From recruiting and retention to company culture and the latest in HR tech, HR Brew delivers up-to-date industry news and tips to help HR pros stay nimble in today’s fast-changing business environment.

HR Brew

Courtney Vinopal

hr-brew.com

Graphic on attitudes on the future of fertility benefits

Graph showing attitudes about employer fertility benefits.

Graph showing the share of surveyed employees who receive fertility benefits.

Democrats hold a press conference on IVF.

Firms likely to expand fertility benefits after Alabama IVF ruling

While fertility treatments remain a rare employer benefit, 63% of US respondents say companies should offer them, according to a HR Brew/Harris Poll survey.

Most HR pros say companies are likely to expand, not reduce, fertility benefits

An office manager sitting at a desk in front of two computers with money floating around her

Tech is changing the game for compensation managers

An explosion of data coupled with advancements in tech means auditing compensation is now a year-round endeavor for HR. 

Heart shaped sticky note labeled "out of office" on a calendar

Why Crunchbase gives employees time off to volunteer 

Crunchbase, a private company data provider, has been offering “volunteering time off” (VTO) to its employees since 2018.

A present icon denoting total rewards and compensation

Total Rewards (Comp & Benefits)

An illustration of reporter Courtney Vinopal's headshot.

Having a baby in the US is significantly riskier than in other comparable countries. As of 2022 the US had 

 than any other high-income country, according to the Centers for Disease Control and Prevention, at 22 deaths for every 100,000 live births.

In recent years midwifery care has emerged as one potential way to address this crisis. Gaps in education and access, however, prevent many patients from working with midwives. A new 

 from Morgan Health, a business arm of JPMorgan Chase focused on healthcare benefits, sheds light on how these trends play out in populations with employer-sponsored insurance.

Just one in five patients on employer-sponsored insurance had a midwife as part of their care team during their last pregnancy, according to the survey held in March. A higher share of respondents (66%), though, said they would be interested in midwifery care for a future pregnancy.

“Lack of knowledge” and “insurance coverage” were cited as the main barriers to midwifery care among those who were interested in it, but didn’t use it.

“People want access to midwifery care,” said Bea Capistrant, VP of healthcare innovation at Morgan Health. “But there are some gaps that we can fill there.” Patients may struggle to understand the scope of a midwife’s practice, how they work with other providers, and how they manage existing health conditions, for example, she said.

A certified nurse midwife is a type of registered nurse that provides a range of reproductive health services, including prenatal care, childbirth, and postpartum care. They can work in hospitals and private practices, as well as birthing centers. Research indicates midwifery is generally associated with more positive clinical outcomes for pregnant people, including fewer cesarean sections and lower preterm birth rates, but a dearth of providers makes it difficult to secure such care in the US.

Available data shows insurance coverage for certified nurse midwives isn’t currently widespread, with just 25% of employers with 500 or more workers covering it, according to Mercer’s 2025 health and benefit strategies survey.

Should employers want to help their employees access midwifery care through a medical plan, they wouldn’t necessarily need to invest in a separate point solution, as some companies have done for doula or fertility services 

. Oftentimes employees can work with midwives just as they would any other provider, such as an OBGYN, on their health plan. Employers may work with their insurance carriers, then, to help connect workers with midwife “providers that are already in-network, on existing health plans,” Capistrant said.

When working with carrier partners, employers can focus on the delta between “educating patients” and “clarifying access,” Capistrant added.

The access piece may be trickier to address, particularly if employees are based in states where midwives aren’t sufficiently integrated into the maternal healthcare system. Midwives are less prevalent than OBGYNs in the US for a variety of reasons, including regulatory requirements that make it difficult to work in certain states, and lower reimbursement rates that translate to lower wages compared to other physicians.

If these broader systemic issues are addressed, though, Capistrant and others expressed optimism that employers would see a positive return-on-investment from directing their workers to midwifery care when it makes sense. One reason is that deliveries that incorporate midwifery care tend to see lower rates of costly procedures like C-sections and NICU visits.

“What our employers want from us is the best possible outcomes, and also they want to be able to manage costs across the board,” said Neel Shah, chief medical officer with Maven Clinic, a reproductive healthcare benefits firm that includes midwives in its network. “They can get more efficiency out of their spending, and they can produce better health by having solutions that incorporate midwives.”

