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Where can I get a reimbursement form?

Click here for the policy and reimbursement form. If you have any questions, call WINFertility at 866-217-9482.

Must I be employed by Hess to be reimbursed?

Yes. To be eligible for reimbursement, expenses must be incurred and the surrogacy must be Legally Finalized while you are employed by Hess.
If you leave Hess, any eligible expenses incurred but not reimbursed prior to your last day at work are not eligible for reimbursement. However, any reimbursements made prior to your leaving Hess are yours to keep.

What expenses are not eligible for reimbursement?

Any surrogacy arrangement that is not legally valid and recognized in the U.S.
Any expenses that violate a state, federal or local law
Compensation to gestational carrier or birth mother
Compensation to egg or sperm donor
Voluntary donations or contributions to the surrogacy agency
Costs paid using funds from any federal, state or local program for surrogacy
Expenses incurred prior to January 1, 2024, or your most recent hire date, whichever is later
Guardianship or custody costs that are not associated with the surrogacy of the child
Cost of living expenses and/or personal items such as: rent, utilities, food, clothing, over-the-counter supplements, toys, furniture, etc.
Loss of income, including but not limited to loss of income due to complications of pregnancy such as bed rest for birth mother/surrogacy
Any childcare expenses
Any costs associated with transferring and/or terminating a surrogacy arrangement
Expenses reimbursed under another employer program
Any expenses not expressly stated as included shall be deemed to be excluded

What expenses are eligible for reimbursement?

Court costs, legal costs and attorney’s fees
U.S.-based surrogacy agency fees
Travel expenses for the intended parents or gestational carrier related to the surrogacy occurrence
Egg/sperm donation agency fees
Fees charged by the surrogacy agency to administer the surrogacy occurrence
Screening costs for gestational carrier and egg or sperm donor
Egg or sperm retrieval fees, IVF and medical costs, if not covered by another source
The cost of transfer of the embryo to the gestational carrier
Donor fertility costs and fees not covered by another source
Egg or sperm shipping and transport fees
Pregnancy medical expenses related to surrogacy not covered by another source
Immigration and immunization fees associated with a surrogacy occurrence
Unreimbursed medical expenses of the child(ren) and/or birth mother/surrogate

How much can I receive?

Up to $15,000 (taxable) per surrogacy event
Up to two surrogacy events

Who is eligible?

You, if you are a regular full-time employee working 30 or more hours per week and intend to become the legal parent of a child born through a U.S.-based surrogate

What expenses are not eligible for reimbursement?

Any adoption that is not legally valid and recognized in the U.S.
Any expenses that violate a state or federal law
Compensation to the birth mother
Voluntary donations or contributions to the adoption agency
Costs paid using funds from any federal, state or local program for the adoption
Guardianship or custody costs that are not associated with the legal adoption of the child
Costs associated with adopting a stepchild
Cost of living expenses and/or personal items such as: rent, utilities, food, clothing, over-the-counter supplements, toys, furniture, car seat, etc.
Loss of income, including but not limited to, loss of income due to complications of pregnancy such as bed rest for the birth mother
Any childcare expenses
Expenses reimbursed under another employer program
Expenses associated with adopting a child over the age of 18 unless physically or mentally unable to care for himself or herself
Any expenses not expressly stated as included shall be deemed to be excluded

For You

LTD coverage replaces 60 percent of your annual base pay up to a maximum benefit payment of $15,000 per month.

So, if your base pay is $300,000 or less, you’ll have coverage that replaces 60 percent of your base pay up to $15,000 per month. However, if your base pay is over $300,000, your monthly LTD benefit will be capped at $15,000.

For Your Children

You must elect Optional Life for yourself first. The amount of coverage depends on the age of the child:

Age 14 days to 6 months: up to $5,000 per child
Age 6 months to 26 years: up to $20,000 per child

For Your Spouse/Partner

You must elect Optional Life for yourself first. Optional Spouse Life coverage is 50% of your Optional Life coverage, up to a maximum of $100,000 (evidence of insurability is required for amounts over $50,000).