The Growing Importance of Family Planning Benefits in Talent Management

There is a powerful relationship between what employees experience in the workplace and their mental health overall. Employers can have a positive impact, but often, the things they do to support employee experience are too little too late. Instead, they need to think about how they demonstrate value - valuing the individual and the work. In this session, we will discuss why traditional support methods often fail and emphasize proactive approaches relevant to HR/organizational leaders, managers, and anyone interested in fostering positive mental health. We will also offer actionable strategies for employers to create a supportive, mental health-friendly workplace.

Transcription:

Rachel Fox (00:10):

Hey everybody, my name is Rachel Fox and I'll be your host and moderator for the next 30 minutes. My name again, I'm a Director of Strategic Partnerships and Business Development at Sunny Day Fund, and I'm excited that you guys are here to talk about this really important conversation. Again, The Growing Importance of Family Planning Benefits And Talent Management. So I want my esteemed panel to introduce themselves. Just tell us a little bit about yourselves and your work, the passion, the mission around your work, and what has you here today.

Nicole Piggott (00:42):

Thanks, Rachel. So my name is Nicole Piggott and I am the President of an organization or a consulting firm called Synclusiv. But I came to that after 30 years of being a VP of HR and watching sort of the evolution of reproductive health in the workplace and how it's impacted my employees and the decisions that we've made at the executive table.

Cynthia McEwen (01:11):

Hi, and I'm Cynthia McEwen. I'm sorry, I'm getting over something. So I am the Head of Diversity, Equity and Inclusion at a company called Progyny, which is a fertility and family building benefits company, but we're also now fully engulfed in women's care. I also am the VP of people, so I am over the internal benefits at Progyny as well come from many, many years of managing human resources and also consulting. And I am very happy to be here.

Rachel Fox (01:52):

Thanks. And my work at Sunny Day Fund revolves around, we set up emergency savings accounts for employees as a company benefit. So people stop rating the 401k. There are a lot of things that require money in life before we're 65, yet workplace savings strategies have exclusively focused on retirement. And again, as we talk about this, I've sat in countless waiting rooms and infertility clinics and talked with many women who said, oh, I completely drained my 401k to be here. Oh, I completely took out a second mortgage on my house to be here. So this is really a conversation that kind of divides people into haves or have nots, and the people who have the money to pursue these options are the ones who ultimately have the ability to do it. And there are many people who don't have the ability to do it because even with great care and health insurance, many healthcare decisions are still being based around finances.

(02:45):

So I'm going to start today with just sharing my own personal story. I think it's nice to have a personal story behind some of the data points in case this is something that you haven't had to experience. This is something that is happening within your workforce and not everybody raises their hand to be as open about it as I have been. And so I'm happy to share my story just to give the conversation a little bit of context. I also have 22 years of employee benefit experience, both working on the insurance carrier side and working as a health broker. So I've seen the disconnect between what employees in the workforce are clamoring for and what some people around a board table decide is what they'll get by with. And then again, as a solution provider, we see a lot of people saving up in their sunny day funds for family plannings or weddings or it's not just a rainy day fund.

(03:38):

There's lots of happy things that require money. So we're helping people accomplish those sunnier goals, especially if they have the pitter-patter of little feet as part of their sunniest dreams. So just quickly as far as my timeline and a quick share of my story, I got married in 2003 and from previous medical challenges, my doctor had said, you're likely to have trouble getting pregnant. It's going to take you a long time. You should be prepared for years of trying. So like basal temperature monitoring every morning and ovulation kits, which work really well for people who ovulate normally. If you don't, they don't work so well and lots of those kinds of things. So I was mentally prepared that this was going to take a long time. What I was not prepared for is that I got pregnant relatively quickly in 2004. My water broke at 19 weeks.

