From recruiting and retention to company culture and the latest in HR tech, HR Brew delivers up-to-date industry news and tips to help HR pros stay nimble in today’s fast-changing business environment.

HR Brew

Kristen Parisi

hr-brew.com

four babies, around six months old in a daycare setting. three have bows on their heads, all looking content

The US birth rate increased by 6.2% in 2021, as workers got lucky with WFH benefits.

What the country’s rising birth rate means for parental leave

Aman Kidwai

The Nylas Alumni Fund is a unique employee benefit

The Nylas Alumni Fund is investing in employees who leave to start their own business.

How one tech company is experimenting with a unique employee benefit

Black graduation cap, a diploma, white ladder, a small book on a table, depicts an attempt for students to achieve the goal or gain success in higher education.

Talent attraction consulting firms

Andersen consulting is the latest to enter the fray, with its own MBA program.

Consulting firms use higher ed perks to attract, retain talent

Benefits guide text on pamphlet next to cup of coffee

Benefits

An illustration of reporter Courtney Vinopal's headshot.

Courtney Vinopal

The White House recently announced a deal with two pharmaceutical manufacturers to lower the price of GLP-1 drugs for weight loss.

Two manufacturers, Eli Lilly and Novo Nordisk, agreed to lower the prices of their drugs from upwards of $1,000 a month to around $350 a month when purchased through TrumpRx, the 

 on Nov. 6. In exchange, the Trump administration said it will allow Medicare to cover the drugs for some patients. This government-funded health plan hasn't previously covered GLP-1s for weight loss. 

While the agreements won’t directly affect most employer-sponsored health plans, they could have secondary effects for companies that are covering the pricey drugs.

Doctors have been prescribing GLP-1s to treat type 2 diabetes for two decades, but the drugs were approved for weight loss in 2014. Clinical studies suggest GLP-1s are effective not only at helping patients lose weight, but also at reducing the risk of other conditions, such as cardiovascular and kidney disease.

 GLP-1s for obesity, even as the drugs are driving up health costs.

“The patient population is enormous, fueled by 

 word of mouth, social media,” said Louis Zollo, national pharmacy practice leader and VP at Segal, a benefits consulting firm. “Folks are going to the doctor asking for these drugs by name, which is not something we normally expect to see.”

The White House deal is intended to lower list prices of three popular GLP-1 drugs—Ozempic, Wegovy, and Zepbound. It could eventually spur negotiations to bring down prices on the employer-sponsored insurance side, Zollo said.

Drug companies, health payers, and pharmacy benefit managers (PBMs) might negotiate with one another and “decide that they’re going to match that same direct-to-consumer price and forego, say, a rebate,” Zollo said, referring to referring to the kickbacks PBMs typically receive for negotiating with pharmaceutical companies.

Still, “right now, we’re not getting any signals that that is going to happen anytime soon,” according to Zollo.

Health economists and policy experts similarly 

 they expect this deal to eventually lower GLP-1 prices overall. “We would expect commercial payers to demand to use these posted prices as ceiling prices,” Rena Conti, a health economist and associate professor at Boston University, told the outlet. 

As employers wait to see whether the Trump administration’s recent efforts have any effect on their health spending, they’re exploring other strategies to contain costs tied to GLP-1s, Zollo said.

In addition to monitoring prior authorization criteria, benefits leaders are also starting to look into point solutions to support employees who are trying to lose weight, “realizing that weight loss is complex and maybe not just a drug-only solution for everybody,” he said. A major challenge with GLP-1s 

, and patients may benefit from other services, such as nutrition guidance or health coaching, if they want to maintain weight loss.

Omada Health, a virtual care program, recently launched a GLP-1 prescribing option with these challenges in mind. Omada plans to offer its “lifestyle modification program” alongside clinical expertise about the drugs themselves with the goal of creating “sustainable and lasting results,” Chief Medical Officer Thomas Tsang told HR Brew. When patients stop their GLP-1 and regain the weight they’ve lost, “that’s a huge loss to the investments that they’ve made,” he said.

President Trump sits at a desk beside a sign that details prices for GLP-1 drugs.

What Trump’s GLP-1 deal means for workplace coverage

While agreements to lower the prices of GLP-1s won’t immediately affect employer-sponsored health plans, they could eventually bring down costs.

