Enrollment in health savings accounts (HSAs) and health reimbursement arrangements (HRAs) continues to grow, but contribution patterns to these account-based health plans are changing, according to a February 2012 report from the not-for-profit Employee Benefit Research Institute (EBRI).
Collectively, HSAs and HRAs are known as consumer-driven health plans (CDHPs). HSAs can be funded by contributions from employees, employers or both; HRAs are solely employer-funded (see the SHRM Online article “Consumer-Driven Decision: Weighing HSAs vs. HRAs”).
Employer-contribution levels to CDHPs have declined for some enrollees, while individual contributions to HSAs have increased, according to the January 2012 EBRI Notes, “Employer and Worker Contributions to Health Savings Accounts and Health Reimbursement Arrangements, 2006-2011,” which analyzed data from the latest EBRI/MGA Consumer Engagement in Health Care Survey, sponsored by EBRI and Matthew Greenwald Associates.
For those with employee-only coverage in a CDHP, annual contributions from their employer have fallen since 2008, according to the study. Among the findings:
• Employers' contribution to CDHPs. The percentage reporting that their employer contributed $1,000 or more to their HSA or HRA dropped from 37 percent in 2008 to 24 percent in 2011.
• Individuals’ contributions to HSAs. The percentage of individuals contributing $1,500 or more increased from 21 percent in 2006 to 44 percent in 2011.
“This may be due to the continued weak economy,” said Paul Fronstin, director of EBRI’s health research and education program and author of the report. “Workers with employee-only coverage continued to respond by increasing their own contributions,” he noted, with a caveat. “Generally, lower-income individuals did not increase their contributions, whereas higher-income individuals did,” Fronstin said.
In 2011, $12.4 billion in HSAs and HRAs was spread across 8.4 million accounts, EBRI found. This was up from 2006, when there were 1.3 million accounts with $873.4 million in assets, and 2010, when 5.4 million accounts held $7.3 billion in assets. This growth reflects the increasing number of employers that offer CDHP-based health plans.
Stephen Miller, CEBS, is an online editor/manager for SHRM.
Cigna Study: CDH Plans Saved $9,700 per Employee over Five Years, SHRM Online Benefits Discipline, February 2012
Boosting HSA Participation, SHRM Online Benefits Discipline, February 2012
Health Accounts Continue to Grow in Numbers, Assets, SHRM Online Benefits Discipline, January 2012
Promoting Health Care Consumerism: A Multifaceted Approach, SHRM Online Benefits Discipline, November 2011
HSAs Viewed as Cost-Saving Option by Employers and Account Holders, SHRM Online Benefits Discipline, November 2011
SHRM Online Benefits Discipline
SHRM Online Health Care Reform Resource Page