A black pregnant woman with a medical cross logo glowing behind her

The case for midwifery in employer health benefits 

 Many patients are interested in working with midwives, but confront barriers tied in part to insurance coverage.

Midwifery care represents an untapped opportunity for benefits leaders

The White House recently rolled out several policies that seek to deliver on President Donald Trump’s campaign promise to expand access to in-vitro fertilization (IVF).

EMD Serono, a fertility medication manufacturer, will offer certain drugs at a reduced cost exclusively through TrumpRx, the White House said in a 

Additionally, the administration clarified that employers can offer fertility services as a standalone benefit, akin to how dental or vision insurance is often offered. The Department of Labor (DOL) 

 that details how businesses may go about this, but it’s unclear whether the policy will spur more companies to cover fertility treatment.

The policies recently rolled out by the White House follow an 

 seeking to protect and reduce the cost of IVF, but fall short of the president's campaign trail promises. Employers won’t be required to cover IVF, nor does the administration plan to offer any financial incentives for them to do so, at least for the moment.

Instead, several federal agencies announced that “employers can now offer standalone benefit packages to employees interested in coverage for treatment of infertility, including IVF,” the White House said. The DOL guidance clarified that employers can cover fertility treatments through an “excepted benefit,” which is a type of benefit that isn’t subject to certain requirements under laws like the Affordable Care Act and the Health Insurance Portability and Accountability Act.

The agency also said it planned to propose a rule “aimed at providing additional ways that certain fertility benefits may be offered as a limited excepted benefit.”

While the excepted benefit recommendation was framed as a “new benefit option” for employers, the guidance doesn’t actually create any new pathways for companies to cover IVF, sources told HR Brew.

“I read this much more as maybe an affirmation of what was already possible, as opposed to new policy,” said Katie Keith, director of Georgetown Law’s Center for Health Policy and the Law. The types of excepted benefits the DOL points to—such as reimbursing an employee’s out-of-pocket costs through a Health Reimbursement Account, or offering fertility treatments through a specified illness policy—are currently possible, but may not make sense from a design perspective.

Nearly one-half (47%) of large employers cover IVF services in their largest medical plan, according to Mercer’s 

 on employer-sponsored health plans. And there’s a reason many employers choose to incorporate IVF into their group health plans, rather than offer it as a standalone benefit, Keith said. IVF patients have to undergo many different types of care, from taking prescription drugs to undergoing lab testing to ultimately seeking out providers for their pregnancy journeys, if the procedures are successful.

“I understand why employers would sort of treat it as part and parcel of their entire benefits package, because the care is so cross-cutting,” she said. While the Trump administration’s proposals may work for a “very narrow” benefit, “I just don’t think this gets you to the kind of comprehensive coverage that is being talked about,” Keith added.

Companies that provide fertility benefits were already offering the White House-endorsed options to their customers, but executives in the sector expressed optimism that these recent policies would move the needle even further on employer-sponsored coverage.

Carrot, a workplace fertility benefit provider, launched a “flex program” allowing employers to purchase its pharmaceutical benefit as a standalone option 

 the White House rolled out its policies. The company’s CEO, Tammy Sun, 

 she believed the moves marked “a really important moment” for the category of benefits Carrot sells.

Employers have increasingly designed fertility benefits as a “carve-out” from their health plans in recent years, Neel Shah, chief medical officer with Maven Clinic, another fertility benefit provider, told HR Brew via email. The excepted benefit approach that the White House supports “​​enables the shortest pathway to a healthy pregnancy, at the lowest possible cost, for most people,” he added.

Shah also pointed to the administration’s efforts to lower the cost of fertility medications, which represent “approximately one-third of the total costs of IVF,” he estimated. A full IVF treatment cycle can cost from $15,000 to $20,000 on average, and the potential for incurring increased health costs has historically been a top reason employers don’t cover it.

The deal to lower prices of some commonly used fertility drugs may help address this concern, but doesn’t tackle other types of treatment that contribute to the high cost of IVF, such as lab visits and embryo storage, 

President Donald Trump speaks at a podium while making an announcement about IVF access.

Trump policies unlikely to boost workplace IVF benefits

The Trump administration clarified that employers can offer IVF coverage as a standalone benefit, but it’s not clear whether the guidance will spur more companies to invest.

