HR Headaches: How Can I Offer Abortion Travel Reimbursement While Respecting My Employees’ Privacy?

When 1 in 4 women receive abortion care worldwide every year, it’s likely that at some point, your employees will need access to reproductive care. With the recent Supreme Court decision to reverse federal protections for abortion rights, abortion benefits have become more difficult, but not impossible.

Many companies are choosing to invest in abortion travel reimbursements to help employees in states with strict abortion restrictions or bans gain access to reproductive healthcare.

But how employers can use a travel expense budget to cover abortion services costs leaves a lot of questions unanswered. Outside of the logistics of providing abortion benefits, the impact of this approach on employee privacy is another concern.

To successfully offer abortion travel benefits and related healthcare services, organizations will need to thoroughly review how their options for abortion coverage will potentially affect both their employee and the company itself.

How does travel reimbursement for employee abortion services work?

Ultimately, travel expenses are used to provide a reasonable excuse for an employee to visit a state with reproductive healthcare without causing suspicion while also gaining tax deductions. At first glance, it appears to be a win-win for employers, and this is how it works:

1. The employer creates a fund for medical travel expenses.
2. Employees are required to submit a medical travel stipend request.
3. The request is either approved or denied.
4. If approved, the organization will reimburse the employee.

TriNet and TriNet Zenefits use a similar structure to facilitate reproductive healthcare access. Effective immediately and through January 1, 2023, TriNet will assist any colleague with up to $4,000 for reimbursement of medical travel expenses, should they be required to access medical care not legally available to them within 100 miles of the colleague’s home. This subsidy is available to TriNet and TriNet Zenefits colleagues in the United States, India, and Canada.

And TriNet isn’t alone. Yelp, Netflix, Starbucks, PayPal, and Reddit are just a few of the big-name businesses providing abortion travel reimbursements.

However, there are a few major legal challenges that employers should be aware of:

• How to best protect employee privacy?
• Is it possible to reduce potential liabilities without sacrificing spending visibility, in case of an abortion-related lawsuit?
• What is the best method for handling confidential data?

The HIPAA Privacy Rule and reproductive healthcare

Currently, the HIPAA Privacy Rule offers some guidance on potential liabilities in states with abortion restrictions. Here is the general summary:

• Unless required by state law, hospital staff are not allowed to disclose abortion procedures or suspected abortions to law enforcement.
• Generally, clinics are not required to give law enforcement information about an individual seeking abortion care. That’s the case even if they have a court order.
• Insurance or healthcare providers are not allowed to disclose personal health information about an individual seeking to access abortion healthcare services in a state where it is legal.

Healthcare providers are either not permitted or required to disclose an individual’s information.

However, it is important that patient privacy continues, even in the workplace. State-specific legalities are changing rapidly, and we are unlikely to clearly see complete abortion restrictions for some time. That is why it is critical to protect employee privacy in your abortion benefits strategy.

Balancing privacy with processing travel costs

For companies attempting to remain compliant, juggling privacy and expense reporting can seem tricky.

The accounting team requires exact and comprehensive documentation for each business expense. These professionals may come in contact with sensitive employee data from time to time.

And if employees are required to submit a medical reimbursement request, these individuals, as well as the employee’s supervisor, may be asked to review the abortion request.

Privacy is essential to protecting both the employee and the organization.

This is where the concern for privacy in the workplace comes in. Employees may be anxious that someone who is anti-abortion within the company could report them, or deny their claim, even if the state doesn’t have a complete ban.

But there are threats outside of the company, too.

Privacy is essential to protecting both the employee and the organization when we look at abortion benefits and state law. So far, only Texas allows private individuals to file a lawsuit if they suspect someone has had an abortion, even out of state.

While it’s possible that this regulation could be overturned, the possibility of legal ramifications for supporting employee abortions is a significant issue.

Employee abortions, as with any other medical procedure, require sensitive information. While companies are required to handle these documents with care via HIPAA compliance, there is a question of whether or not employers should even be aware of the reason for the procedure.

After all, abortions are extremely personal and, to some, controversial. And when abortion services are illegal due to state law, it really only takes 1 accidental leak or intentional whistleblower to land the company and employee in hot water.

How can employers protect employee privacy?

To protect employee privacy, there are a few potential different options depending on your health insurance plan and company structure:

• Do not ask for a reason for the request.
• Do not let company staff review the request, but rather, forward it directly to your health insurance company.
• In addition, do not require a traditional itemized receipt from the healthcare provider, but instead use a bank or credit card statement to match expenses.
• Switch to a fully-insured group healthcare plan, so no one in the company would know about potential abortions and employee data is protected by the insurance company.

To maintain compliance with financial regulation, the insurance company, and the IRS, it’s essential that the accounting team have records of employee travel expenses. But personal details about these expenses should be kept to a minimum, and be handled by as few people as possible.

If possible, a fully-insured group healthcare plan will likely be the best option for most employers, as they can bypass touching and processing sensitive information. This would both protect employee privacy and further reduce company liability.

Other ways to support abortion access and reproductive health

There are other ways to support employee abortions and reproductive health outside of employee travel expenses and reimbursements. Some examples include:

• Providing additional, “no ask” PTO days
• Extending paid or unpaid sick leave
• Remote work arrangements
• Relocation assistance
• Subsidized childcare
• Family planning assistance

Ultimately, the best combination of benefits will depend on several factors. Those include your organization’s budget, employee locations, local laws, and staffing. However, even if you choose not to use travel reimbursements for abortion care, there are ways to give employees the time, privacy, and resources they need for their health.

More on crafting an inclusive benefits package

Abortion benefits are just part of an organization’s overall compensation package. Employers looking to acquire, retain, and foster top talent know they need a competitive benefits strategy. It must be both comprehensive and inclusive.

We’ve put together an extensive guide on the most in-demand benefits in our recent Benchmark report. Check out the full report for the latest on:

• Statistics and trends on health plans.
• How to lower healthcare costs for employers.
• Impacts on healthcare from the pandemic.