After Jennifer Patterson had a baby, she took advantage of a work program that allowed parents to bring their infants to the office for their first six months.
The benefit had a bemusing side effect. “Some people who never had the opportunity to bring their babies to work also enjoy that as a benefit that we have, because it’s really nice to be able to go hold a baby for a few minutes,” said Patterson, human resources director of GL Group, a St. Louis-based educational company. “I was surprised how much time I didn’t actually have with my baby because everybody else wanted to hold her.”
Of course, there are more consequential advantages from such a program for employees, especially women. Beyond the sense of camaraderie and savings on day care-costs, programs such as on-site child care, in vitro fertilization (IVF) coverage and lactation accommodations have played an important role in attracting and retaining workers in an increasingly competitive space.
“Typically these programs start because the company doesn’t want to lose one particular employee who brings up the concept,” said Carla Moquin, founder of the Parenting in the Workplace Institute, an advocacy group for babies-at-work programs. “So they’re willing to give it a try because they really want to retain that particular employee, typically a mom. And then once they see that it works, then they tend to expand it to the rest of workforce.”
And the expansion has spread across the workplace at large. When Moquin began tracking companies with babies-at-work programs in 2005, she found a half-dozen; today she’s confirmed 250. According to the consulting company Mercer, 44% of companies with more than 20,000 workers offered an IVF benefit in 2018, an increase from 37% in 2017. And the quality of offerings within the benefit has been increasing as well.
The landscape for women-focused benefits is still imperfect; some are legally mandated while many are not, and legal requirements in many cases are a patchwork of laws that differ from one jurisdiction to the next. And though there’s a clear trend of employers doing more to tailor benefits for women, unraveling and communicating those benefits remains a work in progress.
The ROI of IVF
In 2016, Intel caught the attention of many employee benefits observers when it offered an upgrade in its IVF coverage, from $10,000 to $40,000 for medical coverage, and an additional $20,000 for prescriptions. The adjustment recognized that a successful fertility program generally required at least two IVF treatments, and the benefits increase was meant to “help more families complete two full cycles of IVF or cryopreservation.”
According to Julie Ann Overcash, vice president of HR and director of compensation and benefits at Intel, about 300 employees have taken advantage of the program since its expansion. And though Overcash says Intel does not collect data on retention as a result of the program, she shared a comment from one grateful employee — “This level of corporate generosity is exceptional” — that symbolizes the kind of enthusiasm companies are hoping for, and increasingly receiving.
More than half of IVF program participants said they stayed longer at employers that covered IVF treatments, and more than 60% described themselves as more loyal and grateful, concluded a report this year from FertilityIQ, a company that collects data on families seeking IVF treatment.
Jake Anderson, co-founder of FertilityIQ, says cultural factors have played one role in the expansion of IVF benefits. “Amidst the #MeToo movement, companies have rightfully tried to demonstrate that they are family-friendly, female-friendly and broad-minded,” he said.
But more pragmatically, even beyond matters of retention, employers also might recognize that patients paying out-of-pocket for IVF are more likely to choose multiple-embryo transfer, which is more likely to produce twins or triplets, Anderson said. When IVF is covered, patients are more likely to choose single-embryo transfer. Bottom line: IVF coverage may be cost-effective in the long run. “A singleton birth costs $20,000, a twin birth, $100,000, a triplet birth, $500,000,” he said. “That cost gets absorbed by your employer or insurer. So even if they’re not paying for IVF, they may end up paying for the downstream decisions involved with IVF. And so there is a real eagerness to wrestle this issue of single-embryo transfer to the ground, ensure that patients are having one child per time, and to tamp down the cost and risk of high-order, multiple births.”
One aspect of IVF coverage doesn’t receive high marks, however: communication of the benefit. Nearly three-fourths of respondents to FertilityIQ’s survey said their employer did not do a good job of communicating IVF coverage to workers. Companies say they make a point of highlighting it in their benefits literature. For instance, a spokesperson at the food company Chobani, which this year removed the annual cap on its $25,000 IVF benefit and offered it to rank-and-file workers, says the benefit is highlighted in all its annual open enrollment materials. Intel’s Overcash says the benefit is communicated on its intranet and via a dedicated family-benefit partner.
But Anderson says that may not be enough. “There are people that all of a sudden decide that they need to go to a fertility clinic, and that can be a decision that happens within a month,” he said. “And if the benefit was in the fifth paragraph of the policy, there’s a good chance that they don’t know about it. I think to the extent that it’s feasible, you need to continually message, ‘If you’re trying to have a child, we help cover this, come see us.’ ”
44% of companies with more than 20,000 workers offered an in vitro fertilization benefit in 2018, an increase from 37% in 2017, according to Mercer research.