(04:29):

I delivered her at 20 weeks, and I had a stillborn at that time, and we still have her hand prints and footprints in our house. It's something that's a big part of our family. It's a big part of my story and certainly a big part of my journey. I never had the luxury of private grief, so everybody knew about it. We had baby showers planned. It was a thing. So this is just a part of my journey, and I became very open about this, my anticipated years of trying ensued unsuccessfully. So I then took a break to just travel and drink and pout because that's super helpful. And everybody's like, oh, it just happens when you're not trying, right? Everybody's got a scenario for you. I came back, I did three IUIs that all failed. And at this time, again, this is 20 years ago, my health insurance did not pay for hardly any of this.

(05:18):

I have the luxury of my husband working for the federal government, which means I could choose between Aetna and Blue Cross and United, but the only one that had any fertility benefits at that time was Aetna. And they would pay for 20% of prescription costs and they would pay for 50% of IVF up to three live births. So I'm paying 80% of all the medications, of which there is a lot. I'm paying for all the I IUIs out of pocket. So three I UIs all failed. You'll recognize a pattern here. I took another year off to travel and drink and pout. I worked for Aflac at this time as a 10 99. I won lots of trips and we made lots of use of that to escape this whole journey. In 2010, I went back for three more. IUIs two failed and one was successful.

(06:10):

I carried her to 17 weeks before my water broke, and so we had lost her. So I was always past the magical 13, not supposed to tell anybody until 13 weeks. And then everything's okay. Well, my body didn't get the memo on that. Every single time my water breaks, my white count skyrockets, and then we don't have a pregnancy anymore. So this was not the course of events that I was anticipating. This is not the way things were supposed to go. This was not supposed to be my story. I took another year off because it worked so well for me in the past. I had no access to a lot of support. I had no access to mental health at that time. That wasn't really a thing. My husband was kind of like, oh, don't talk about it. It makes people uncomfortable. And I had a lot of people come out of the woodwork, high school and college friends that would reach out to me and said, I've just been through a miscarriage, or I just went through this and nobody talks about this but you and I don't know who else to go to talk about this.

(07:07):

And some people do talk about it, and I've always been very open about it, part of my journey. But I understand it's a very private thing for many people. But I said, if you go to those kitchen tables where there's a lot of women talking, just ask them about it. They're all going to have a story. We just don't talk about it. We don't normalize it. And so we end up feeling defective and really broken when these things happen, and it's really isolating. Luckily, I was able to thrust myself into my job and find success there because you just feel like the opposite of King Midas. I was like, everything I touch is not turned into gold and you just want to have some sort of worthiness. I have a lot of these little dots develop across the bottom. Does anybody have a guess as to what those little dots might be? They're pink and blue.

Nicole Piggott (07:54):

Are they the gender of?

Rachel Fox (07:57):

They're the genders of my nieces and nephews that were born during this time. So I have two brothers. My husband has two brothers. We are in a family of baby makers. Some pop 'em out two at a time during this time. So this really put a strain on my family relationships, my friend relationships. I was in such a dark place. I lost my ability to be happy for other people. Christmas and Thanksgiving and Easter became very strained and I would hang out with all the guys in the living room watching football instead of hanging out with all the women in the kitchen talking about their kids. I was like, I have nothing in common with these people anymore and I don't know where I belong. I don't know where I fit in. And I was again, just, I have to get out of here. And there were many of these times where I was like, I'm just going to buy one my plane ticket to Rome and my husband and I are just going to go and meander for a little bit.

(08:42):

Luckily, I was a 10 99 working with Eric at Aflac. He worked for the federal government. We had lots of time off and we could get away, but I was like, I'm not going to bake you a lasagna. I'm not going to make you some booties. I'm not going to come clean your house. I'm not at the point where I'm making lemonade yet. And so many of my family members really wanted to come over and pull me out into the sunshine. And I just really wanted somebody to sit in my cave with me and tell me it was okay to feel terrible and angry and frustrated and sad and throw empty beer bottles at the flour delivery guy. I was not handling things well and I just wanted somebody to come and get that because I didn't have a lot of support. In 2012, I went for my first egg retrieval and I did a fresh transfer.

