'Use of Health Care Services and Access Issues by Type of Health Plan: Findings from the EBRI/MGA Consumer Engagement in Health Care Survey,' and 'Retirement Readiness Ratings and Retirement Savings Shortfalls for Gen Xers: The Impact of Eligibility ..

Access Issues by Type of Health Plan: Many American have difficulty getting access to health care services regardless of their type of health plan, according to a new report by EBRI. Impact of Eligibility for Participation in a 401(k) Plan: Eligibility for participation in a workplace 401(k) savings plan is one of the single-most important factors in closing the retirement savings gap for Generation X, according to a new report by EBRI.

Use of Health Care Services and Access Issues by Type of Health Plan: Findings from the EBRI/MGA Consumer Engagement in Health Care Survey

In 2011, 30-40 percent of respondents, depending on the question, reported some type of health care access issue for either themselves or family members. Individuals in high-deductible health plans (HDHPs) were more likely than those with traditional coverage to report access issues.
Individuals with health problems are more likely than those without health problems to report access issues.
Individuals in households with less than $50,000 in annual income are more likely than those in households with $50,000 or more in annual income to report access issues.
Length of time individuals had been with consumer-driven health plans (CDHPs) had an impact on access issues in 2011.
Among individuals with CDHPs for less than a year, 42 percent reported access issues, compared with 33 percent of those with CDHPs for one to two years, and 32 percent among those with CDHPs for three or more years.

Retirement Readiness Ratings and Retirement Savings Shortfalls for Gen Xers: The Impact of Eligibility for Participation in a 401(k) Plan

The dollar value of retirement savings shortfalls for Gen Xers varies considerably with the number of future years of eligibility for 401(k) plans, particularly for those in the highest severity category (simulated to have a shortfall of $200,000 or more): 13 percent of those with no future years of 401(k) eligibility have shortfalls in this range vs. only 3 percent for those with 20 or more years.
Future eligibility for 401(k) plans makes a significant difference in reducing the percentage of households with shortfalls of $200,000 or more for all gender/family status combinations, but single females experience the largest absolute reduction in the percentage of those with shortfalls in this range.

10 Figure 6 Figure 2 ® Figure 4 . “Projections of Future Retirement Income Security: Impact of Long Term Care Insurance.” 2005 American Society on updat signific Among References A third study contrast, appr Retireme Appendix B: Brief Chronology The References A brief description of the EB doll eantly m d versi th ar val e lo nt Saving wer-income examin o u oximately o n of e of re like shortfa the ed adh ly tha nati 82 gr l s Shortfalls lonal model n s perce e oup, for those RI Retirement Security Projection Model rence Gen n Ct of to ma Dwithout HP Xers tho wa en in s varies consi s produ rollees of RSPM tenanc e with health 2 were ced for e probl 0drugs or dn erab more years o e o the ms for car more ly May 2 to report with ld ikely iac th 0 (R 1 c fe num t 0 to future h EBRI h SPM) is provide nditions an at they those with traditional ber el policy igi of or th and b f ilit fo uture y cholesterol y are simu eir f rum an d in Appendix amily m ears of d use late an e c eli mbers overage d d fo d to A followed by a g in th ibility und that have did not e July to report for no 2 401 fill 010 (k) Retirement Readiness Ratings and Retirement Savings Use of Health Care Services and Access I Those “At Risk,” by Age Cohort ssues by Type of Distribution of Retirement Savings Shortfalls Aging/Natio Per-indiv nal Cou idu ncil o al Distribution n Aging Joint Confer of Retirement ence, March 2 Sav 005. ings Shortfalls for Married Gen 23 Distribution of Retirement Savings Shortfalls for Single Male Gen Xers, Figure 4 Cop chronology of its development and utiliz eland, Craig, and Jack VanDerhei. “T ation he Decli in Appendix B. See Va ning Role of Private Defi nDerhei ned Be (Febru nefit Pe ary 2011 nsio ) for additional n Plans: Who Is Affecte detail on the d, and plans. pres pres defic Issue Brie access cript cript its, wh This is issues in most years ion ions f.ile dr , particular s only 3 ug r kippe