Consumer / Employer

How one company has moved to support reproductive rights despite looming regulatory uncertainty

The reversal of Roe v. Wade led Forma to make a series of changes to its reproductive health benefits on top of what it originally offered — both for its internal employees and its customers.

health insurance, payers, group insurance



Even before the June 24 decision to overturn Roe v. Wade, benefits company Forma already offered various health plans that made sure abortion is a covered procedure with a flexible time-off policy, CEO Jason Fan said.

But the reversal of Roe v. Wade, which gave women the constitutional right to abortion, led Forma to make a series of changes on top of the original benefits — both for its internal employees and its customers, which includes big-name companies Zoom and Lululemon.

Now Forma is offering its employees a Specialty Health Reimbursement Arrangement, which provides $5,000 per calendar year for expenses related to abortion services out of state. This includes travel expenses, child care costs, out-of-pocket medical costs and legal expenses. The company also offers a flexible PTO policy for those seeking abortion services. For customers who want to give its employees something similar, Forma is helping them do so. 

In choosing to reimburse up to $5,000, Forma is providing a more generous benefit than even Amazon, which is reportedly covering expenses up to $4,000.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

Forma is incorporated in Fremont, California, and was formerly called Twic. It is a life benefits platform that helps companies create customizable benefits for its employees and charges a software licensing fee. Another company that operates similarly is HealthEquity, according to Fan.

Forma isn’t the only company making changes when it comes to reproductive rights, according to Michelle Long, senior policy analyst for the Women’s Health Policy program at Kaiser Family Foundation. Many major companies are figuring out ways to administer these benefits through their health insurance plan or contract them with another outside company.

Still, there are a lot of unknowns when it comes to abortion rights, and potential risks for companies looking to provide coverage for their employees, she added. As of July 8, abortion is banned in 8 states, according to KFF.

“At this point, there are more questions than there are answers,” Long said.

Support for employees

Once the draft opinion on Roe v. Wade was leaked in May, Forma began preparing for the official decision. The company has confirmed that 29% of its employees live in the states where abortion is banned or is likely to be banned, Fan said. Another 12% live in states that are undecided. 

“We operate in the benefit space, so we need to take a more proactive approach on this topic, which we did,” Fan said. “Then we started to look at the second layer, which is ‘What are some of the actions that we can do to use our product and operate to actually do good?’”

In addition to providing support for its employees, Forma is helping its customers put together a package similar to its own plan that fits their organization. The company is providing customers a collection of resources, in the form of links, articles and information about support groups offered by state and local governments and nonprofits.  Forma can also help them set up a health reimbursement arrangement — which covers expenses for abortion and abortion-related travel not adequately covered by medical plans — and stay compliant with state government regulations.

“Across the board, we’re seeing very high engagement within our customer base who are looking to pretty much replicate the same type of support [as our own plan],” Fan said. “[There are] some different flavors and tastes to it, but really just providing support for the employees during the time of need.” 

Although Forma is anticipating additional changes to state regulations in the future, the company still wanted to act quickly to show its employees and customers support, Fan said.  

“As long as we have the right principles, the right mindset, we know we can get through [these changes],” Fan said.

‘Untested waters’

While some employers move to support their employees with abortion access, there are some gray areas, according to Michelle Long of KFF. For example, some states have a ban that applies to aiding and abetting an abortion. 

“What does that mean for employers?” Long said. “It’s been untested so far, but I expect that we’ll see some litigation come up in the future about, does aiding and abetting apply to an employer who is covering abortion? Does it apply to an employer who is offering to pay the travel costs for their employees?”

There are also security concerns, Long said. Even with the HIPAA privacy law, law enforcement could receive a court order or a subpoena to access information on a person’s abortion. But it would take a very motivated state law enforcement agency to do so, Long added. 

“With so much unknown, it’s difficult for companies to prepare, Long said. “To an extent, this is kind of untested waters … I think a lot of it is learning as you go along because there are just so many questions and things that are vague in these spots.” 

Employees also have their own worries. One area of concern is the cost to receive care, even if they are covered by an insurance plan. In many cases, a person seeking an abortion may have to pay the costs upfront and then be reimbursed. But many Americans may not be able to afford the costs immediately, Long said. There also may be some issues with a person’s network. Networks tend to be pretty local, so traveling out of state may force the person to receive out-of-network care.

At Forma, its employees have two options, according to Fan. They may incur the costs themselves, submit a receipt and be reimbursed. Or they may use the Forma debit card employees are given and pay the expenses directly.

Employees of other companies with a different corporate culture might have to wrestle with issues of privacy while accessing these benefits. Some people may be concerned about approaching their employer to request the benefit, Long said. In these circumstances, it might be easier to go through a health insurance plan that covers abortion-related services and get reimbursed after incurring the expenses. Going through an insurance company instead of approaching the employer can add a protective layer of privacy, she added. 

 ‘The right mindset’

For companies like Forma it was important to put together a package based on everything they know so far, despite the gray area. But it is still anticipating changes ahead, Fan said.

“I think the important thing is to make sure that we have the right mindset,” Fan said. “The rest of it is just execution, being able to constantly be watching out for changes and then being able to adjust the strategy around this topic.” 

Photo: AndreyPopov, Getty Images