White House actions seem unlikely to move the needle on workplace fertility benefits

As Tesla shareholders prepare to vote on whether to grant CEO Elon Musk a pay package valued at nearly $1 trillion, the billionaire argued that this proposal isn’t actually about the money at all—but rather about maintaining control over the electric vehicle maker.

In an Oct. 22 earnings call, Musk and Tesla’s CFO, Vaibhav Taneja, said they didn’t want to refer to the proposed pay package as “compensation” at all. Instead, Musk said he was concerned with “how much voting control I have in Tesla,” particularly given the company’s goal of building an “enormous robot army.”

The package Musk referenced would award him additional shares if he meets certain Tesla benchmarks over the span of a decade, including delivering 1 million robots, and having 1 million robotaxis in commercial operation. Should he meet the milestones Tesla’s board has set, Musk could gain a 25% stake in the company, and in turn increase his voting power.

While the official vote is on Nov. 5, at least one major Tesla investor—Norway’s sovereign wealth fund—has said it will vote against the proposal.

In recent years, Musk has sought to pivot Tesla away from selling electric vehicles in favor of self-driving cars and a humanoid robot the company calls Optimus. On the call, the CEO claimed he wouldn’t spend the money if he received the proposed award, but said he wanted “a strong influence over that robot army” if he built it. “That’s what it comes down to in a nutshell. Like I don’t feel comfortable building that robot army if I don’t have at least a strong influence,” he added.

(It should be noted that Musk has had a strong influence in both the public and private sector, with mixed results. After he bought the social media app Twitter, changed its name to X, and discarded the site’s content moderation rules, the platform’s value dropped by an estimated 80%).

Tesla board urges shareholders to approve Musk’s unusual pay package. 

If granted, this compensation plan would be the 

 in history—but its sheer size isn’t the only thing that makes it unusual.

The committee that put together this proposal also bucked traditional executive compensation norms when designing it, HR Brew 

. They decided against proposing Musk’s pay based on what CEOs earn at similar peer group companies, arguing such benchmarking would be “irrelevant” given the types of goals that Tesla’s CEO has been given.

This isn’t the first time Tesla’s board has tried to award Musk an unusually large compensation package. When shareholders decide whether or not to grant Musk this super-sized payday on Nov. 5, they’ll also be asked to vote on partially restoring Musk’s previous pay package, valued at 

While shareholders initially approved that previous pay package, Judge Kathaleen McCormick 

 on grounds that investors weren’t given adequate information about the proposal, and certain Tesla board members involved in the negotiations weren’t independent. Tesla is currently appealing that decision.

The debate over Musk’s pay comes at a time when the gap between what CEOs earn compared to rank-and-file workers continues to invite scrutiny; Starbucks and United Healthcare are among the companies that have recently been criticized for awarding their CEOs pay packages that are much larger than what their median workers earn.

But beyond setting a new standard for CEO pay, the Nov. 5 shareholder vote could also have broader implications for corporate governance practices, a professor and student from Case Western Reserve School of Law recently argued in a 

 published in Bloomberg Law. The Delaware Supreme Court’s decision in the case involving Musk’s previous 2018 package, they added, “will further determine whether Tesla’s governance approach becomes a framework for other founder-led companies or a cautionary tale about the limits of executive control and the importance of board independence.”

Facing off-camera, Elon Musk smiles widely in a suit.

Elon Musk argues $1T Tesla package is about control, not cash

The Tesla CEO recently suggested the proposal is more about maintaining influence than earning additional compensation. 

Elon Musk and Tesla’s board once again make the case for largest corporate payday in history

Health premiums are rising this year, and as a result employers may start to shift more costs onto their workers.

The annual premium for an employer-sponsored family health plan is $26,993 this year, on average, up 6% from 2024, according to 

 from the Kaiser Family Foundation (KFF). The average annual premium for a single-coverage health plan comes in at $9,325, a 5% YoY uptick, according to KFF’s estimate.

Workers bear about 16% of the premium cost if they’re on single coverage plans, while those enrolled in family coverage plans pay more than one-quarter (26%) of their premium, on average.

What’s driving health premiums higher? 

Prescription drug prices were the top factor cited by firms with 200 or more workers as driving costs higher.

