Why the cheapest family health benefit often costs employers more

Choosing benefits based on upfront cost alone can lead to higher long-term healthcare spend. Yet when employers evaluate healthcare benefits, cost is often the starting point. Without coordinated, clinically managed care, gaps across fertility and maternity journeys can result in unnecessary treatments, complications, and avoidable costs for employers.

What you need to know:

90% of employers cite rising benefits costs as a top concern, but the lowest price doesn’t equal the best value
Hidden costs, like absenteeism, turnover, and unmanaged risk, can significantly increase total spend
Fertility and maternity care are major cost drivers, with IVF costing up to $25,000 per cycle and NICU stays averaging $64,800 per birth
Clinically managed programs can reduce complications and deliver savings of up to $9,600 per birth
Evaluating vendors based on outcomes, not just pricing, leads to better financial and employee experience results

With healthcare spending continuing to rise, benefits leaders are under increasing pressure to control budgets while still offering programs that support employees and their families. In 2025, nine in ten employers cited rising benefits costs as the top issue influencing their benefit strategies, and 43% said expectations for an enhanced employee experience were a concern.

As a result, 63% of employers say they plan to reallocate or rebalance their benefits spending over the next three years. While it can be tempting to prioritize the vendor with the lowest upfront cost, when it comes to women’s and family health benefits, focusing solely on price can obscure a more important metric: total cost of care.

Why upfront pricing doesn’t tell the full story

Many benefits vendors promote competitive pricing as a key differentiator. While lower vendor fees may appear attractive during procurement, they don’t always reflect the full financial impact of a program.

While premiums, deductibles, and co-pays are the most visible costs of coverage, there are also covert expenditures that can spiral, especially when there are gaps in benefits offerings. These can include:

Administrative costs
Compliance costs
Absenteeism and presenteeism
Turnover and recruitment costs
Legal risks and liabilities

When evaluating benefits that support women’s and family health journeys, employers must consider that these often involve multiple stages of care: fertility treatment, pregnancy, postpartum recovery, and early parenting support.

When these journeys are not clinically managed, gaps in care can lead to higher downstream costs. Employers may see increased claims tied to:

Unnecessary fertility procedures
Unmanaged pregnancy risk
Preventable complications
Neonatal intensive care admissions

These outcomes can significantly increase overall healthcare spend.

Increased costs due to unnecessary fertility treatments

Fertility care costs have increased, with 70% of employers recognizing higher spend over the last three years. IVF costs often reach $25,000 per cycle, and fertility drug prices have risen 84% in the past decade, making it prohibitive for employees to cover treatment without employer support or going into debt.

However, lifestyle adjustments and treatable conditions are often overlooked, particularly in cases of male infertility, resulting in couples unnecessarily progressing to IVF. Research from the UK, for instance, reveals that 80% of GPs had received no education on male fertility, and 97% would not be able to accurately examine for a varicocele, which is one of the most common yet treatable causes of male infertility and is present in 40% of primary infertility cases in men.

Maven helps 30% of fertility members achieve pregnancy without IVF or IUI treatment through comprehensive support for employees preparing to have a family before they even begin trying to conceive.

The financial impact of pregnancy complications

Maternity costs have risen 50% in the past decade, and pregnancy complications are one of the most significant drivers of maternity-related healthcare costs. 57% of benefits leaders say high-risk pregnancies have impacted healthcare costs for their organization, with nearly one in five reporting significant increases.

Without early risk identification and proactive support, conditions such as gestational diabetes, hypertension, or preterm labor can escalate quickly. This is particularly relevant given changing maternal health profiles, with more women navigating pregnancy at older ages and with pre-existing conditions.

These risk factors increase the likelihood of preterm birth. Complications linked to pre-term delivery can result in neonatal and intensive care expenses averaging $64,800 per birth. Across employer-sponsored health plans, this is estimated to contribute between $6 -14 billion in additional medical costs each year.

In addition to direct healthcare spending, high-risk pregnancies result in longer medical leaves and complex disability claims, and can make it more difficult for employees to return to work. Only 32% of HR leaders say all or almost all employees return to work after parental leave.

However, when risks are identified early and managed effectively, many complications can be reduced or avoided. For employers, these improvements translate directly into lower healthcare costs.

Programs that provide proactive maternity care management can help employers save thousands of dollars per birth by reducing complications and improving outcomes.

Families using Maven experience 15% fewer C-sections and up to 27% fewer NICU stays, measured across more than 17,000 pregnancies and supported by the largest datasets in digital maternity care. For employers, this translates to an average saving of $9,600 per birth.

Why clinical management matters

The difference often comes down to how care is delivered.

Some benefits focus primarily on access, connecting employees to provider networks or offering reimbursement for services, while others provide active clinical management throughout the care journey.

In clinically managed models, care teams continuously monitor members, identify risks early, and guide employees toward evidence-based treatment options. This approach helps ensure that employees receive the right care at the right time.

Maven’s model actually drives value through:

Clinical programming that delivers proven results across 25,000 pregnancies
Dedicated Care Advocates for every member, ensuring personalized support and coordination
More than 600 specialized providers who are available 24/7 across time zones.
Comprehensive coverage that supports both partners — not just the employee — and family members up to the age of 26

What benefits leaders should ask vendors

As the women’s health benefits market grows, comparing programs requires looking beyond pricing alone.

Benefits leaders are increasingly asking vendors questions such as:

How are clinical risks identified and managed?
What measurable outcomes does the program deliver?
How does the care model reduce unnecessary treatments?
What cost savings have other employers achieved?

Answers to these questions provide a clearer picture of the true value a program can deliver.

Value is measured in outcomes

The most effective women’s and family health benefits are designed to improve outcomes, not simply reduce vendor fees.

When programs prioritize coordinated care, early risk identification, and clinical guidance, employers often see measurable improvements in both employee well-being and healthcare spending, with up to $5,000 savings per member.