Ozempic and Wegovy are about to get cheaper. Will employer-sponsored plans benefit?

New York-based employers that don’t already offer a qualified retirement savings program to their workers will be required to enroll them in a state-sponsored Roth Individual Retirement Account (IRA) starting next year.

The requirement stems from a bill passed by the New York State Senate in 2021, which amended the state’s General Business Law to establish the program. Gov. Hochul only 

 the launch of the program, titled the New York State Secure Choice Retirement Savings Program, on Oct. 8.

New York is the latest state to enact an “auto-IRA” program to improve access to employer-sponsored retirement benefits.

How New York’s Secure Choice program will work. 

Private-sector employers with 10 or more employees who have done business in the state for at least two years will be required to enroll their workers in the Secure Choice program by sometime next year. Employers with 10–14 employees have until July 15, 2026 to register, while those with 15–29 have until May 15, and those with 30 or more have until March 18.

Employees who are 18 and older will be enrolled in the Roth IRA program at a default contribution rate of 3%, though they can put up to 10% of their wages into the account. While enrollment is automatic, workers can opt out of the program at any time. They can also choose to “auto-escalate,” or gradually increase their contribution rate automatically, each year.

The New York-provided Roth IRA is portable, meaning employees control it, and can continue to contribute to it if they move jobs. Employers won’t be considered fiduciaries of the plans, nor will they be required to contribute to them.

Businesses that are expected to register for the program will be notified by the state, which will provide access codes.

Twenty states have now enacted “work-and-save” programs similar to New York’s, 

 by the American Association of Retired Persons, which has lobbied for such legislation.

These laws are seen as one potential solution to the retirement crisis, which refers to shifting demographic and economic trends that are negatively affecting Americans’ ability to save enough to stop working one day. Some 42% of Americans working full-time lacked access to a retirement plan as of 2024, according to 

“We know that having access to an employer-sponsored retirement savings plan makes it significantly more likely, 15 times more likely, that a worker is going to be saving for retirement,” Angela Antonelli, executive director and founder of the Center for Retirement Initiatives at Georgetown’s McCourt School of Public Policy, recently told HR Brew.

Antonelli said she and her colleagues had advocated for programs like the one in New York, and expressed optimism that features like auto-enrollment and auto-escalation could “really help make a difference in encouraging workers, not only to start to save,” but also boost “how much they save.”

Legislative Lowdown recurring feature illustration

New York to require some employers to offer state-sponsored IRAs

Employers that don’t already offer their employees a qualified retirement savings benefit, such as a 401(k), must enroll their employees in the state program.

Legislative lowdown: New York launches state-mandated retirement program

Zohran Mamdani won the Nov. 4 election for New York City Mayor by campaigning relentlessly on a message of affordability, with a platform that he said would uplift working class people. In his victory speech that night, he reiterated proposals to deliver on this promise, including a rent freeze, fast and free buses, and universal childcare.

The mayor-elect also pledged to “stand alongside unions and expand labor protections,” arguing that “when working people have ironclad rights, the bosses who seek to extort them become very small indeed.”

We dug into three Mamdani proposals that could have implications for HR teams and the wider workforce.

Mamdani has said he wants to raise the minimum wage for New York City workers from $16.50 an hour to $30 an hour.

The mayor-elect wants to implement the proposed wage hike in phases, reaching a $30 minimum by 2030, according 

 shared with City & State. Small businesses with 10 or fewer employees would see the higher minimum wage phased in over a longer period of time.

Some business leaders expressed concern about this proposal ahead of Mamdani’s win. A $30 minimum wage would be “unsustainable” for some business owners in Queens, the president of the borough’s Chamber of Commerce, Tom Grech, 

. “The average merchant can’t afford a minimum wage increase now. That would kill the bottom line. They’d have to cut employees,” he said in June.

Paul Piccigallo, a management-side labor attorney with Littler, 

 he believed the proposed wage hike would have a “monumental effect on employers,” pointing out that small business owners are already struggling to keep up with “extraordinarily high rent [and] business costs.”

Paying higher wages doesn’t always hurt businesses’ bottom lines, as some companies have discovered in states like California, HR Brew 

. Other jurisdictions have already enacted similar hikes to what Mamdani is proposing—Los Angeles tourism workers, for example, 

 to a $30-an-hour minimum wage starting in 2030.

