Labor & Employment Law Daily Wrap Up, DOL NEWS—EBSA issues FAQs document regarding ACA and IVF, (Oct 21, 2025)
Organizations Mentioned:Employee Benefits Security Administration
By WK Editorial Staff
The FAQs include information related to Executive Order 14216, “"Expanding Access to In Vitro Fertilization.”
Last week, the Employee Benefits Security Administration issued a new Frequently Asked Questions document regarding implementation of certain provisions of the Affordable Care Act. Released jointly by the Departments of Labor, Health and Human Services, and the Treasury, the FAQs clarify the categories of “excepted benefits” under the ACA and related laws, which are exempt from most ACA market reforms. They outline four categories: (1) non-health insurance products (e.g., auto, liability), always excepted; (2) limited excepted benefits like standalone vision, dental, long-term care, and certain FSAs, EAPs, and HRAs when meeting regulatory criteria; (3) independent non-coordinated benefits such as specified-disease (e.g., cancer) or hospital indemnity policies; and (4) supplemental coverage (e.g., Medigap, Tricare) that complements a primary plan.
In Vitro Fertilization. The FAQs reference Executive Order-14216, “Expanding Access to In Vitro Fertilization,” issued by the White House in February 2025, which directed federal agencies to identify ways to reduce costs and enhance access to IVF. The Departments of Labor, HHS, and Treasury underscored their commitment to leveraging existing regulations to permit employers to structure fertility benefits—such as IVF—within the framework of excepted benefits. Specifically, they clarify that certain fertility benefits can be offered either as independent, non-coordinated excepted benefits (such as a specified illness policy covering infertility) or as limited excepted benefits in separate contracts without coordination with traditional group health plans.
Under the independent, non-coordinated category, an employer may offer IVF treatments through a standalone policy, provided it meets certain conditions: a separate contract, no coordination with other plan benefits, and payments made regardless of other coverage. These benefits must be insured (not self-funded) to qualify. Meanwhile, fertility expense reimbursements—including IVF—can be provided through excepted-benefit HRAs if they comply with existing HRA regulations, and fertility coaching or navigation services may be included in employee assistance programs (EAPs) that meet limited excepted benefit criteria by avoiding significant medical care coordination and cost-sharing.
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