efil percent d lsdos d ly tru ee cr seas of to make e have for the ed those shortfall in survey. the both in medicatio CDHPs the h However, s of $ igh 2 an 0est se 0 n las d tra ,0 in 00 tth veri long d e or more. itional hty cate igh er, or er p lans in gor d co e,y layed or me ($ but gro 20 decli 0,00 u avoi p,ne 0 o CDHP enrol dd re more for more): d getting l the ees 13 hea p C were ercent lth care DHP more lik popu of t due hose w latio to ely n. to ith Buntin, M.B., A VanDerhei (M.ay M. Haviland, R. McDevitt, and N. Sood. “Health 2012) depicts Retirement Savings Shortfalls care Spending and Preventive by age cohort, as well as Car mari e in High-Deductible tal status and and EBRI launched a major project to provide this type of retirement income security measurement in the late 1990s for (per Individual) for Gen Xers, by Gender and Family a Status Shortfalls for Gen Xers: The Impact of Eligibility for Health Plan: Findings from the EBRI/MGA Consumer Xers, by by Number Number of of Future Future Years Years of of Eligibilit Eligibility y for for Participation Participation in in a a 401(k) 401(k) Plan Plan Early Boomers Late Boomers Gen Xers Access Issues Among Individuals With CDHP, How.” In Robert L. Clark and Olivia Mitchell, eds., Reorienting Retirement Risk Management. Oxford University impact of the 2008–2009 crises in the financial and real estate markets on retirement income adequacy. The cost. ( report no fut study a u S a re tatistical sig ccess year lso foun is of 4 ssues n d 0ificance tests ac in most years 1poorer (k) elig CDHP ibility hav of t dru ross h h g ee co ssh u e mplianc ortfalls i rvey. alth status e n th for a ar is range vs. on e not sthma, cardiac shown ily 3 n the , and chol perc table ent este be for those cause eve rol, anwith d it ry di fou 20 or mor ffer nd t ence hat C e by yea D he HP rs. alth Consumer-Directed Health Plans.” American Journal of Managed Care, Vol. 17, No. 3, March 2011. several states gender, . T efor stimon bot concerne y. U.S. C h Baby 25% d Boomers ong whress. Senate S ether t and heir Ge resn peci i dents Xers. al Comm woul The d RSS ittee on Ag ha ve suf values fin icie provide g. nt i Do We Have a C ncome information when trh isis in A ey rea on average c m he eric d r ae ?indivi tirement Resudual lts From the a ge. June 2012 • Vol. 33, No. 6 Press for the Pensi 16% on Research Council, 2010: 122–136. 18% by Employer Contribution to Account, 2006–2011 The Figure Partici Engagement in Health Care Survey ne4 w mo provi del pation in a 401(k) Plan des th was use e same d toanalysis as Fi analyze how gure eligib 3, alt ility for hough participatio limited to on n in a de ly singl fineed cont male ribution Gen Xers. plan Figu imre 5 pacts retir provide es ment Percentage of Deemed (born between (born between (born between EBRI-ERF Retirement Security Projection Model (T-141), 27 Jan. 2004. 11 enrollees term status was sta Future eligibility for tinated the dr istically sign 401(k) ifi u plans makes a g cant.) supply earli esignific r than trad ant dif itio fe nal-plan rence in pati redu en cing the ts. Adher per enc ce e was ntage consiste of housntly an eholds d with retirement income deficits. These numbers are present values at age 65, and represent the additional amount After conducting studies for Oregon, Kansas, and Massachusetts, a national model—the EBRI Retirement Security VanDerhei and Copeland (2001). 24 2006 2007 2008 2009 2010 2011 Where the world turns for the facts on U.S. employee benefits. 8 income a Charlt results for on, M.E., B.T d sin equg ale fema cy in . Lev Sept le y, R.R Gen Xers a ember . High, J.E. 2010. nd Fi It Schne gure was also use 6 ider, a provides nd J.M. Brooks. “Effects of d to compute the (per-indiv Ridual etirement ) re Health Savings sults for married Savings Short Accoun falls Gen Xers. Altho for Ba t–Eligby Boo ible Pla um n gh s on ers ® CDHP Enrollees Helma signific shortfalls of nantly lower for , Ruth, Craig C $200,000 or m 16 o C p % D eHP patients by lan od re for , and Jack Va all gen ad llnDer er/ measures. family hei. “T status he 201 combin 2 Retirem atio ens, but nt Confid singl ence e Surve females y: Job In experi securit ence tyh , D e larg ebt W ese t igh Adequate Income 1948–1954) 1955–1964) 1965–1974) Projection Mo that individua del ls would (RS 14 P% M)— have w as develope to save by ag d in e 2 65 0 0to 3, an elim d in inat 20e10 their it wa expected s updated to i deficits ncorporate in retirement several