Fertility Benefits as HIPAA Excepted Benefits
The source discusses recent guidance issued by the Departments of Treasury, Labor, and Health and Human Services regarding how employers can offer fertility benefits as a HIPAA excepted benefit under existing regulations, as prompted by a February 2025 Executive Order aimed at expanding access to In Vitro Fertilization. These Frequently Asked Questions (FAQs) clarify the conditions under which fertility coverage can be offered within three categories of excepted benefits: independent, noncoordinated benefits; excepted benefits Health Reimbursement Arrangements (HRAs); and Employee Assistance Programs (EAPs). The source explains that certain fertility benefits, such as those provided under a specified disease policy, can qualify as an independent, noncoordinated excepted benefit if specific requirements are met, though future rulemaking is planned to allow for self-funded options. Furthermore, employers can utilize an excepted benefit HRA to reimburse out-of-pocket fertility costs up to a specified limit, and EAPs can offer non-medical coaching and navigator services related to fertility. The guidance underscores that excepted benefits are generally exempt from many Affordable Care Act market reform requirements.