Offering free childcare to parents of kids between six weeks and five years old was one of Mamdani’s central campaign promises. In a video explaining the pledge, Mamdani argued that the lack of affordable childcare in the city represented a “major cost to our economy.” New York City lost $23 billion in 2022 because parents left or downshifted their careers as a result of caregiving responsibilities, according to 

 by the New York City Economic Development Corporation.

In recent years employers have tried to better retain working parents by 

 the cost of childcare. One Los Angeles-based shapewear company, Cakes Body, even covers the 

 of childcare for its workers—though a benefit this generous is quite rare.

If Mamdani delivers on his promise to offer free childcare to New Yorkers, the benefit could provide a boost to HR leaders who are trying to address workforce losses that started during the Covid-19 pandemic, and have worsened in recent years. Labor force participation among mothers with young children 

in the first six months of this year, the most significant decline in more than 40 years.

If New York City HR leaders want to understand how universal childcare could affect their workers, New Mexico might be a good place to start. On Nov. 1, it became the first state to 

 to its residents, funded by revenue from oil and gas production.

 by the courts before it took effect, and efforts to limit the practice in New York state have also 

. Mamdani says he wants to implement a “total ban on coercive noncompete clauses,” working to revive legislation introduced by New York City Council members to this end last year.

Noncompetes, which typically prevent employees from going to work for a competitor for a certain period of time, are a common feature of employment contracts in industries ranging from sales to food service. The Mamdani campaign 

 and other similar labor practices “restrict workers’ rights, weaken their negotiating power, suppress wages, and have no place in a just economy.”

Even if New York City bans noncompetes, there are still other restrictive covenants HR teams may consider including in contracts to protect confidential information or trade secrets, such as non-solicitation provisions. Multi-state employers likely have experience navigating non-compete restrictions in other jurisdictions, as well.

At least one member of Mamdani’s transition team could be helpful in carrying out a noncompete ban. Lina Khan, who was the Federal Trade Commissioner when the agency tried to ban noncompetes, will serve on this team, according to a Nov. 5 

Zohran Mamdani at election night victory speech

How Zohran Mamdani’s agenda could reshape NYC workplaces

The mayor-elect says he wants to raise the minimum wage to $30, as well as ban noncompete agreements.

How 3 key Mamdani policies could affect NYC employers

Having a baby in the US is significantly riskier than in other comparable countries. As of 2022 the US had 

 than any other high-income country, according to the Centers for Disease Control and Prevention, at 22 deaths for every 100,000 live births.

In recent years midwifery care has emerged as one potential way to address this crisis. Gaps in education and access, however, prevent many patients from working with midwives. A new 

 from Morgan Health, a business arm of JPMorgan Chase focused on healthcare benefits, sheds light on how these trends play out in populations with employer-sponsored insurance.

Just one in five patients on employer-sponsored insurance had a midwife as part of their care team during their last pregnancy, according to the survey held in March. A higher share of respondents (66%), though, said they would be interested in midwifery care for a future pregnancy.

“Lack of knowledge” and “insurance coverage” were cited as the main barriers to midwifery care among those who were interested in it, but didn’t use it.

“People want access to midwifery care,” said Bea Capistrant, VP of healthcare innovation at Morgan Health. “But there are some gaps that we can fill there.” Patients may struggle to understand the scope of a midwife’s practice, how they work with other providers, and how they manage existing health conditions, for example, she said.

A certified nurse midwife is a type of registered nurse that provides a range of reproductive health services, including prenatal care, childbirth, and postpartum care. They can work in hospitals and private practices, as well as birthing centers. Research indicates midwifery is generally associated with more positive clinical outcomes for pregnant people, including fewer cesarean sections and lower preterm birth rates, but a dearth of providers makes it difficult to secure such care in the US.

Available data shows insurance coverage for certified nurse midwives isn’t currently widespread, with just 25% of employers with 500 or more workers covering it, according to Mercer’s 2025 health and benefit strategies survey.