GLP-1 drugs for weight loss are top-of-mind for some employers when it comes to prescription drug spending, the survey indicates. The share of employers with 5,000 or more employees covering GLP-1s rose to 43% in 2025, compared to 28% last year. And nearly two-thirds of these firms said the drugs had a “significant” impact on their plan’s prescription drug spending.

 tracking employer spending on healthcare. The high cost of GLP-1s—with list prices ranging from $1,000 to $1,500 a month—has prompted some employers to limit 

Other cost drivers that employers said were contributing “a great deal” to higher premiums included chronic disease, higher utilization of services, and hospital prices.

Such trends put employers in a difficult position, KFF noted in a discussion regarding the report. Though companies can raise the out-of-pocket amounts workers pay for their healthcare to address these rising premiums, their employees are likely already concerned about such practices.

Nearly half of large employers surveyed by KFF said their employees were highly or moderately concerned about current cost-sharing levels at their organizations. And many workers already incur significant costs from their employer’s medical plan; one-third of those enrolled in a single coverage plan have a deductible of $2,000 or more, for instance.

“Employers have nothing new in their arsenal that can address most of the drivers of their cost increases, and that could well result in an increase in deductibles and other forms of employee cost sharing again, a strategy that neither employers nor employees like but companies resort to in a pinch to hold down premium increases,” Drew Altman, KFF’s president and CEO, said in 

High health insurance premiums can make a serious dent in workers’ earnings over time, particularly if they’re low-income, HR Brew 

Though it’s rare, some companies do cover the entirety of their workers’ health premiums, NPR 

. Zocdoc, a scheduling platform for healthcare providers, offers a zero-premium plan to employees who pay a higher deductible. “It is a growing expense, no doubt,” Zocdoc CEO Oliver Kharraz told the outlet. “But we think that it’s our job to make sure that the company is healthy enough that we can afford to bear it.”

Illustration of an open hand with a coin on the left and an open hand in a doctor's white coat with a heart that has a cross in the middle

Employers eye cost-sharing as health premiums climb 6%

The average annual premium for an employer-sponsored family health plan rose to nearly $27,000 this year, according to a recent KFF report.

Health insurance premiums are up, putting pressure on employers and workers

Companies are beefing up security for top executives in the wake of violent events targeting corporate leaders.

Personal security was the second most common benefit companies were considering offering to their executives when they were surveyed between April 30 and June 27, according to a 

 from Ayco, a financial planning and wealth management arm of Goldman Sachs.

More than one-quarter of compensation and benefits professionals surveyed said their organization offered its CEO personal security benefits, a 10-percentage point increase from 2023. Such benefits may include having at least one security person accompany an executive on business travel or during public events, hiring an armed driver and security company vehicle, or conducting a home security assessment.

This uptick comes as the Securities and Exchange Commission (SEC) is evaluating disclosure requirements surrounding executive perks, and considering whether security benefits should be subject to current rules.

A number of incidents that occurred since Ayco last conducted this survey in 2023 have seemingly prompted companies to take a closer look at their security benefits.

United Healthcare CEO Brian Thompson was fatally shot last December outside of a Hilton hotel in Midtown Manhattan while he was making his way to a gathering for investors. More recently, four people 

 by a shooter who breached the entrance of an office building on Park Avenue, also in midtown Manhattan.

Following Thompson’s shooting, the board of animal health company Zoetis moved immediately “to establish a security function within our organization,” Roxanne Lagano, EVP, general counsel and corporate secretary, said during a Sept. 16 panel on executive compensation hosted by the Conference Board.

CEOs and other executives are much more visible today due to their presence on forums like social media, “so security has become much more relevant from that perspective,” Lagano said. She added that security is “not viewed as a perk,” but rather “as a necessary business expense.”

Though more companies are starting to see security as a necessary expense for its executives, it’s still generally considered a “perquisite” under current SEC guidance, and thus subject to the agency’s disclosure rules.

The SEC requires public companies to disclose how much they spend on executive perks like air travel, country club dues, or tickets to sporting events if the costs amount to more than $10,000 annually, unless a firm can demonstrate such benefits are “integrally and directly related to the performance of the executive’s duties.”

Some investors and representatives from public companies questioned whether security should still be considered a perk, though, when the SEC held a roundtable on disclosure requirements in June.