Anderson estimates that “comfortably over 75%” of employees do not pursue an employer IVF benefit simply because they’re unaware of it. He suggests that HR managers be particularly mindful of employees’ emotions when it comes to IVF. “Oftentimes their marriage is strained, they are having an existential crisis, they’re trying to figure out how to do their job and get to the clinic,” he said. “And so the mindset for a lot of these people is not what you would expect. They may not necessarily think to go to HR to get answers. Maybe they’re reluctant to do it because they don’t want to tip their hand to anybody in the company that they’re trying to conceive. I don’t think people find their way to the HR professionals like all of us would assume they should.”
Lactation, Babies, and the Law
Breastfeeding accommodations are no less complicated for employers, despite the fact that there are more legal requirements supporting it. The Patient Protection and Affordable Care Act of 2010 (PPACA) requires that nursing mothers be provided with break times and an appropriate space (i.e., not a restroom) to express milk. However, the PPACA generally applies only to workplaces with 50 or more employees, and state and municipal regulations fill in the gaps in various ways. It’s an ongoing effort. For example, Illinois passed a law last year requiring that lactation breaks be paid, and in March, a law went into effect in New York City requiring that employers with four or more employees provide a room reasonably close to the employee’s work area with a refrigerator, electrical outlet, chair and flat surface.
Here, too, employers have recognized the benefits of providing these accommodations. According to research from the U.S. Department of Health and Human Services, mothers who breastfeed their babies miss fewer workdays than colleagues who don’t, and employers with lactation support programs have retention rates above the national average.
But Cheryl Lebedevich, senior workplace program manager and policy analyst at the United States Breastfeeding Committee (USBC), says the array of regulations have left many HR managers frustrated with the scope of the benefit and how to communicate it. “What happens a lot of the time is that employers call and say, ‘Just tell me what to do. We want to make sure we’re doing what’s needed.’ And it’s complicated when the requirements vary by state.”
Still, Camille Abbe, USBC’s events and public relations manager, suggests HR departments can be more proactive with employees and have plans in place well ahead of a pregnancy. “Moms shouldn’t have to advocate for it,” she said. “The minute someone announces that they’re pregnant, an employer can initiate a conversation about it: ‘Here’s our policy, here’s where the lactation space is,’ and so on. This would create a culture that is much more supportive.”
Mothers who breastfeed their babies miss fewer work days than those who don’t, and employers with lactation support programs have retention rates above the national average.
Allowing new parents to bring their babies to the workplace is less complicated, as there are no legal requirements around doing so. And as a relatively low-cost benefit, it’s proved to be popular in the public sector, which can’t always compete with the private sector in terms of compensation and benefits. (For instance, last year Arizona expanded its Infant at Work program to cover 11 state agencies.) However, Parenting in the Workplace’s Moquin says that a written policy is essential for any such program to succeed.
The policy should include language that the baby will not be disruptive to the work environment. “That sounds unrealistic, but in practice it creates a situation where parents are very responsive to the early signs of distress the baby makes, which means that the baby’s needs are getting met quickly,” she said. “So the babies tend to be much happier and calmer and quieter than management expected. And because they’re so happy, co-workers end up bonding with the babies and wanting to pitch in.”
To alleviate concerns among higher-ups that the program won’t work, Moquin suggests trying a pilot. “Even three or four weeks is typically enough time for a company to see that it is actually viable if you set it up right,” she said. “And the parents find ways to make it work, and after that the novelty kind of wears off and people just get used to it.”
GL Group, which has had its program in place since 1993 and has graduated more than 45 babies from its program, has been comfortable with the guidelines it sets. Babies can only come to the office of the St. Louis educational company until they are six months old, Patterson said, and employees are required to be on staff for a year before taking advantage of the program. “We want to be sure that someone can come in and learn their job before they are able to have a distraction like that,” she said. (The company also provides day-care compensation for employees who work in the warehouse or other areas where having a baby nearby would be impractical or unsafe.)
And, perhaps as a lesson to HR leaders regarding other benefits, the company makes a point to regularly communicate about the program. GL Group highlights it as a “wow” benefit during recruiting and orientation, and throughout the year. “We do talk about it in our interviews and our recruiting process because we want to let people know that we have an environment where this could happen,” Patterson said. “So, if there’s somebody who doesn’t think that they would want to work in an environment like this, we tried to be very transparent about who we are and what we expect. We talk about it a lot.”
Mark Athitakis is a contributing writer for Workspan magazine.