Should employers want to help their employees access midwifery care through a medical plan, they wouldn’t necessarily need to invest in a separate point solution, as some companies have done for doula or fertility services 

. Oftentimes employees can work with midwives just as they would any other provider, such as an OBGYN, on their health plan. Employers may work with their insurance carriers, then, to help connect workers with midwife “providers that are already in-network, on existing health plans,” Capistrant said.

When working with carrier partners, employers can focus on the delta between “educating patients” and “clarifying access,” Capistrant added.

The access piece may be trickier to address, particularly if employees are based in states where midwives aren’t sufficiently integrated into the maternal healthcare system. Midwives are less prevalent than OBGYNs in the US for a variety of reasons, including regulatory requirements that make it difficult to work in certain states, and lower reimbursement rates that translate to lower wages compared to other physicians.

If these broader systemic issues are addressed, though, Capistrant and others expressed optimism that employers would see a positive return-on-investment from directing their workers to midwifery care when it makes sense. One reason is that deliveries that incorporate midwifery care tend to see lower rates of costly procedures like C-sections and NICU visits.

“What our employers want from us is the best possible outcomes, and also they want to be able to manage costs across the board,” said Neel Shah, chief medical officer with Maven Clinic, a reproductive healthcare benefits firm that includes midwives in its network. “They can get more efficiency out of their spending, and they can produce better health by having solutions that incorporate midwives.”

A black pregnant woman with a medical cross logo glowing behind her

The case for midwifery in employer health benefits 

 Many patients are interested in working with midwives, but confront barriers tied in part to insurance coverage.

Midwifery care represents an untapped opportunity for benefits leaders

The White House recently rolled out several policies that seek to deliver on President Donald Trump’s campaign promise to expand access to in-vitro fertilization (IVF).

EMD Serono, a fertility medication manufacturer, will offer certain drugs at a reduced cost exclusively through TrumpRx, the White House said in a 

Additionally, the administration clarified that employers can offer fertility services as a standalone benefit, akin to how dental or vision insurance is often offered. The Department of Labor (DOL) 

 that details how businesses may go about this, but it’s unclear whether the policy will spur more companies to cover fertility treatment.

The policies recently rolled out by the White House follow an 

 seeking to protect and reduce the cost of IVF, but fall short of the president's campaign trail promises. Employers won’t be required to cover IVF, nor does the administration plan to offer any financial incentives for them to do so, at least for the moment.

Instead, several federal agencies announced that “employers can now offer standalone benefit packages to employees interested in coverage for treatment of infertility, including IVF,” the White House said. The DOL guidance clarified that employers can cover fertility treatments through an “excepted benefit,” which is a type of benefit that isn’t subject to certain requirements under laws like the Affordable Care Act and the Health Insurance Portability and Accountability Act.

The agency also said it planned to propose a rule “aimed at providing additional ways that certain fertility benefits may be offered as a limited excepted benefit.”

While the excepted benefit recommendation was framed as a “new benefit option” for employers, the guidance doesn’t actually create any new pathways for companies to cover IVF, sources told HR Brew.

“I read this much more as maybe an affirmation of what was already possible, as opposed to new policy,” said Katie Keith, director of Georgetown Law’s Center for Health Policy and the Law. The types of excepted benefits the DOL points to—such as reimbursing an employee’s out-of-pocket costs through a Health Reimbursement Account, or offering fertility treatments through a specified illness policy—are currently possible, but may not make sense from a design perspective.

Nearly one-half (47%) of large employers cover IVF services in their largest medical plan, according to Mercer’s 

 on employer-sponsored health plans. And there’s a reason many employers choose to incorporate IVF into their group health plans, rather than offer it as a standalone benefit, Keith said. IVF patients have to undergo many different types of care, from taking prescription drugs to undergoing lab testing to ultimately seeking out providers for their pregnancy journeys, if the procedures are successful.

“I understand why employers would sort of treat it as part and parcel of their entire benefits package, because the care is so cross-cutting,” she said. While the Trump administration’s proposals may work for a “very narrow” benefit, “I just don’t think this gets you to the kind of comprehensive coverage that is being talked about,” Keith added.

Companies that provide fertility benefits were already offering the White House-endorsed options to their customers, but executives in the sector expressed optimism that these recent policies would move the needle even further on employer-sponsored coverage.