(09:25):

At that time I had four viable embryos from my egg retrieval because they were like, we've pumped you full of so much stuff at this point, you really just need to do IVF. And I was like, great, something my health insurance is going to kick in for. So they did pay for 50% of my IVF course. So I had one fresh transfer and she took and I froze the other three. So I carried her until 28 weeks when my water broke. She was born at 29 weeks, just under three pounds. She was in the NICU for about a month, but overall was pretty healthy, happy, great story. When she was a year old, we went back, got another frosty out that frosty took. I carried her until 30 weeks. She was born at 31 weeks. And when she was a year old, I went back for another frosty, carried him to 34 weeks before my water broke.

(10:19):

And when he was a year old, I went back for my last and final embryo. And that one not was not a successful transfer, but when we talk about, again, there's a huge emotional capacity to all of this, there's a huge mental aspect to all of this where I was not getting mental support. We didn't have those kind of resources back then. The financial aspect of this, I mean this cost me over $50,000 out of my own pocket that I was doing to enable this to make this happen. Yes, they paid for 50% of each of the first three IVFs that were successful. They paid for nothing for the last one that wasn't successful. They paid nothing for the I UIs and they only paid 20% for the medical, for the prescriptions. So this again impacted many aspects of my life and really who I am as a person. And again, I think it's nice to compare what my story is with what things look like now, how fertility benefits have emerged as an employee benefit because so many people were going through this alone like I was. And so I really want to talk to Cynthia about what is different, what could this picture look like as far as what's available now in fertility benefits and what are we chasing? What is the ideal state where we hope things will eventually get for people?

Cynthia McEwen (11:34):

Sure. And thank you Rachel, for being willing to share your story because that cannot be easy no matter how many times you do it. I can tell you what it can look like because I can tell you that there are a lot of places where it doesn't look like what it can look like. What you described, having fertility and family building benefits through a major insurance carrier is what a lot of companies have. So that looks like first establishing infertility, which may be six to 12 months of unsuccessfully trying to become pregnant. And so that assumes a few things. That assumes a heterosexual couple. But even then, if you can establish that definition of infertility, you are now dealing with either percentages of coverage or caps on coverage or both. So you may get that 50% or 80% of coverage, but you may cap out at 15,000 lifetime max under traditional coverage through a major medical carrier. And just as you described that 15,000, or even if it's higher than that, can go quickly. And another thing that tends to happen with major medical carriers is that they will insist that you try something that they want you to try first. So you can't go straight to IVF.

(13:22):

They may say, oh, you need to do a couple rounds of IUI first, all of that going towards that lifetime max that you may be facing. So the setup of benefits in that fertility space is already counting against many employees who need to access those benefits, what we want it to look like. So what it can look like is what most employees are looking for in their benefits anyway. It's personalized, it's bundled so you know exactly what the spend is, and you don't run out of money in the middle of a treatment or in the middle of whatever your doctor has said you need in order to be successful and it's supported. So that is somebody is on this journey with me. Someone who knows more about this journey than I do is helping me figure it out as I go along. And that's not Google. It's not I got to go out and get my own information. It's really someone who has that experience. The other pieces of this, which I alluded to and you did as well, is access. So am I able to see the kind of professional that I need to see? Is that accessible for me from a financial standpoint? Is it accessible for me from a geographical standpoint?

(14:55):

And then is it inclusive? Maybe I am a single parent by choice, maybe I identify as LGBTQ plus and I have a same sex partner or spouse. I may not be able to fit that definition of infertility for the healthcare company, but I still need some kind of assistance if I'm going to be able to build my family and maybe I need to get a surrogate or maybe I need to adopt. But the fact is that in order for a benefit to be inclusive, you have to think about all of those different segments of your employee population to ensure that you are offering something that everyone can access. And they're not having to train their bank accounts.

(15:41):

Or take out second mortgages or find other ways to access a benefit that might actually be something that is accessible for others in your company.

