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S 797119th CongressIn Committee

Family Building FEHB Fairness Act

Introduced: Feb 27, 2025
Standard Summary
Comprehensive overview in 1-2 paragraphs

The Family Building FEHB Fairness Act would expand and protect access to fertility treatment under the Federal Employees Health Benefits (FEHB) program. It would add a new category of benefits called “Fertility treatment benefits” within the FEHB framework and define a broad set of services that qualify as fertility treatment. The bill empowers the Office of Personnel Management (OPM), in coordination with the Secretary of Health and Human Services (HHS), to determine what specific services and related items are covered. The changes would take effect one year after enactment. In short, federal employees, retirees, and their eligible family members enrolled in FEHB would gain coverage for a wide range of fertility-related treatments and services, subject to the agencies’ determinations and coordination with health authorities.

Key Points

  • 1Adds “Fertility treatment benefits” to the FEHB program under title 5 U.S.C. 8904, expanding the set of covered health services for federal employees and their families.
  • 2Broadly defines fertility treatment to include:
  • 3- Preservation of oocytes, sperm, or embryos for later use
  • 4- Artificial insemination (including intravaginal, intracervical, and intrauterine)
  • 5- Assisted reproductive technology (ART), including IVF
  • 6- Genetic testing of embryos
  • 7- Fertility medications (prescribed or OTC as indicated)
  • 8- Gamete donation
  • 9- Other related information, referrals, treatments, procedures, medications, lab services, and technologies as determined appropriate
  • 10Requires the Director of the Office of Personnel Management, in coordination with the Secretary of Health and Human Services, to determine the specific scope and details of coverage.
  • 11Takes effect one year after enactment (not immediately), giving time for plan design and implementation.

Impact Areas

Primary group/area affected: Federal employees, retirees, and their eligible family members enrolled in the FEHB program, who would gain access to a broad package of fertility treatments.Secondary group/area affected: FEHB program administrators (OPM) and participating health plans, which would face plan design, cost, and coverage determinations, as well as negotiations with providers for expanded services.Additional impacts: Potential increases in FEHB program costs and premium considerations; greater demand for fertility services and ART; potential implications for access and equity in federal employee benefits; evolving guidance on what constitutes “appropriate” fertility-related services as defined by OPM in coordination with HHS.
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