Navigating Health Insurance Selection for IVF Benefits

The purpose of this study is to evaluate the effectiveness of an educational intervention on health insurance literacy and utilization of in vitro fertilization (IVF) insurance benefits. The investigators hypothesize that the intervention is acceptable and satisfactory and will result in increased health insurance literacy and utilization of IVF benefits.

Eligible individuals will receive a health insurance educational guide to support choosing among 5 health plans for IVF coverage. They will also receive receive a one-page guide with a link to the Open Enrollment website that is available to all employees during the open enrollment period.

Eligible individuals will receive a one-page guide with a link to the Open Enrollment website that is available to all employees during the open enrollment period.

The educational guide includes 4 content areas: 1) Definition of key insurance terms; 2) premiums, deductibles across the five 2023 health plans; 3) Summary of how premiums and deductibles can affect out of pocket costs; 4) Guide to finding in-network IVF providers and facilities.

9 items from the Health Insurance Literacy Measure will assess participants' confidence using their health insurance and being proactive with their health insurance for IVF services. Items will be scored from 0 (not at all confident) to 3 (very confident). Higher scores indicate better health insurance literacy.

6 items from the Health Insurance Literacy Measure will assess participants' likelihood of comparing health insurance plans. Items will be scored from 0 (not at all confident) to 3 (very confident). Higher scores indicate better health insurance literacy.

The 15-item Economic Strain and Resilience in Cancer tool will be used as a self-report subjective measure of financial hardship related to infertility and IVF services. Items are scored from 0 (least hardship) to 10 (most severe hardship). Higher scores indicate worse financial hardship.

Inclusion Criteria: Employees eligible for health insurance coverage Reproductive aged (18 to 50 years) Intention to grow their family in the next year Primary language English or Spanish Exclusion Criteria: None

Deidentified individual participant data generated during the study will be available from the principal investigator (H. Irene Su) upon reasonable request.

Requests for deidentified individual participant data can be made beginning 12 months after publication and for up to 36 months post publication.

Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals. Requests may be made to the principal investigator (H. Irene Su).