Employers often target benefit offerings to specific groups of workers—think dependent care accounts or student loan repayment matching contributions—so maybe it was inevitable.

Quick Hits

• As the workforce in the United States ages and includes more women than ever before, employers are recognizing the health challenges posed by menopause, which can affect job performance.
• An increasing number of employers are considering adding menopause-specific benefits to the health benefits packages they offer employees.
• Some employers may be interested in simply providing additional menopause-related resources for employees, including access to or information about menopause education courses, community support groups, or menopause specialist care providers.

As the U.S. workforce ages and includes more women than ever before, more employers are considering benefits and other workplace changes specific to menopause. Symptoms of menopause or precursor perimenopause can make work more difficult, uncomfortable, or even impossible, and employer programs aim both to help affected women and increase retention.

Menopause benefits can range from simple employer policy changes to workplace accommodations, to medical benefits that are a part of, or integrated with, the employer’s major medical plan. Employers may consider offering reduced-hours schedules, expanded sick leave that could be used for perimenopuase or menopause symptoms, increased or more flexible paid time off, and more opportunities for employees to work from home. This is a key consideration for employers as the recently proposed regulations interpreting the newly enacted Pregnant Workers Fairness Act (PWFA) includes menstruation (and, ostensibly, menopause and perimenopause) under the definition of “pregnancy, childbirth, or related medical conditions” that fall under the PWFA’s protections. Employers may also want to evaluate their existing hiring and retention policies and respectful workplace, anti-harassment, and anti-discrimination training modules to address possible sex, pregnancy, age and/or disability-related bias and animus that could give rise to legal risk and discrimination claims.

Accommodations in the workplace can include increased temperature control options, such as portable fans or air conditioners, for individual office spaces. There are also a range of menopause benefit programs available. Employers may be interested in simply providing information and resources to employees, without offering a traditional ERISA-covered benefit program. Such resources can include access to or information about in-person or online menopause education courses, community support groups, and directories of menopause specialist care providers—a specialty that is rarely a searchable category within provider directories. Employment tax consequences will vary depending on factors such as whether the employer merely provides information to existing resources or provides discounted or free resources to employees through a partnership with a vendor.

Specialized menopause benefits can also be added to existing health benefit programs, as fertility benefits are. Access to menopause specialists can be offered through new or existing telehealth benefits, and mental health benefits specific to menopause can be offered through new or existing employee assistance programs or virtual mental health benefit programs. Third-party service providers, including some that offer benefit packages in the fertility and family-building benefit space, also administer standalone or medical-plan-integrated menopause benefits. This can be a straightforward way for employers to provide comprehensive benefits, especially those that are already working with one of these vendors for other benefit offerings.

Existing health plans may already provide or could be amended to provide important benefits. Employers may want to review their major medical plans for coverage of hormone therapies prescribed for menopause, which are often excluded due to their high cost. Other areas to review include coverage for low bone density and cardiovascular disease treatments, prescriptions, and preventive care services. It is generally easier for employers with self-funded medical and prescription drug plans to expand coverage.

Employers have another option to provide new or expanded benefits that may be expensive or not widely used (think fertility or gender dysphoria benefits): health reimbursement arrangements, or HRAS, that are integrated with a group health plan according to Affordable Care Act standards. This allows an employer to set a dollar limitation on specific items and services, such as hormone therapy treatments for menopause, which can be a useful way to trial a new benefit and collect utilization and claims data among the employer’s own workforce, giving valuable information and options for future years.