Rachel Fox (15:53):

And just to piggyback on that concept of creating a really inclusive program, if you're an HR person in charge of creating this policy that many times you're going across state lines and the state legislations in various states are going to have limiting impacts or limiting resources that we might have to deal with. So Nicole, how do we create equitable company policies for family planning strategies and what do we need to be considering? How do we need to be looking at it?

Nicole Piggott (16:23):

Well, that's a great question. As someone who's spent the last 30 plus years in this space, I've seen the evolution of these policies. And there's two elements of policy that I think we should all take away in this room. There are a number of policies that organizations should put in place in order to facilitate the access to reproductive health, flexible work arrangements, leave policies that give people the options to be able to take longer leaves than your woefully inadequate maternity leave you have here in the us. I'm Canadian, it's shocking to us. We have 18 months off and 12 weeks my staff in Utah and California just used to blow my mind.

(17:21):

So those things. But in addition to that, mental access to mental health support during this journey, and that means also educating leaders in the organization to be aware of what their employees need in terms of support as they engage in this journey. It is not simply a clinical matter, it's also an emotional journey for your employee. And how are we equipping leaders to be able to accompany and support their staff during these journeys? So it's leadership development using your EAP and your benefits providers to help educate your leaders on how they can support employees during these journeys. So these are sort of the evolutions of policy. However, it's more than just putting policy in place. How do you create a culture in your organization that actually encourages people to utilize these policies? Because just putting policy in place and having a culture that somehow puts a chilling effect on how you access these policies is as good as not having these policies at all. So I've seen organizations that have all these great policies on paper and they would win every award, but have a culture where it is somewhat frowned upon for you to take advantage of these policies that you have access to. So it's more than just having the policy, it's creating a culture that engages and allows employees to fully access those policies and feel supported and not feel that they're putting their career at risk

(18:52):

When they utilize these policies.

Rachel Fox (18:55):

Yeah, I think that as we talk about the priorities for leadership and developing the values as a company that we really want to stand for. Cynthia, how do you feel like we can prioritize this conversation in the budgeting conversation as we're talking about benefits and what we want to make important? Because again, I've noticed that that disconnect seems to be pretty common between what employees are clamoring for and what gets decided for them to have access to for them. So how do we make it a priority in the budgeting conversation?

Cynthia McEwen (19:27):

Sure. I actually had the pleasure of having to make the pitch, not once but twice, that we needed fertility benefits at a previous employer. And I can tell you that one of the aspects of your story is probably one of the most compelling arguments that you can make. You were able to carry children, but some of them came very early and that meant NICU stays, right? So anyone who is a benefits manager in the room has ever looked at claims reports and seen your large claims, a one month stay in the NICU is going to affect your renewal for sure. Multiples. I have 13-year-old twins. I was able to carry them to 37 weeks, but I was fully prepared and my doctors told me to be prepared for them to come early, what these cute little teeny creamy outfits that neither of them could fit into. But I did that because the reality is that if you are successful in your fertility and family building journey, the risks sometimes don't go away. And you need that support and you need to have the best providers available to you so that they can be following you on that journey. And if you can find in a benefit a way to mitigate the big claims

(21:16):

That may come through as a result of fertility and family building benefits, that's a huge argument to make for why we need to find budget. Why do we need to have this more inclusive, this more supported journey for our employees? The other thing is that fertility and family building benefits are becoming a must have, not a nice to have, but a must have. Employees are asking for these benefits. Candidates are looking for these benefits when they are looking at your benefits packages for sure. Over 40% of candidates out there are looking and examining your benefits packages to see if you have fertility and family building benefits. They may not need it now,

(22:06):

