures a seamless experience for both the member and the plan.
With a comprehensive fertility benefit from their health plan and Carrot, members can access fertility coverage plus:
- 1:1 expert guidance through clinical, legal, and emotional aspects of care.
- Access to Carrot’s network of vetted providers ranging from fertility clinics to legal and adoption agencies and more, supporting all paths to parenthood
- Steerage to in-network providers, including specialty providers for menopause and fertility, to deliver the best outcomes possible
- Ongoing care navigation and care coordination with their health plan to connect members to the right care at the right time
This kind of support increases plan satisfaction and builds long-term loyalty.
Carrot helps health plans get ahead — and stay ahead
Health plans have a choice: meet the minimum of state mandates or lead the way with inclusive, whole-person fertility benefits that work for all members, not just those who meet narrow eligibility criteria.
Carrot partners with health plans to:
✅ Expand inclusive, whole-person fertility coverage across all populations
✅ Improve clinical outcomes and reduce high-cost maternity claims
✅ Connect high-risk members to the health plan ecosystem and clinical teams early to mitigate risk
✅ Improve member engagement and satisfaction, using fertility and family-building benefits as a growth & retention tool
✅ Provide customizable, scalable solutions to groups
✅ Utilize engagement-based pricing, charging only when members actively use services - offering more predictable costs and better alignment with actual utilization
✅ Navigate a fast-changing legal landscape
By moving beyond the mandate and offering thoughtful, comprehensive fertility and family-building care, health plans can differentiate themselves, control escalating maternity costs, and provide meaningful, equitable support to every member.
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