Law.com Subscribers SAVE 30%

Call 855-808-4530 or email [email protected] to receive your discount on a new subscription.

Employers Can Deny Coverage for Certain Infertility Treatments

BY ALM Staff
October 07, 2003

An employer's medical plan that denies coverage for certain female-only infertility procedures does not violate either the Pregnancy Disability Act (PDA) or Title VII of the Civil Rights Act of 1964. The Second Circuit, in a ruling of first impression, concluded that neither are violated. Saks v. Franklin Covey Co., 2003 WL 122396 (2d Cir. 1/15/03) (Martin, Parker, and Sotomayor, Cir. Judges).The employer's self-insured medical plan in this case provided benefits for 'medically necessary' procedures. The plan covered a variety of infertility products and procedures benefiting both men and women, but expressly excluded coverage for 'surgical impregnation procedures' such as in vitro fertilization. Plaintiff-appellant Rochelle Saks received various infertility treatments, including in vitro fertilization. The plan declined to reimburse her for procedures related to her attempts to be surgically impregnated. Saks sued, lost before the district court, and appealed the denial of her sexual discrimination and PDA claims.


The Second Circuit affirmed. The court first considered Saks' PDA claim. The court acknowledged that the PDA provides protection against discrimination based on pregnancy and 'related medical conditions.' It rejected the notion, however, that the PDA was intended to create a new protected category based solely on reproductive capacity. This could not be, reasoned the court, because 'reproductive capacity is common to both men and women '.' In contrast, 'the PDA requires that pregnancy, and related conditions, be properly recognized as sex-based characteristics of women.' Therefore, concluded the court, to extend protection under the PDA to both men and women would be incompatible with PDA's purposes. In short, the mere fact that a plan provides inferior coverage for infertility treatment does not mean it is violative of the PDA.


The court began its Title VII analysis by noting that the circumstances in this case were somewhat unique ' in vitro fertilization is performed only on women, but treats infertility, a condition that afflicts both men and women. The court gave as an example a male suffering from low sperm count. In that case, the infertile male's healthy female partner would need to undergo artificial insemination. 'Because male and female employees afflicted by infertility are equally disadvantaged by the exclusion of surgical impregnation procedures, we conclude that the Plan does not discriminate on the basis of sex.' In reaching this conclusion, the court distinguished this circumstance from that faced by the Supreme Court in International Union v. Johnson Controls, 499 U.S. 187 (1991), which struck down a fetal protection policy that required women to prove their inability to become pregnant to gain certain jobs. This policy, reasoned the court, was a disadvantage to women only in contrast to the plan here, which limited coverage to both men and women equally.

This premium content is locked for Entertainment Law & Finance subscribers only

  • Stay current on the latest information, rulings, regulations, and trends
  • Includes practical, must-have information on copyrights, royalties, AI, and more
  • Tap into expert guidance from top entertainment lawyers and experts

For enterprise-wide or corporate acess, please contact Customer Service at [email protected] or 877-256-2473

Read These Next
Yachts, Jets, Horses & Hooch: Specialized Commercial Leasing Models Image

Defining commercial real estate asset class is essentially a property explaining how it identifies — not necessarily what its original intention was or what others think it ought to be. This article discusses, from a general issue-spot and contextual analysis perspective, how lawyers ought to think about specialized leasing formats and the regulatory backdrops that may inform what the documentation needs to contain for compliance purposes.

Hyperlinked Documents: The Latest e-Discovery Challenge Image

As courts and discovery experts debate whether hyperlinked content should be treated the same as traditional attachments, legal practitioners are grappling with the technical and legal complexities of collecting, analyzing and reviewing these documents in real-world cases.

Identifying Your Practice's Differentiator Image

How to Convey Your Merits In a Way That Earns Trust, Clients and Distinctions Just as no two individuals have the exact same face, no two lawyers practice in their respective fields or serve clients in the exact same way. Think of this as a "Unique Value Proposition." Internal consideration about what you uniquely bring to your clients, colleagues, firm and industry can provide untold benefits for your law practice.

Risks and Ad Fraud Protection In Digital Advertising Image

The ever-evolving digital marketing landscape, coupled with the industry-wide adoption of programmatic advertising, poses a significant threat to the effectiveness and integrity of digital advertising campaigns. This article explores various risks to digital advertising from pixel stuffing and ad stacking to domain spoofing and bots. It will also explore what should be done to ensure ad fraud protection and improve effectiveness.

Turning Business Development Plans Into Reality Image

This article offers practical insights and best practices to navigate the path from roadmap to rainmaking, ensuring your business development efforts are not just sporadic bursts of activity, but an integrated part of your daily success.