But they want to know that should they need it, it will be available to them. And over 60% of employees are considering looking elsewhere if they don't have the benefit where they are right now. So on top of the risks to your benefits by not having an inclusive benefit that helps employees through that journey and hopefully mitigates those risks to your medical coverage spend, there's also the attraction and retention of talent that has to be at the forefront of almost everyone's people strategy. So those are definitely some ways to start thinking about how do I make this pitch? How do I get my decision makers to start thinking about why something like this is important? And again, at least for some of our Progyny clients, employees are not quiet anymore about what they are looking for. So we've had a couple of clients who came to us because their employee resource groups got together and they're like, look, we need to talk to somebody about why we don't have this because my spouse's company has this or my friend's company has this, and so why are we so different? And why are we as a company thinking differently about what we should have access to as employees? So even if you're not right now, having that issue could very well become an issue that if you get out in front of it, you don't then have the masses mounting against you saying, we want fertility and family building benefits. So there are lots of ways to at least start the conversation and partnering with a company that can help you make that case. It's certainly going to help you get even further with that.

Rachel Fox (24:05):

And I think that we see that at Sunny Day Fund too. Like we are an emergency savings vehicle, but hence our name. We're not just a rainy day fund. We help people save up for their happier things. And so we see a lot of employers using this to help employees save up for fertility treatments or these are the things that are important to their life. So whether it's saving up for tuition or saving up for childcare or going on vacation or saving up for a wedding or saving up for a car down payment money is a conversation. I have heard the word cost or money or financial or expensive in every single session that I've been to since I've been at this conference. So much of benefits is how do we make life more affordable for our employees and how do we prioritize the things that are important to them to make these pathways of access available to them for things that are important to them.

(24:55):

So we've certainly seen an uptick in people designating a savings bucket where they're payroll, deducting money into this savings bucket specifically for family planning needs. This is not a cheap journey. Even if you have fertility benefits, it's not going to be free for you. We still need to equip people with the way that this is what you need to be prepared for and we're going to try to meet you halfway and do as much as we can, but it's going to be a difficult journey regardless. So as we see things like fertility benefits and it really covers I think many different areas, right? It's impacting your healthcare spend, it's impacting mental health, it's impacting financial resources in that family. It's impacting family relationships that we need to provide counseling for. So Nicole, how do we support people when this is like I made the joke before, it's not like we're going to just like, should I buy a third fish? This is something where I feel compelled to fulfill this need in my life to the point where people are liquidating their 4 0 1 Ks, taking out second mortgages. This is not a decision that people are taking lightly, but this is something where it's like, I feel compelled to do this for me to feel whole as a human. And how do we bring that conversation again to life and support people in all of those different areas?

Nicole Piggott (26:13):

So that's a great question. So picture this for me. There's a very personal story that I want to share with you. My best friend we met in daycare, I was 18 months old, she was 24 months old. Our parents, our fathers were grad students at university together. We've known each other our entire lives. Our kids have grown up together. I had my children. She started later having her children. She had her first child was a struggle. She went through a number of pregnancies before she successfully had Jessie, but she wanted to have another child. She went through the entire process up to IVF, drained her bank account, drained her retirement fund, and took out a second mortgage on the house. She told me, I'm at the point where I can afford one more kick at the can.

(27:18):

It wasn't successful. She didn't stop there. She went and started seeking out back alley people who claim that they had the latest, greatest concoction to be able to successfully produce a pregnancy. And I got an urgent frantic call from her mother to say, please come. She'll only listen to you. We need her to stop. And I got in my car, drove six hours, showed up on her doorstep, and I said to her, honey, you need to be around for Jesse. If you keep on this journey, we are going to lose you. She's now got permanent damage to her heart as a result of the concoction she was taking to try and get pregnant. So when we talk about this being a compelling issue for our employees, our employees do not feel that this is a capricious decision that they're making. Like even buying a house which they can rent, people will accept to rent versus buying.

(28:23):

But having a child is something for some people that it is like breathing. It is a must for them. And they will exhaust absolutely every option including putting their lives at risk in order to do that. So we as employers need to keep that in mind that, and I was just looking at the data with my staff before I came here. 88% of employees would change their employer over this issue. They would seek out another employer that provided benefits that enabled them to have a child, but they would do it even if they were not planning on having children because it would say something about that kind of employer. So we are in an era where we have to stop talking about this as a nice to have it is a must have it. The other thing is the definition of family has changed dramatically over 30 years.

