Fertility and family-forming benefits are top of mind for many organizations, whether it’s to stay competitive in attracting and retaining key talent or match benefits to diversity, equity and inclusion (DEI) goals.

Surrogacy reimbursement programs are one such benefit that may particularly appeal to LGBTQ+ and queer employees. While many different families consider surrogacy for different reasons, it is the only biological pathway to parenting for some LGBTQ+/queer couples or individuals. Nine percent of employers provided a surrogacy reimbursement program, with 29% adding or enhancing surrogacy reimbursement, according to a 2020 survey by WTW.

From a financial perspective, surrogacy costs more than other pathways to parenthood. In general, surrogacy costs can range from around $80,000 to upwards of $200,000. For more perspective, read “Maven exec shares his family’s $175k surrogacy journey” by EBN.

Surrogacy and LGBTQ+ Families

The number of LGBTQ+ families is expected to grow dramatically. Up to 3.8 million LGBTQ+ millennials are considering expanding their families in the coming years, according to Family Equality’s LGBTQ Family Building Survey. This survey showed that 64% of young LGBTQ+ people intend to use either assisted reproductive technology (which includes surrogacy) or foster care and adoption to form their families. Forty-three percent of those employees who plan to grow their families expect that they will need to rely on fertility treatments, adoption or surrogacy, and 30% of employees want financial support for family building, including surrogacy, adoption and fertility allowances, according to Maven.

Queer people face unique challenges when it comes to starting a family. Some employers are recognizing that medically diagnosed “infertility” and similar language could exclude LGBTQ+ and single people. Making family-forming benefits and assisted reproductive technology available to all members of an employer community may be one way to ensure that benefits are equitable and inclusive.

Surrogacy Pathways

Surrogacy reimbursement programs may help employers show that LGBTQ+ families are recognized and valued. Surrogacy is the process where the intended parent(s) create embryos either using their own egg and sperm or donor egg and/or donor sperm, and the embryo is transferred to the gestational carrier, who carries the pregnancy for the intended parents, explained Progyny’s Surrogacy 101 webinar.

Some people desire a biological parent pathway, where one member of a couple is genetically related to the child. A biological relationship can make parental legal rights easier to establish. Cisgender men (those whose gender identity corresponds with their sex at birth) in same-sex relationships (or single men) need an egg donor and gestational carrier (surrogate) to have a biological child.

Surrogacy Reimbursement Programs

While there’s a huge variety, here are some common elements of policies that I reviewed.

Contractual requirements

• Some employers require contracts with a bona fide surrogacy agency.
• Some exclude contracts outside of the U.S. or in an unlawful state.
  

Timing of reimbursement

• Typically, employees can submit expenses for reimbursement only after the surrogacy contract is completed, meaning either the surrogacy contract results in live birth and proof that the employee is the parent on the birth certificate, or other court order for parental rights is granted. Expenses could be incurred by the intended parents over a period of two or more years.
• Reimbursement might be contingent upon being employed from the time when expenses are incurred until payment is approved on a fully completed contract.
  

Eligible employees

• Starting at 20 hours worked per week
  

Eligible expenses

• May be limited to court costs and attorney fees
• Fees from egg or sperm donation agency and surrogacy agency, shipping fees
• Medical/assisted reproduction expense reimbursement ranges from none to all (e.g., In vitro fertilization (IVF), egg or sperm extraction). The intended parent’s group health plan could cover the assisted reproductive technology expenses; the policy might be worded to cover expenses not reimbursed by another program or plan.
• Typically, compensation to a surrogate is not eligible for reimbursement (can be living expenses, travel, short-term disability income replacement if there are pregnancy complications). However, some policies specifically include surrogate escrow funds.
  

Maximums

• Lifetime maximums range from $20,000-$60,000. Some employers have no maximums.
• Some maximums are designed as a flat dollar amount per event or contract with a maximum of two events or contracts.
• Some specify that a lifetime maximum is shared among surrogacy and elective fertility preservation benefits.
• When both people in the couple work at the same company, policies vary between providing each employee with their own lifetime maximum or treating the family as one employee. Some employers say all expenses are reimbursed once per child.

Using a Specialty Vendor

There are third-party vendors that handle employee expense substantiation and employer reimbursement; examples include Carrot, Progyny and Maven. Mercer reported that, of respondents that offered fertility benefits, 12% use a specialty vendor to administer the benefits. “Use of a specialty vendor is more common among larger employers: 21% of respondents with 5,000 or more employees use a specialty vendor, compared to 14% of those with 500 or more employees (and just 2% of those with 10-499 employees),” Mercer found. Features vary, so it’s important to research and compare options. Some vendors help employees with supports like advocacy and care navigation. Many vendors provide educational resources for employers and employees.

To learn more…