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SAG-AFTRA Health Plan to Cover Infertility Treatment Starting in 2025

SAG-AFTRA Health Plan to Cover Infertility Treatment Starting in 2025

The SAG-AFTRA Health Plan will soon add infertility treatment benefits to its coverage, its board of trustees stated on Saturday.

The 40-member board — equally comprised of representatives for management and the performers’ union — unanimously approved the change, which will take effect on Jan. 1, 2025. Starting that year, plan participants and spouses who take part in the plan are qualified for “medically necessary” infertility treatment coverage. The Plan has partnered with Carrot Fertility, a benefits platform and network of providers, to offer treatment and prescription drugs at “no cost share up to the family lifetime maximum of $30,000” with Carrot providers, the announcement stated.

Starting in 2025, the benefit will allow participants and covered spouses who receive a diagnosis of infertility to access a “care team” at Carrot and receive covered treatments of IVF, IUI and prescription drug therapy, among other services. Additional details will be available in a document that will be provided to participants later in the summer.

The Health Plan previously provided infertility treatment coverage prior to a reduction in benefits that occurred in 2003, according to a SAG-AFTRA Health Plan spokesperson. Participants have been asking for this coverage since, and the trustees responded to those calls with the benefits addition.

With this addition to its coverage, SAG-AFTRA joins the Producer-Writers Guild of America Pension & Health Plans and the Directors Guild of America-Producer Pension & Health Plan in providing infertility benefits. Those two plans added infertility coverage in 2022. (The Motion Picture Industry Pension & Health Plans did not respond to The Hollywood Reporter‘s inquiries about whether it covers infertility treatments by press time.)

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Still, ultimately only a small percentage of SAG-AFTRA union members will stand to benefit. Before the 2023 SAG-AFTRA strike, about 25,000 members in the union qualified for cover under the Health Plan. (As of 2023, about 160,000 performers were members, suggesting nearly 16 percent of the union was eligible before the strike.) This year, per the Plan’s eligibility criteria, SAG-AFTRA members must earn at least $27,000 or work 104 days in four consecutive quarters in order to participate in the Health Plan.

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