(29:14):

And so for some people, this is the only option to having children that they can explore. So we need to get with the program and look at this. The data is the thing that we bring to the table. When I'm at the executive table, I sit down with senior leaders and I say, let the data speak to you. Are you prepared to lose your talent to your competitors because they're providing these services and you're not these benefits and you're not. That's the conversation. Are you prepared to lose your talent to others because you will. So it's more than just leading with your heart and your values. The numbers speak as well.

Rachel Fox (29:56):

Well, I think one more thing that I wanted to touch on quickly before we get to some questions, just because we have an election coming up, it's a very polarizing thing and there's lots of concerns that people have about how is this going to impact our options, our resources, our future decisions that we're going to have to make either from a policy standpoint or from an individual standpoint as far as what we have access to. And I know that there's been some new developments and good user stories that we can talk about that, but Cynthia, I was just curious about your thoughts about how the legislative process plays a role in this conversation.

Cynthia McEwen (30:38):

Sure. So we've already seen in this country some evidence of different thought around fertility and family building. And certainly we have the example of the overturning of Roe v. Wade as sort of a potential concern around legislation and the impact of legislation. But here's the thing, the good news is that what we are still overwhelmingly hearing is that there is support both parties for continued access to IVF continued access to being able to build your family. But the reality is that there are states where the absence of legislation has been the concern and actual legislation related to abortion has taken a turn

(31:42):

Where people are concerned about access to fertility services. So one thing, I wish I had a crystal ball, so I could see into the future on what is going to happen here, but one very quick thing that a lot of companies did that we certainly did, it was a travel benefit. If you can support employees' ability to travel to get the care that they need, and whether that is about abortion or whether that's about fertility services or whether that's about accessing transgender services, their insurance plans very quickly put that into place so that we as employers could access that for our employees. That's a quick and easy thing to do for sure, because access is a very easy thing that you can provide to employees. But I also think that to Nicole's point, companies have to come out to their employees about who they are, what their values are, what they stand for, and that's to their employees.

(32:58):

But that also means sometimes taking a stand publicly, that means standing either behind legislation or against legislation because again, employees are looking for what kind of company am I working for? And a lot of companies, big and small can actually affect change by standing up for what is right in terms of allowing employees to have access to the care that they need and having to be able to make decisions with their health insurers and their providers. And if we can come together on at least that concept, I don't think that we have to worry as much about the politics of this because we can certainly make certain things easier for our employees just in what we do internally.

Rachel Fox (33:56):

Yeah. Yeah, such a good point. I know Heather's walking around with the mic. Is there anybody that has questions about this topic for our panel? Yes.

Nicole Piggott (34:10):

Sorry, we can't see you. So yes.

Rachel Fox (34:12):

It'sVery bright.

Audience Member 1 (34:13):

Hi. Thank you so much for this conversation. Do you anticipate that infertility benefits will be a regular add to healthcare policies in the future? And kind of when do you expect that and definitely want to get ahead of it?

Nicole Piggott (34:29):

I heard part of it, maybe I can kick it off. So the question was do we anticipate that this will be part of policies into the future? And so I absolutely think it will be. I think the time is long passed where employers can act as this is a nice to have much as we've, we've seen the evolution of other policies. This has now become something that is starting to become part of the conversation and policy renewals and even brokers and policy providers are already starting to impress upon employers that it's no longer something that you can really consider as an add-on. It's something that needs to be integrated into your policy decisions. The family is becoming more complex, the needs of your employees is becoming more complex, and your benefits program needs to provide a variety of solutions to meet the needs of a workforce that is much more complex than it was 30, 40 years ago.

