EBRI Notes

Availability, Contributions, Account Balances, and Rollovers in Account-Based Health Plans

Dec 11, 2008 16  pages


Consumer-driven health surveys: This report presents findings from the 2008 EBRI Consumer Engagement in Health Care Survey, as well as earlier surveys, examining the availability of HRA and HSA-eligible plans (so-called consumer-driven health plans). It also looks at employer and individual contribution behavior, time enrolled in such plans, account balances, and rollover behavior.

CDHP enrollment: In 2008, 3 percent of the adult population with private health insurance was enrolled in a health reimbursement account (HRA) or had a high-deductible plan with a health savings account (HSA) in 2008. An additional 3.6 percent were eligible for an HSA but did not have such an account. Overall, 6.6 percent of adults with private insurance were either in a consumer-driven health plan (CDHP) or were in a high-deductible plan that was eligible for an HSA, but had not opened an account.

CDHP eligibility: Among individuals with traditional employment-based health benefits and a choice of health plan, 40 percent were eligible for a CDHP in 2008, up from 33 percent in 2006. About 22 million workers were eligible for such a plan in 2008 but chose to remain in the more traditional plan.

Contributions: Workers with employee-only coverage and an employer contribution have seen their annual employer contributions increase, and a majority of workers with family coverage receive a contribution of $1,000 or more. The percentage of individuals with employee-only coverage contributing nothing to an HSA was 19 percent in 2008. Persons both with and without health problems are about equally likely to contribute to an HSA, and their contribution levels are about the same.

Longer time in plan: Between 2006 and 2008, the percentage of individuals in a CDHP for one to two years increased from 30 percent to 41 percent, and the percentage in these plans for three to four years increased from 9 percent to 19 percent.

Account balances: The amount of money that individuals have accumulated in their accounts has grown. The percentage of individuals reporting that they had nothing in their account declined from 14 percent in 2006 to 9 percent in 2008. The percentage of individuals reporting an account balance of at least $1,000 increased from 25 percent in 2006 to 44 percent in 2007, and remained at 43 percent in 2008.

Rollover behavior: The percentage of persons reporting no rollover fell from 23 percent to 16 percent between 2006 and 2008. The percentage reporting a rollover of $1,500 or more increased from 13 percent in 2006 to 27 percent in 2008.