“There is a strong belief among many that security benefits…should be a separate disclosure,” said Jonathan Barber, Ayco’s VP and head of compensation and benefits solutions. He noted that although security is labeled as a perk, companies often mandate it for their executives after conducting a risk assessment.

“The thought is, is that really fair for a company to disclose something, and the expense to be scrutinized as a perquisite?” he added.

While the SEC may be mulling changes to these disclosure regulations, Barber said he wouldn’t expect to see any new guidance prior to 2027. Until then, he expects companies to emphasize their justification for investing in security-related benefits when disclosing them, especially when they involve air travel.

 for allowing their executives to use the company jet for personal reasons, such benefits hold more water from a corporate governance standpoint if they’re justified by concerns like security, Barber said. More than half (54%) of respondents to Ayco’s survey said their principal reason for letting executives use the company aircraft was security. Similarly, 64% said they offered executives a chauffeur for this reason. Respondents who said their organizations offered access to the company jet for reasons like convenience or efficiency were more likely to put limits on such benefits, Barber noted.

Police examine the location where United Healthcare CEO Brian Thompson was shot in midtown Manhattan.

Executive security benefits grow after United Healthcare shooting

Employers are investing in security for CEOs and other executives, but whether such benefits should be classified as a “perk” is a subject of current debate. 

More companies offer security to CEOs in wake of United Healthcare CEO shooting

Kathryn Larkin got her start in the world of total rewards as a lawyer, advising clients of companies like Deloitte on how to design benefits.

This involved a fair amount of problem-solving, Larkin told HR Brew. After a while, she said, “you wish that you could set things up so maybe you wouldn’t need to solve the problems,” she said. To design benefits with a solutions-oriented approach, she needed to be part of HR.

This desire for a seat at HR’s table led Larkin to take on a position as director of global benefits for Air Products, an industrial gas company, where she also served as their in-house employee benefits and executive compensation counsel.

After nearly 14 years with Air Products, the investment management company Vanguard tapped Larkin to be its head of global benefits in 2024. In this role, Larkin works with her team to educate workers so they get as much as they possibly can out of the benefits Vanguard offers.

Vanguard tries to promote physical, personal, and financial wellness through its offerings, and sees this mission as an extension of its business, Larkin said. The company views its 20,000 employees as its biggest asset “because they’re the ones who are actually doing the work that provides the shareholder value.”

To that end, one financial benefit that Vanguard touts to its workforce is a Health Savings Account (HSA) seed and match. The company puts $500 toward individual employee HSAs, and $1,000 for those with families, as well as matches contributions by 1.5 times what the worker puts into their account. Vanguard encourages employees to view HSAs as a long-term savings vehicle for retirement, Larkin said.

Once individuals turn 65, they can use an HSA for anything, though expenses that don’t qualify as medical are taxed. Because HSA funds roll over into the next year, “it’s kind of a pressure valve for individuals, you’re building this kind of medical nest egg,” she said.

There’s a fair amount of education that goes into positioning the HSA—which is offered to employees on high-deductible health plans—as a tool for long-term savings. Vanguard says she understands that workers may need to use the funds for medical expenses in the near-term, but encourages them to tap into other benefits first if possible so they can save at least part of their HSA funds. The company’s flexible spending accounts, for example, can be used for dental and vision costs.

“You will have medical expenses in retirement,” Larkin explained, referring to items like prescriptions or hearing aids. “So think of it as your 401(k) for your medical.”

Larkin’s team has employees focused on both strategy and operations. She described the latter team members as “the engine that makes the benefits run,” with a focus on troubleshooting any questions or concerns that may arise from Vanguard employees.

Vanguard’s communications team monitors questions that come through ServiceNow and flags any “pain points” that come up in the benefits process, Larkin said. “They’ll sit with me and provide a report and say, ‘Do you realize a lot of people are asking questions about X? We think we need to get out in front of this, something doesn’t seem to be working.’”

One of the most common pain points that comes up concerns medical benefits—which isn’t surprising given 

 and complex this area of total rewards has become. When questions about medical plans arise, Vanguard can direct them to in-house advocates with Aetna, the company’s insurance provider. The idea behind hiring these contractors was to allow people with specific expertise to handle medical benefits-related questions, Larkin said.