signific (which, ant By Jack By Paul Fronstin, Ph. VanDerhei, Ph.D., D., Employee B Employeee Be nene fit fit R Research esearch Insti Intstitute ute Employer Contributes to Account 12 VanDerhei, Jack, and Craig Copeland. “The Impact of Deferring Retirement Age on Retirement Income Adequacy.” EBRI 25 Figure 1 and each Va Generatio nfigure Der Utilizati he shows a tr i and n Xers i on a Cope nd n lemen a Exp Octo nd (July en dous im ber ditur 20 2010. es.” 02 pact ). Amer from futur ican Joure nal of Man years of 4 ag0e1d( Care k) eligibility on , Vol. 17, No. 1, Januar RSS, single y 2 femal 011. e Gen Xers on Retirement Confidence, Savings.” EBRI Issue Brief, no. #369 (Employee Benefit Research Institute, March 20% Among absolute Not filled a prescription due to cost or skipped doses to make CD redu HP ction in enrollees the , bot peh rcentage of employer th contributio ose withn short s to HRAs falls in or HSAs this range. and the length of time the individuals had depending on the simulated lifepath, could be a relatively short period or could last decades). The additional changes, incl Issue Brief, uding th no. 358 (Empl e impacts of odefi yee Benefit Res ned benefit e pla arch Institute, June 2 n freezes, automa0 tic 11enrol ). lment provisions for 401(k) plans, and 100% 44.3% 43.3% 43.9% 14% 9 2012). Retirement and health benefits are at the heart of w Access Issues, by Type of Healtorker h Plas’, emplo n, 2005–2011 yers’, and our nation’s medication last longer 13 exp Most recently, erience the lar a study gest a 12 fou %bsol nd that C ute reductio DHPs r n ie nsulted in the percenta reductions in ge o 35% f those the w use of 28% ith shortfal non 23% -ge ls of neric more t 32% prescri han pt$2 ion dr 31% 00,0ugs. 00. 26% 10 owned the accounts were examined. Very few differences in access issues were found between individuals whose the re savings VanDerh cent required cris ei an es in t d Cop for h e e Gen lafina nd (D Xe nc ecemb rs ial an vary d e r 20 housi from 02) napproxima . g markets.te EBRI has ly $25,000 rece (per ntly u indivi pdate dual) d RSPM for married for chan hges in ouseholds, financi al and TM Chen, S., R.A. Delayed or avoided getting health care due to cost Levin, and J.A. Gartner. “Medication Adherence and Enrollment in a Consumer-Driven Health Plan.” In October Use of Health Care Services and Access I economic security 2010 testimony . Fo befor unded in 1978, EBRI is e the Senate Health, Education, the most authoritative and objective source of 41 Labor and Pe 29 nsio 26ssues by Type of ns Committee 20 on “The 23 Wobbly 20 Introduction Introduction 90% 33.0% 31.8% 33.8% . “The EBRI Retirement Readiness Rating: Retirement Income P 2005 2006 reparation 2007 and 20 F08 uture Prospe 2009 cts.” 201EBRI Issue 0 2011 Brief, Approximately 18 percent of those with no future years of 401(k) eligibility 4 would experience a shortfall of this 12% VanD employers erhei, Jack. “Retirement contributed to the Income Ade accounts aq nd ua thos cy for Bo e whos ome er e s and Gen mployers Xer did snot. : Evidence fro In 2011, m 41 the 2012 EB percent of iRI Retireme ndividuals wh nt ose increasing to $42,000 for single males and $76,000 for single females. real estat 14 Either of the above e market conditions as well as underlying demographic changes and changes in 401(k) participant behavior 53 38 35 40 39 34 a Amer no. 344 (Emp ican Jour 10 lo nal of Man % yee Benefit Re aged Care search Institute 16, no. 2 (F , Jul ebruar y 2010). y 20 10): e43 -e50. Stool: Reti information on these critical, complex issues. rement (In)security in America,” the model was used to analyze the relativ Traditie o import nal ance of employer- VanDerhei and Copeland (2003) In 2001, a Measuring reti handfu rement sec l of largu e, rit self-insured y—or retirem employers start ent income aded o equacy—is an ffering he extremely alth reimburs impo ement arra rtant topi ngements (HRAs c. The May 2012 )—a EBRI Health Plan: Findings from magnitude compared w 15% ith approximately 5 percent of the EBRI/MGA Consumer those with 20 or more years of future eligibility. Security Projection Model,®” Ma 80% y 2 012, EBRI Notes, 5 18.0% no. 5 (Emplo yee Be 17.2% nefit Rese arch Institute, Ma 19.4% y 2012): 2–14. Health Care Us employers did not contr e an ibutd Access Issues by Plan Type e to the accounts reported access issues, compared with 34 percent of individuals whose since Jan Employer uary Does Not Contribute 1, 2010 (base to Account d on a database of 23 26 million 401(k) participants). Appendix A: Brief Description 10% of RSPM Not filled a prescription due to cost or skipped doses to TM,1 provided retirement benefits and Social Security. 