Proposed Rule Aims to Entice Employers to Provide Fertility Benefits

Three U.S. federal agencies on Monday, May 10, jointly announced a proposed rule aimed at expanding access to fertility benefits, including in vitro fertilization (IVF), by allowing employers to offer them as a new category of “limited excepted benefits.” The move is designed to make fertility treatments such as IVF more accessible and affordable for workers by easing regulatory burdens on employer-sponsored health plans.

The agencies proposing the rule are:

The Department of Labor (DOL)
The Department of Health and Human Services (HHS)
The Department of the Treasury

The rule proposal is a cornerstone of the Trump administration’s efforts to address declining birth rates and support family formation, according to a press release posted on the DOL website. It also is a formal response to President Donald Trump’s February 2025 Executive Order, “Expanding Access to In Vitro Fertilization,” which mandated policy initiatives to ensure reliable and affordable fertility care.

Under the proposal, employers could offer standalone fertility coverage — covering diagnostics, IVF, medications and treatments — separate from their core medical plans, similar to how dental and vision coverage currently operates. The rule addresses the current landscape where, despite many workers having employer-based healthcare, robust fertility coverage remains sparse. According to WorldatWork’s 2026 Total Rewards Inventory of Programs and Practices research, 60% of surveyed HR and total rewards professionals said their organizations offer “family development programs,” which can include fertility benefits.

Key aspects of the proposed rule include:

A new category of benefits by establishing “limited excepted benefits” for fertility treatments, which would be exempt from many Affordable Care Act (ACA) requirements.
Reduced regulatory burdens by allowing for standalone, flexible coverage that is not integrated into comprehensive major medical insurance.
Targeting affordability by seeking to reduce the significant financial burden of IVF treatments, which often cost tens of thousands of dollars.

The proposed rule sets a few main requirements for the benefits:

Substantially all of the benefits must be for diagnosis, mitigation, or treatment of infertility or related reproductive health conditions.
Benefits are capped at a combined lifetime maximum of up to $120,000 for the participant and their beneficiaries, indexed for inflation for plan years starting after 2028.
Employers must provide a notice that clearly describes the coverage and meets other specified requirements.

Comments are due 60 days from its publication in the Federal Register.

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