1 in 6 couples of child-bearing age are struggling with fertility. They are having to pay out -of-pocket for treatments such as in-vitro fertilization (IVF), IUI or AI (artificial insemination) because they have a medical condition that requires some additional help to conceive. It's not just women - sperm counts have plummeted over the last 20 years according to the WHO (thanks to cell phones in pockets or plastics in the water - estrogen reduces sperm), and it's not just because people are waiting longer. Many people are in their 20s and 30s and need help because the incidence of infertility has increased.

While governments may cover some IVF, it is not enough. People are going into debt or asking their family for help conceiving. Private insurance may cover it if its a large employer, large insurer, or grandfathered contract -- but many employers have the choice to remove fertility coverage because it's impacting premiums. 

I believe it's our role -- as health insurance professionals -- to find ways to help employers keep this coverage without adding costs. The most seamless way to do so is to couple fertility coverage with a managed drug formulary. We use either the Reformulary through Co-operators Life or the Conditional Drug Formulary through Green Shield Canada. It typically negates any increase for fertility (+3% to health rates) by a decrease (-3% to health rates) as a result. 

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