Asking Your Employer About Abortion and Medical Travel Reimbursement Benefits
Advocate for support. Protect your privacy. Help build a more equitable workplace.
The ability to choose if, when, and how to have a child is crucial to workers’ health and wellbeing personally and professionally. For employees who live in states where abortion is outlawed, access to safe abortion care can be difficult and costly.
A recent Kaiser Family Foundation survey found that 18 percent of benefits managers at companies with 5,000+ employees did not know what their plan’s abortion coverage is. That figure jumps to 33 percent for companies with 1,000-5,000 employees and 42 percent for companies with fewer than 1,000 workers. Lack of understanding of critical health benefits amongst benefits managers underscores how limited the transparency and communication of these benefits is for workers.
If you’re one of the many workers hoping that your employer will communicate more detailed information about your reproductive and maternal health (RMH) benefits, you are not alone. There are steps that you can take to be an advocate for your company to do more. Below we break down how to nudge your company toward better transparency of its reproductive health policies.
RMH Compass considers a best-in-class benefit one that covers elective and non-elective abortion, with a medical travel reimbursement benefit that has no dollar limit through an Employer-Sponsored Health Plan (ESHP), plus a Lifestyle Spending Account (LSA) or Employee Relief Fund (ERF) that can cover unreimbursed travel costs, such as childcare, lodging and mileage.
Get Organized and Find Your Allies
Despite the economic ups and downs of the past few years, we are in a historically tight labor market where employers are competing to find and retain talent. As an employee, you have power to voice your preferences and act as a change-agent inside your company.
If you’ve been in your job for a few years, manage a team or have been promoted, guess what? Your company values you and your expertise and wants to keep you satisfied. If you are white or cisgender, recognize that marginalized groups may not feel the same psychological safety and job security to speak out on these issues. Your identity allows you to lead internal activism that other colleagues may not feel comfortable pursuing. Workers from marginalized communities are often most in need of these benefits.
Companies spend about 30% of total compensation on worker benefits, and Human Resources and Benefits managers want feedback from employees. Ask your HR/Benefits team if they’re open to re-evaluating what RMH benefits they can provide to workers. One low-stakes way to start the conversation is to ask if they’ve considered doing a benefits survey (if they don’t already).
It can feel overwhelming to tackle a big issue alone, so don’t. Find your reproductive and maternal health allies and approach organizational leadership as a coalition. There is safety and strength in numbers, so this is a strategic way to tackle a complex problem without taking it on alone.
Where to find those allies? A good place to start is with an Employee Resource Group (ERG). If your company has a womens and/or parents ERG, reach out to ERG leadership, attend meetings, and ask if the group has discussed the RMH needs of the workforce. Asking questions is an effective way to identify and attract like-minded colleagues to these efforts.
Beyond ERGs, find people that share your interest in reproductive and maternal health. The best way to find an ally is to ask the question “Have you heard anything about whether our firm is considering enhancing our RMH offerings?” or “Are you satisfied with the RMH benefits we have access to?” Finding one (or more) mid- or senior-level allies helps to ensure that discussions are taken seriously and involve key decision-makers. Consider those senior allies as the sponsors of your efforts; engage them in the process by asking for advice on who to speak with and how to navigate internal dynamics.
Engage men. Men have wives, mothers, daughters and sisters and are increasingly impacted by these issues in a wide range of ways. Including men as allies in this effort builds a diverse group of stakeholders to broach these issues with senior leadership together.
Ask these Questions of Your Benefits Administrator
1. Are both elective and non-elective abortions covered by all of our Employer Sponsored Health Plans (ESHPs)? If all plans do not cover, which ones do?
Usually this information is included in a summary plan description. Some health plans do not cover abortion at all, and some only cover those deemed medically necessary. It’s best for all types of abortion to be covered. Ask to confirm what language is being used in your health plans.
2. Do all ESHPs cover travel costs for medical care? Are medical travel expenses related to reproductive health covered? Is there a maximum dollar cap on reimbursement?
Usually this information is included in a summary plan description. Ask to see the specific language to ensure that abortion care and abortion travel benefits are covered and so that you understand what the maximum reimbursement is. Some medical travel reimbursement benefits only cover specific medical care, such as joint replacement or organ transplants, so read the fine print to ensure that there are no exclusions for travel related to abortion care.
3. If medical travel costs are not covered under an ESHP, are there other mechanisms to reimburse the costs?
If I need to access this benefit, how would this happen? What is the proper channel to do that? Do I go through our employer sponsored health plan or do we have an alternate reimbursement method, such as a Health Savings Account (HSA) or LSA (Lifestyle Savings Account) or ERF (Employee Relief Fund) from which I can draw funds?
4. Has the company given specific consideration to how worker health data is kept private and safe, especially given law enforcement threats and “aid and abet” laws in several states?
Direct administration of abortion care benefits or medical travel reimbursement by HR or benefits teams forces employees to share personal medical information, creating a digital paper trail, undermining privacy and putting companies at legal risk. A third-party administered approach ensures confidentiality, preserves employee trust and mitigates legal liability.
5. Has the company put any resources together outlining how these benefits are accessed by employees?
Having a centralized resource on what abortion care is covered and what is not, highlighting any differences across different health plan offerings, can help workers select the right health plan during Open Enrollment. Ideally, that resource will clearly explain how benefits can be accessed and outline how worker health data will be kept private and safe from law enforcement inquiries.
If your HR/Benefits teams are unsure of how they can answer these questions, we encourage you to share RMH Compass’ Abortion and Travel Reimbursement Trend Report and Resources to learn how they can cover these expenses.
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