Carrot, a workplace fertility benefit provider, launched a “flex program” allowing employers to purchase its pharmaceutical benefit as a standalone option 

 the White House rolled out its policies. The company’s CEO, Tammy Sun, 

 she believed the moves marked “a really important moment” for the category of benefits Carrot sells.

Employers have increasingly designed fertility benefits as a “carve-out” from their health plans in recent years, Neel Shah, chief medical officer with Maven Clinic, another fertility benefit provider, told HR Brew via email. The excepted benefit approach that the White House supports “​​enables the shortest pathway to a healthy pregnancy, at the lowest possible cost, for most people,” he added.

Shah also pointed to the administration’s efforts to lower the cost of fertility medications, which represent “approximately one-third of the total costs of IVF,” he estimated. A full IVF treatment cycle can cost from $15,000 to $20,000 on average, and the potential for incurring increased health costs has historically been a top reason employers don’t cover it.

The deal to lower prices of some commonly used fertility drugs may help address this concern, but doesn’t tackle other types of treatment that contribute to the high cost of IVF, such as lab visits and embryo storage, 

President Donald Trump speaks at a podium while making an announcement about IVF access.

Trump policies unlikely to boost workplace IVF benefits

The Trump administration clarified that employers can offer IVF coverage as a standalone benefit, but it’s not clear whether the guidance will spur more companies to invest.

White House actions seem unlikely to move the needle on workplace fertility benefits

Kathryn Larkin got her start in the world of total rewards as a lawyer, advising clients of companies like Deloitte on how to design benefits.

This involved a fair amount of problem-solving, Larkin told HR Brew. After a while, she said, “you wish that you could set things up so maybe you wouldn’t need to solve the problems,” she said. To design benefits with a solutions-oriented approach, she needed to be part of HR.

This desire for a seat at HR’s table led Larkin to take on a position as director of global benefits for Air Products, an industrial gas company, where she also served as their in-house employee benefits and executive compensation counsel.

After nearly 14 years with Air Products, the investment management company Vanguard tapped Larkin to be its head of global benefits in 2024. In this role, Larkin works with her team to educate workers so they get as much as they possibly can out of the benefits Vanguard offers.

Vanguard tries to promote physical, personal, and financial wellness through its offerings, and sees this mission as an extension of its business, Larkin said. The company views its 20,000 employees as its biggest asset “because they’re the ones who are actually doing the work that provides the shareholder value.”

To that end, one financial benefit that Vanguard touts to its workforce is a Health Savings Account (HSA) seed and match. The company puts $500 toward individual employee HSAs, and $1,000 for those with families, as well as matches contributions by 1.5 times what the worker puts into their account. Vanguard encourages employees to view HSAs as a long-term savings vehicle for retirement, Larkin said.

Once individuals turn 65, they can use an HSA for anything, though expenses that don’t qualify as medical are taxed. Because HSA funds roll over into the next year, “it’s kind of a pressure valve for individuals, you’re building this kind of medical nest egg,” she said.

There’s a fair amount of education that goes into positioning the HSA—which is offered to employees on high-deductible health plans—as a tool for long-term savings. Vanguard says she understands that workers may need to use the funds for medical expenses in the near-term, but encourages them to tap into other benefits first if possible so they can save at least part of their HSA funds. The company’s flexible spending accounts, for example, can be used for dental and vision costs.

“You will have medical expenses in retirement,” Larkin explained, referring to items like prescriptions or hearing aids. “So think of it as your 401(k) for your medical.”

Larkin’s team has employees focused on both strategy and operations. She described the latter team members as “the engine that makes the benefits run,” with a focus on troubleshooting any questions or concerns that may arise from Vanguard employees.

Vanguard’s communications team monitors questions that come through ServiceNow and flags any “pain points” that come up in the benefits process, Larkin said. “They’ll sit with me and provide a report and say, ‘Do you realize a lot of people are asking questions about X? We think we need to get out in front of this, something doesn’t seem to be working.’”

One of the most common pain points that comes up concerns medical benefits—which isn’t surprising given 

 and complex this area of total rewards has become. When questions about medical plans arise, Vanguard can direct them to in-house advocates with Aetna, the company’s insurance provider. The idea behind hiring these contractors was to allow people with specific expertise to handle medical benefits-related questions, Larkin said.

