Employer support for women's health gaps and opportunities

This article was first published by Mercer here.


Over the past year or so, there have been several news stories about employers adding or enhancing fertility benefits such as coverage for in vitro fertilization (IVF) or, less commonly, egg freezing. While previously considered a “luxury” benefit, fertility treatment coverage, along with other family forming benefits such as support for surrogacy and adoption, have become table stakes in some industries (tech, for one). At the same time, the new focus on offering more inclusive and equitable benefits – as well as the need to stay competitive in prolonged tight labor markets – has caused many employers to look beyond family-forming benefits towards a more holistic approach to supporting women’s health.

Despite some progress, gender disparities in pay and career advancement persist and this has a trickle-down effect on healthcare affordability for women in the workforce. Women are more likely to work part-time jobs and be in lower-paying job functions and are nearly twice as likely as men to be low-income employees (defined as earning less than $60k per year). Mercer’s 2022 research found that women are more likely than men to feel challenged in affording the healthcare they need (35% vs 27%). While pay equity is part of the issue, the gender gap in healthcare affordability is also linked to benefit program designs that historically have overlooked the unique health care needs of women: the full spectrum of reproductive health issues and health conditions that disproportionately or solely affect women.  

Advances in support for women’s health

This is changing. In the past year, we’ve seen employers focusing attention on reproductive health benefits ranging from preconception, through pregnancy, to menopause. According to Mercer’s latest research, 37% of employers with 500 or more employees provide at least one specialized benefit or resource to support reproductive health, which could include benefits to support high-risk pregnancies, lactation, pre-conception family planning, pregnancy loss, or menopause. That number rises to 48% among organizations with 5,000 or more employees.

Employers can now consider a range of new digital health solutions that have entered the market to fill gaps in the reproductive health spectrum. These solutions typically pair a virtual provider network with educational resources, online communities, and coaching or concierge support to facilitate access to specific services such as contraceptive care, medication abortion, LGBTQ+ reproductive care, sexual healthcare, and menopause treatment.

With much recent media and government attention to maternal mortality (in particular, racial disparities), some employers are offering enhanced maternity support for high-risk individuals and revisiting health plan coverage of maternity providers and facilities for low-risk individuals. Medical insurers and health start-ups alike are showing greater focus on pregnancy support, resulting in new partnerships targeted at providing enhanced care navigation and education alongside existing medical benefits. Some recent innovative approaches have included distributing medical devices designed to monitor specific health metrics and creating digital communities for parents with babies in the NICU. Additionally, in an effort to increase options for low-risk birthing people (as well as to reduce cost), some employers are adding coverage for out-of-hospital birth with midwives and providing reimbursement for doulas.

There remains an important opportunity to better support women with chronic conditions, from uterine and hormone health to cardiometabolic diseases that are more prevalent among women.

Actions to consider

While start-ups mature and scientific and technological advancements catch up to address women’s unmet health needs, employers can look within their existing benefit ecosystems and organizational infrastructure to enhance support of women. Consider the following actions:

  • Reviewing life and disability policies to ensure that benefits are payable for symptoms related to perimenopause or menopause, menstruation-related conditions such as endometriosis, PCOS, and gender affirming care.
  • Ensuring that behavioral health solutions are adequately staffed and trained to support various health needs specific to women, including unintended pregnancy, gender affirming treatment, menopause, pregnancy loss, etc.
  • Implementing manager and supervisor trainings, both in an effort to direct people to resources and break down stigma. Focuses include menopause, pregnancy loss, and return to work after parental leave, among others.
  • Reviewing policies related to return to work after parental leave, reduced schedule options, and flexible work options.
  • Providing accommodations such as desk fans or ergonomic support. Adjusting dress code policies to be more flexible or less formal.
  • Connecting employees with similar interests and needs via communities or Employee Resource Groups; leveraging those groups for feedback on benefit strategy/offerings.

Women’s health is a broad topic that encompasses much more than just reproductive health. Women-specific health conditions and experiences require women-specific solutions and treatment. Employers wishing to attract and retain women, to support families by way of supporting women, or to focus on reproductive health, can begin by identifying and addressing the gaps and opportunities in their current programs.