15 Notes then-ne artic w type le provided u of healthpdat plan e. In s for t 20h 04, e pre indi viously viduals pu with blish ce ed EB rtain high-de RI Retireducti ment R ble healt eadine hss Ratings plans (HDHP s as well ) were allow as the ed to While these RSS values may appear to be relatively small considering they represent the sum of present values VanDerh Not filled a prescription due to cost or skipped doses to make . “The Impact of PPA on ei (January 2004). Retirement Income for 401(k) Participants.” EBRI Issue Brief, no. 318, (Employee Benefit Engagement in Health Care Survey employers did contribute to the accounts (Figure 4). Otherwise, in mos , p. 2 t years of the survey, there were no Fronstin, Paul. make medi "F cati indi on l ngs from as 8%t longer the 2011 EBRI/MGA Consumer Enga 22% gem 22en %t in Health C 23% 21% are Surve 22% y." EBRI Issue Brief, 23% 23% no. The 2011 EBRI/MGA Consumer Engagement in Health Care Survey, along with results from prior years, can be used EBRI focus . “Modifying the F es solel edera yl on emplo Tax Treatment of 401( yee2 benefits research — no lobb k) Plan Contributions: Projected Impa ying ct on Participa or advocacy nt Account . One of the Thus, EBRI Emp while ba nle oyee sic objectives arly Benefit Re one-half of (44 sear RS perc ch Institute Not PM is to ent) of simulate the thees Early Boo (ISSN 1085 percenta mers ?4452) is publish are ge o considered f the popu ed monthl to lation be y “a b that wi y t trisk” using the 100 per he Emplo ll be “at yee Be risk” o nefit Research f hav cent ing medication last longer 8% 26* 28 26 36 27 26 average Ret contributRese e to irement Savi health arch Institute, June 2 savings ngs accounts Shortfalls 008). (HS (RSA Ss). Collect ). ively, HRAs and HSA-eligible plans are known as consumer- that may include decad th es of deficits, it is important to remember that only a portion of the simulated lifepaths The origi Delay nal ed version of or avoided RS getti PM n was g healused to th care due analyz to ce th ost e future 17 economic well-being of th 19 16^ 22^e retired 15^ population 12^ at t 19^he 16 The Impact of Nursing Home and Home statistically 365 (Emp Bala significant nces,” Mar loye ediff c Benefit Rese h 201 eren2, ces EBRI Notes, betwe arch eInstitute), Decemb n the no. 3 (Emplo two groups. ye He er 20 e Be alth C 11. nef it Resear are Costs on Retirement Savings ch Institute, March 2012): 2–18. Institute, 1100 13 St. NW, Suite 878, Washington, DC 20005-4051, at $300 per year or is included as part of a membership to exami In February ne pl EBRI 2an pa 011, the stand rticipant mod s alone in em e sl was ’ report used ing pl to of health care access issues for them oyee analyze ben the efits im rese pact ar of ch th as e 2 an 008– inde 20 pend selves 09 crisis in t e n and t t, nonprofit, and no hhe eir fami financi lya membe l and r npa ers. T al rtisan estate he threshold, retireme VanDerh Delayed or avoided getting health care due to cost nt inc e approximately o i (2 ome that 005). is in nadequate e-third (3 to c 3 per oc ver basic ent) have ex les penses an s than 3790 d pay perc for ent 32 uninsur of the23 fed healt inancial h 24 r car esource e costs for the s 23 necessary to 24* 10% drivenE hea ither lth plans (CDH of the above 6% Ps). 29 30 28 33^ 29^ 28 31^ modeled subscription. Pe were consider riodicals postag ed to ebe rate paid in “at risk.” In Washingt otheron, DC, and additional mailing offi words, the average RSS values ces. are PO reduced STMASTER by : Send address the inclusion state level. EBRI and the Milbank Memoria 27 l Fund, working with the governor of Oregon, set out in the late 1990s to organization. 