Such efforts are ultimately in service of helping employees “get every ounce of every benefit we have,” Larkin said. Whereas employers were focused on cost-savings when she first entered total rewards, that perspective has shifted today, as businesses now view benefits as driving the “total value proposition” for their workers, she observed.

In Larkin’s view, the measure of a successful benefits program is one that’s “highly utilized and valued.” Given this philosophy, it’s not hard to see why Vanguard’s 401(k) program, for instance, has a 98% participation rate.

“If you have benefits that people aren’t using, you’re wasting money,” she added.

A portrait of Kathryn Larkin, head of global benefits at Vangaurd.

Vanguard’s head of global benefits on maximizing value

The investment management firm’s head of global benefits said her team aims to help workers maximize offerings such as HSA accounts. 

Vanguard’s Kathryn Larkin wants employees to squeeze ‘every ounce’ out of their benefits

President Trump may have recently declared English as the official language of the United States, but the situation is more complicated in workplaces like hospitals, which serve patients with varying levels of English proficiency every day.

Language barriers can affect patients’ experiences with the healthcare system, and in turn their overall health, according to a 

. Adults with limited English proficiency were less likely to report their healthcare provider involved them in decision-making about their care, with 63% responding that this occurred in the last three years, compared to 82% of English proficient adults. And these adults were more likely to say they were in fair or poor health (34%) than those who were English proficient (19%).

In light of such challenges, HR leaders at healthcare organizations are incorporating language certifications into their learning and development programs. Such programs may not only help current employees better serve their non-English speaking populations, but also contribute to their own career development, sources told HR Brew.

Novant Health, an integrated health system headquartered in Winston-Salem, North Carolina, has employees who are interested in both English- and Spanish-language learning, according to Lauren King, VP, talent acquisition and workforce development.

Novant offers English as a second-language course through Future Forward, a training and advancement program it launched in August. Through the program, Novant pays up to $5,250 a year for full-time employees to take either degree or non-degree courses, including professional certification and English language proficiency classes.

“One of the No. 1 courses we see people enrolling in right now is actually Spanish-speaking for healthcare careers,” King said at an Oct. 6 panel during WBR Research’s HR Healthcare conference in Boston. Such opportunities appeal to “our care workers who want to be able to communicate with their patients at a different level, and maybe some of their team members and peers,” she said.

JPS Health Network reimagined its qualified bilingual staff program to give more employees the opportunity to apply their language skills in the workplace, CHRO Ashley Ridgeway-Washington said during a separate HR Healthcare panel. Her team found that a large share of Spanish-speaking employees were providing informal translation to patients with the network, which is based in Fort Worth, Texas. Since making it easier to become certified as an interpreter, the organization has seen a 23% increase in the number of qualified bilingual staff, she said. Pursuing a language certification “gives them the opportunity to provide more robust interpretation for our patients, and also get a differential for that when they’re doing it.”

JPS is also developing a program that allows employees to take on additional shifts to work as interpreters, Ridgeway-Washington said. The network typically spends seven figures each quarter on remote interpretive services, but finds “that the outcomes are much better with on-premise, in person interpretive services,” particularly in departments for trauma patients or maternity, women, and children. “So we’re really working hard to build a stronger bench of interpreters,” she added.

Workers in the healthcare sector may enroll in language courses for a variety of reasons, Katie Brown, founder and chief education officer for EnGen, a language upskilling platform, told HR Brew. She said her organization sees internationally trained healthcare workers seek out English courses so they can feel more comfortable talking with colleagues and patients. At the same time, clinical healthcare workers may seek to learn any number of languages—from Spanish to Haitian Creole to Ukrainian—to better serve their patient populations.

“The common theme is that we need to be able to deliver care in the language that reflects the communities that we’re serving. And that’s a ‘both, and’ situation.”

Whatever approach HR teams land on for incorporating language learning into their benefits, Brown said it’s a good idea to make sure these efforts are aligned with talent acquisition strategies. This is particularly true for sectors like healthcare, where employers continue to struggle to fill certain roles, and may be overlooking promising internal talent.

“There are opportunities to leverage existing infrastructure to help people get foundational skills…that could then be leveraged within the workplace to promote people from within and build talent pipelines,” she said.

Close up of a healthcare professional holding a tablet with a floating globe icon inside a speech bubble.