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Board authorizes staff to design $15,000 per-lifetime surrogacy and adoption reimbursement program
Summary
The Health Services Board authorized staff to draft policy and funding for a $15,000-per-lifetime reimbursement for surrogacy and adoption, to be paid from plan performance guarantees rather than trust premiums; eligibility and operational rules will be brought back for approval.
San Francisco — The Health Services Board authorized staff to design a program that would provide up to $15,000 per employee, lifetime, to reimburse surrogacy or adoption expenses. Funding would come from plan performance-guarantee receipts rather than trust premiums.
Staff and Aon Hewitt outlined reasons for offering the benefit (including supporting LGBT families) and said the $15,000 cap reflects common employer practice; the underlying average cost of surrogacy/adoption can exceed $50,000–$100,000, so the benefit would be a partial reimbursement. CFO Pamela Levin explained the funding mechanism: performance guarantees from vendors are non-premium funds that can be set aside in an external pool for targeted programs; HSS estimated available performance-guarantee receipts at a level that could seed the program but noted ongoing availability depends on vendor performance.
Commissioners asked about eligibility (age limits, medical screening, geographic limits for surrogates), potential demand and whether the program could create an initial “run” of applications. Staff said qualifying steps in surrogacy/adoption processes would act as a filter and that they would return with policies, tax-reporting guidance and an accounting plan. The board voted to authorize development of the program and directed staff to return with formal policies and an implementation plan for Board approval.