(35:35):

We also have a multi-generational workforce, and so we need to not only think about the reproductive at the point of conception and having children, women go through a very broad reproductive journey, starting with menstruation and ending with menopause. There needs to be support and benefits plans that follow women through their reproductive journey. It doesn't end with the production of a child. So I think they're absolutely going to be going there. Sorry, Cynthia, I just didn't want to build on your previous point. I think it was important. I was struck this morning. I woke up to a decision in Georgia where analysis and a committee was assembled to evaluate the death of a young woman who died after her DNC was delayed. She had taken the morning after pill, the fetus had been partially expelled, and she had fetal tissue remaining in her uterus. And because of the legislation, the reversal of Roe v Wade, the decision to provide her with the DNC was delayed 20 hours and she died as a result of that.

(36:59):

I don't believe, I firmly believe that most legislators did not consider this scenario when they made the decision to embark on this journey to reverse Roe v Wade. But it does highlight that that is not a decision that any person who is not medically capable of understanding the consequences of those decisions should be making. It should be made with an individual, with their physician. And so to me, these instances highlight how deleterious these decisions can be. And I do agree with you that employers need to do more than just provide alternative services for their employees. They need to put the money and their conversations at the lobbying level where they profess their values to be.

Cynthia McEwen (37:51):

I was just going to add one more point about the, is this a now conversation or is there still some time? You're actually also starting to see there are some states where fertility coverage, some type of fertility coverage is mandated. Many of you probably are in companies that are multi-state where you have employees from state to state. And I can tell you that one of the other points about inclusivity is also that geographical inclusivity. If you have to give a benefit to someone in this state as part of your company, you have to also think about how to equalize that across the rest of your company. And so there's going to be pressure applied from a lot of different places in terms of what your benefits packages need to look like. This is just one of them, but we obviously firmly believe that this is a very serious one.

Rachel Fox (38:58):

I can't see anything. Anything else? Any other questions? Yep, go ahead.

Audience Member 2 (39:01):

I have a question. Hi. Hi. Thank you again for everything that's been spoken about on this panel. Is there anything that you can speak to as far as support or options for those who are looking to be single parents by choice and how companies can better support those individuals?

Cynthia McEwen (39:23):

Sure. I can tell you that that should absolutely be part of your benefit as well. And that's again, that inclusion piece. So if you're going to have a fertility and family building benefit, you should be thinking about single parents by choice, the ability to have donor tissue be part of your benefit. So whether it's donor eggs or donor sperm, that again, those bundled services is why it's so important because what you want is to be able to access that benefit and go all the way through implantation, pregnancy and then obviously delivery. So I don't think that that is a separate consideration. I think any of the carriers who are offering fertility and family benefits, certainly Progyny makes sure that single parent by choice is part of the benefits, what they need as part of the benefits package. And again, I do want to stress that these are journeys that do need to be supported. You talked very much, you both have talked very much about the mental health aspect of a fertility journey and providing that mental health support either through your benefit. I know many employers also have separate mental health benefits as well. However you do it. There is that additional element of support. I think particularly for someone who is a single parent by choice who may not have the additional support that may come from being a couple, going through a fertility journey.

(41:09):

It's of utmost importance that that piece of the benefit that you're not just giving them the how do I access this from a physical standpoint, but also from a mental and emotional standpoint that's going to be just as important.

Nicole Piggott (41:25):

Can I add to that? One of the things that employers do need to do, and I know we're almost at time, we're at time is, and we did this at one of the organizations where I was the VP of HR for the Americas. So from Canada to South America, we put in place a family leave policy that we benchmarked off of Canada. So our American employees had top up on their pay to keep them, to take away that burden of economic impact of an unpaid leave so that they could take care of their children, get them to a certain age before they had to worry about returning to work. They had job security during that time, so their job was secure for them when they were ready to come back and they had income security. And so one of the things that I encourage senior leaders to do is to benchmark off of one of your regions that has a more generous policy, to your point, to equalize the benefit across your organization. Because believe you me, people are looking across the pond at where those benefits are provided

Rachel Fox (42:35):

For sure. Thank you guys very much. Appreciate you guys coming. Thank you. Hope.