Most Account Holders Fail Basic HSA Quiz

Data show a significant consumer education gap

By Stephen Miller, CEBS July 10, 2014

High-deductible health plans and health savings accounts (HSAs) have been in the market for over a decade now—and flexible spending accounts (FSAs) and health reimbursement arrangements (HRAs) have been around for much longer. Yet consumers, including current account holders, do not fully understand them.

Only 30 percent of current HSA holders aced a basic HSA proficiency quiz by answering all nine questions correctly. And, at a 50 percent pass rate on the FSA proficiency quiz, FSA holders didn't score much better, according to the 2014 Consumer and Employer Healthcare Benefits Survey, commissioned by Alegeus Technologies, a provider of health care and benefit payment administration platforms.

The study polled more than 1,000 consumers and 500 employer health benefit decision-makers throughout the U.S. The results point to a significant consumer education gap and a need for enhanced decision-support resources to help consumers better manage their ever-growing responsibility for health care purchase and funding.

Particularly for HSAs, a lack of understanding of the full account value proposition may be hindering adoption, as more than 40 percent exhibited a lack of understanding of the ability to save beyond the plan year or invest their HSA funds.

Survey findings also revealed that:

65 percent of employers communicate about health benefit enrollment only during open the enrollment period.

Nearly 60 percent rely only on plan summary documents and enrollment forms to communicate benefit plan/account options.

Only a third offer interactive tools such as plan comparison calculators.

Interestingly, in terms of quality of communication and support, employers seem to think they are doing a better job than consumers perceive they are doing. In their assessment of the quality of various aspects of employer benefit communications (clarity, depth, format, personalization and frequency), consumer ratings were consistently 20 percent lower than employer ratings.

“As consumers continue to assume greater responsibility for their health care purchase and funding, there is tremendous opportunity to help streamline and simplify the consumer health care experience,” said Alegeus CEO Steve Auerbach, in a news release.



Contributions that I make to an HSA are tax-free: correct.

I can leverage my HSA savings to cover future health care expenses in retirement: correct.

I gain access to my full annual HSA election amount on the first day of the plan year: false (only the amount contributed to date is available for reimbursement).

If my balance reaches a certain amount, I can invest my HSA contributions: correct.

I can contribute to an HSA regardless of which health plan type I’m enrolled in: false (an HSA must be linked to a high-deductible health plan).

I can change my annual election amount at any time that I want: true.

I can have a health care FSA and an HSA at the same time: false (participants may not contribute to an HSA if they also have a medical FSA; however, a limited-scope FSA covering dental and vision care is allowed).

If I don’t use my funds by the end of the year, I lose them: false (unlike an FSA, participants do not forfeit or lose any unused funds).

My employer owns my HSA: false (unlike a health reimbursement arrangement, an HSA is owned by the participant).

Stephen Miller, CEBS, is an online editor/manager for SHRM. Follow him on Twitter @SHRMsmiller.

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