Proposed Rules on Excepted Limited Fertility Benefits
On May 10, 2026, the Departments (of Health and Human Services, Labor, and Treasury) released proposed rules to allow plan sponsors to provide fertility benefits as an excepted limited benefit separate from their major medical plan. If these rules are finalized, fertility services through this limited benefit would not be required to meet other federal group health plan requirements (such as HIPAA, the No Surprises Act, the Affordable Care Act, and others). If finalized, these rules would be effective for plan years beginning on or after January 1, 2027.
A summary of the changes and potential action items for plan sponsors can be viewed at the link below.
Please contact your Horizon Actuarial consultant or use the "contact" page if you have any questions.