When states require fully insured employers to cover in vitro fertilization (IVF), what do self-insured employers provide?

While state in vitro fertilization coverage mandates are important policy initiatives to improve access to in vitro fertilization, our findings suggest that state mandates are insufficient to expand access to all patients since a minority of self-insured employers in our sample covered in vitro fertilization. In addition, it is insufficient to label a health plan as simply "covering" or "not covering" in vitro fertilization; instead, the details of that coverage matter since the "coverage" may not be sufficient for the patient to afford even one in vitro fertilization attempt.