Portable Fertility Insurance: Why Group Benefits Leave Most Employees Without Coverage
Most workplace fertility coverage isn't really yours. Here's what that means.
What if the fertility benefit you're counting on is only yours as long as you keep your job?
What if a layoff, a career change, or a company restructure wiped it out at exactly the wrong moment?
Most employees never think about this until they're already in the middle of a fertility journey. By then, the options are limited and the costs are significant.
Fertility benefits have become one of the most requested perks in the workplace, but the majority of what exists today lives inside group insurance plans that only large employers can afford to offer. When the job ends, the coverage ends with it.
Dr. Christy Lane and Laura McDonald, co-founders of Flora Fertility, joined the podcast to talk about the gap in how fertility benefits are currently structured, what individual underwriting actually means, and why the distinction between group coverage and portable coverage matters more than most people realize.
(00:00) Two Founders, One Problem They Both Lived
Dr. Christy Lane is a global leader in InsureTech, a founder, investor, and award-winning health scientist with expertise in AI, digital health, and wearable devices. She co-founded Flora Fertility and the Stanford Wearable Health Lab and serves as a venture partner with IA Capital in New York. She has spent her career in women's health research since the 1990s and is a mom of three who went through IVF herself. She had no idea she had PCOS until she was already trying to conceive.
Laura McDonald is the co-founder and CEO of Flora Fertility. Before Flora, she founded, scaled, and sold Canada's largest financial media company focused on women and wealth, and authored two bestselling personal finance books. She watched her cousin struggle to afford fertility treatment in a major city, with a solid income and partial coverage, and still coming up short financially. That experience pointed her toward insurance as a potential solution.
Their backgrounds are different enough to be complementary. Dr. Lane brings the science and underwriting models. Laura brings the experience of taking new financial products to market. Flora is the result of three-plus years of building something that, according to both of them, had never been done before.
(11:00) The Numbers Most People Get Wrong About Fertility
The conversation in the media tends to focus on IVF and egg freezing. Those are real and important parts of the picture, but they're not the whole picture.
According to Dr. Lane, only about 10% of people who need fertility treatment will ever require IVF. The other 90% are addressed through earlier interventions: consultation, diagnostics, medication, or IUI. Many people don't know they have a diagnosable condition until they're already trying to get pregnant.
A few other statistics worth knowing:
1 in 6 women will need some form of fertility treatment, and in some North American estimates that's closer to 1 in 5
Over 50% of young women are already thinking about their future fertility, with one study putting that number at 72% by age 23
60 to 80% of employees still have no fertility coverage through work
The average cost of fertility treatment across the full spectrum sits around $50,000, not the six-figure number that tends to dominate headlines
The IVF-centric narrative shapes how both individuals and employers think about fertility benefits, and it creates a significant blind spot around the broader and more common experiences most people actually have.
(17:00) How the Existing System Fails Most Employees (And Why It's Hard to Fix)
Here's the basic problem with how group fertility benefits work right now.
Step 1: An employer wants to offer fertility coverage. They look at the available group plans.
Step 2: Those plans use risk pooling, meaning everyone in the group gets covered regardless of individual risk. The insurer doesn't know who in the group is actually going to need treatment, so premiums get priced to account for that uncertainty.
Step 3: The cost lands somewhere most small and mid-size companies can't justify. The plans designed for this space have historically required thousands of employees to make the math work.
Step 4: The employer either skips fertility coverage entirely, or gets a stripped-down version that barely moves the needle. 60 to 80% of employees end up with nothing.
Step 5: The employee who does have coverage changes jobs, and starts over.
Dr. Lane was direct about why building an alternative took so long. Individual underwriting for fertility had never been done. It required domain expertise in reproductive medicine, new predictive models, reinsurance backing, and regulatory groundwork for a product category that didn't exist. The fact that it's hard is precisely why it hadn't happened yet.
(26:00) What Egg Freezing Actually Gets You (And What It Doesn't)
Egg freezing gets a lot of attention as the go-to option for women who want to protect their future fertility. Laura shared a statistic that reframes the conversation a bit: only 6 to 15% of people who freeze their eggs ever actually use them. And if they do use them, that's an IVF cycle.
She described a conversation with a young woman who said:
"I'm hearing that freezing my eggs is the only way to ensure my future fertility. You just made me realize I actually just need an insurance policy." - Laura McDonald, Co-Founder and CEO of Flora Fertility
The point isn't that egg freezing is the wrong choice. For some people, at certain ages, it makes sense. But it's expensive, it's invasive, and it's built entirely around a future that may not materialize. A 20-something who isn't planning to start a family for several years has options beyond egg freezing that don't require putting their body through a medical procedure upfront.
The conversation gets into how to think about those options depending on where you are in your reproductive planning, and why the two aren't always the either/or choice they're assumed to be.
(39:00) What Should HR Actually Do With This?
As many as 88% of women report asking for fertility benefits at work. Most HR teams want to respond to that. The question is how.
If you're at a large company with a robust group plan, this conversation is still useful context for understanding what your employees are actually experiencing and what gaps your coverage may have.
If you're at a smaller organization, this is where it gets more interesting.
What does it cost to offer individually underwritten fertility coverage? Less than you'd expect, because the employer isn't absorbing claims risk. You decide what percentage of the monthly premium to cover. That's your number. It doesn't move based on utilization.
Does it have to go through open enrollment? No. That alone removes one of the biggest logistical barriers HR teams face when trying to add something mid-year.
Who is eligible? You decide: employees within the age range, spouses, adult children. The flexibility is part of the design.
Laura also flagged something relevant for anyone thinking about the policy environment right now. At the time of recording, the current administration had put out guidance specifically recommending that fertility benefits be offered outside of traditional group or health plans. That's a meaningful signal for how this space is likely to evolve.
What the Conversation Leaves You With
Most employees don't think about fertility coverage as something they can own independently of their employer. Most HR teams don't know there's an alternative to expensive group plans.
Those two gaps exist alongside each other, and they leave a lot of people without coverage during one of the most significant experiences of their lives.
There's more in the full conversation, including how emerging wearable technology and microbiome science are starting to shape personalized reproductive medicine, how male fertility factors into the treatment picture, and what the data actually says about who needs IVF versus who doesn't.
Connect with Dr. Christy Lane & Laura McDonald at Flora: HeyFlora.com | LinkedIn | IG: @heyflorahealth
Connect with Traci here: https://linktr.ee/HRTraci