Such efforts are ultimately in service of helping employees “get every ounce of every benefit we have,” Larkin said. Whereas employers were focused on cost-savings when she first entered total rewards, that perspective has shifted today, as businesses now view benefits as driving the “total value proposition” for their workers, she observed.

In Larkin’s view, the measure of a successful benefits program is one that’s “highly utilized and valued.” Given this philosophy, it’s not hard to see why Vanguard’s 401(k) program, for instance, has a 98% participation rate.

“If you have benefits that people aren’t using, you’re wasting money,” she added.

A portrait of Kathryn Larkin, head of global benefits at Vangaurd.

Vanguard’s head of global benefits on maximizing value

The investment management firm’s head of global benefits said her team aims to help workers maximize offerings such as HSA accounts. 

Vanguard’s Kathryn Larkin wants employees to squeeze ‘every ounce’ out of their benefits

President Trump may have recently declared English as the official language of the United States, but the situation is more complicated in workplaces like hospitals, which serve patients with varying levels of English proficiency every day.

Language barriers can affect patients’ experiences with the healthcare system, and in turn their overall health, according to a 

. Adults with limited English proficiency were less likely to report their healthcare provider involved them in decision-making about their care, with 63% responding that this occurred in the last three years, compared to 82% of English proficient adults. And these adults were more likely to say they were in fair or poor health (34%) than those who were English proficient (19%).

In light of such challenges, HR leaders at healthcare organizations are incorporating language certifications into their learning and development programs. Such programs may not only help current employees better serve their non-English speaking populations, but also contribute to their own career development, sources told HR Brew.

Novant Health, an integrated health system headquartered in Winston-Salem, North Carolina, has employees who are interested in both English- and Spanish-language learning, according to Lauren King, VP, talent acquisition and workforce development.

Novant offers English as a second-language course through Future Forward, a training and advancement program it launched in August. Through the program, Novant pays up to $5,250 a year for full-time employees to take either degree or non-degree courses, including professional certification and English language proficiency classes.

“One of the No. 1 courses we see people enrolling in right now is actually Spanish-speaking for healthcare careers,” King said at an Oct. 6 panel during WBR Research’s HR Healthcare conference in Boston. Such opportunities appeal to “our care workers who want to be able to communicate with their patients at a different level, and maybe some of their team members and peers,” she said.

JPS Health Network reimagined its qualified bilingual staff program to give more employees the opportunity to apply their language skills in the workplace, CHRO Ashley Ridgeway-Washington said during a separate HR Healthcare panel. Her team found that a large share of Spanish-speaking employees were providing informal translation to patients with the network, which is based in Fort Worth, Texas. Since making it easier to become certified as an interpreter, the organization has seen a 23% increase in the number of qualified bilingual staff, she said. Pursuing a language certification “gives them the opportunity to provide more robust interpretation for our patients, and also get a differential for that when they’re doing it.”

JPS is also developing a program that allows employees to take on additional shifts to work as interpreters, Ridgeway-Washington said. The network typically spends seven figures each quarter on remote interpretive services, but finds “that the outcomes are much better with on-premise, in person interpretive services,” particularly in departments for trauma patients or maternity, women, and children. “So we’re really working hard to build a stronger bench of interpreters,” she added.

Workers in the healthcare sector may enroll in language courses for a variety of reasons, Katie Brown, founder and chief education officer for EnGen, a language upskilling platform, told HR Brew. She said her organization sees internationally trained healthcare workers seek out English courses so they can feel more comfortable talking with colleagues and patients. At the same time, clinical healthcare workers may seek to learn any number of languages—from Spanish to Haitian Creole to Ukrainian—to better serve their patient populations.

“The common theme is that we need to be able to deliver care in the language that reflects the communities that we’re serving. And that’s a ‘both, and’ situation.”

Whatever approach HR teams land on for incorporating language learning into their benefits, Brown said it’s a good idea to make sure these efforts are aligned with talent acquisition strategies. This is particularly true for sectors like healthcare, where employers continue to struggle to fill certain roles, and may be overlooking promising internal talent.

“There are opportunities to leverage existing infrastructure to help people get foundational skills…that could then be leveraged within the workplace to promote people from within and build talent pipelines,” she said.

Close up of a healthcare professional holding a tablet with a floating globe icon inside a speech bubble.