6% It analyzes and 6 reports research data without spin or underlying agenda. All findings, Shortfalls Either of the above 47 44* 34 TM 43 38 41* . “ERISA At 30: The Decline of Private-Sector Defined Benefit Promises and Annuity Payments: What Will It s markets on r urvey include etirement s questions inco om n medi e adequacy. cation th ad herence and delays/avoidance of health care. cover 17 remaind the er o retir f te heir ment lives onc expens ees they r and un etire. insu However, red healtht h car e EBRI e costs. Th Retireme e nu nt mber Rea d dro iness Rating™ also provides ps to 18 b percent if the threshol information d is This Among Notes indivi arti duals cle provides whose e sensitivity ana mployers contribute lysis on the to the Re account, tirement in Rea mos diness Ratin t years of the gs survey by givin the g a co dntributio ditional in n form level ation had changes to: EBRI Notes, 1100 13 St. NW, Suite 878, Washington, DC 11 20005-4051. HDHP Copyright 2012 by Employee Benefit . “Tax Reform Options: Promoting Retirement Security.” EBRI Issue Brief, no. 364 (Employee Benefit Research Greene, J., J. VanDerhei (M Hibb arch 20 ard, J.F 06). . Murray, S.M. Teutsch, and M.L. Berger. “The Impact of Consumer-Directed Health Plans On of simulated Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2006 retirement lifepaths that will not run sho -r 2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008 t of money. Figure 2 provides a more detailed -2011. way of see if this sitwheth uation coul er on fi d be nan addressed for cial data, option the state. T s, or trends, hat analysis are reve f aling ocused and primar reliable ily on sim — the re ulate aso d ret n EBRI informatio irement wealth n is Mean?” EBRI Issue Brief, no. 269 (Employee Benefit Research Institute, May 2004). Retirement Readiness Ratings and Retirement Savings EBRI has Research Institute. All rights reserved, Vol. 33, no. a gone to great lengths to model the major risk 6. s to retirement income adequacy since the initial introduction relaxe on the distri N d ot to Institute, Nove f il8 led a pr 0 bu perce tion of the likely num esnt. cri4% pti mber 20 on due to 11).c os ber o t or sfk y ippe ears before th d doses to ose at risk “run short of money,” as well as the percentage on the Advocates of percent CDHPs claim age of t4% he at ed that -risk popu they lation simultaneously that is relative prov ly close to ided consumers having wit ade h br quat oader choices than were e financial resources for currently no impa CDHP = consumer-driven health plan with deductible $1,000+ (individual), $2,000+ (family), with account. ct on access issues. However, in 2011, individuals whose employers contributed less than $1,000 were more 28 Prescripti the gold sta on Drug Use.” ndard fo Healt r priva h Affairs te analysts a 27, no. 4 (Jul nd de y/cisi Augus on t 2008): 11 makers, gove 11 -111 rnme 9. nt policymakers, the media, and 18 looking at the same results by showing the distribution of RSS (per individual) for Gen Xers by gender and with a compar ® ison to ad hoc thresholds for retirement expenditures. To examin An Apri l 20e h 11 earticle alth care a introdu cceced a ss issues, new me the sample was thod of analyz divided into thr ing the resultse from t e groups: he RSP those with CD M. Instead o HPs, those f simply computing with VanDerh make m ei (S edieptemb cation las er 20 t long 06er ) 32 29* 29* 31* 28* 28* 31*^ ® of RSPM * Difference between Employer Contributes to Account and Employer Does Not Contribute to Account is statistically significant a in 2003, including stochastic health care risks such as nursing home and home hea t p = 0.05 or better. lth care costs. Even Shortfalls for Gen Xers: The Impact of Eligibility for of compensation they wou 5% ld need in terms of additional savings to have a 50, 70, or 90 percent probability of retireme availabl likely tha . “Can America Afford e, w nt inc n tho hilome adequacy e the se with ir a em ggrplo egate decisions Ty . It also oer morrow contriprov 's Retirees: Re butio ides more would ca ns of at p cos least su detai lts F t$1,0 s lreom the EBRI-ERF more e d a 0n 0alysis on to re ffect port iv the ely than access issu Retireme dist top-down, ributio es nt Securit n(Figure of the conven y RSS. Pr 5). ojtionally ma ection Mo Unlike previou del. naged ” s the public. family . status. Testimon For y. U.S. exa 2% Cong mple,ress. Senate F 67.9 percent inanc of simulated e Committ ee. T retirement ax Reform pat Options: Prom hs for single ot male ing R Gen etire ment Security Xers do not (T-170). an overal HDHPs, and t Delay l per ed h c or ose wit entage of avoided h 2% tra getti thd en itional simulate g healthealth h cd l are ife c due paths overage. to cos in t Individu a particular co 31* als wer hort t e 33* ass higned at wo 32* to t uld not he 30* CDHP a have suf 28* ndf HD icient HP grou 2 retirem 6* ps 26* e i nt f they Figure 1 provides a similar type of analysis but focuses exclusively on the Gen Xer cohort. The population was filtered though 19 these EBRI Issue Brief, events will not no. 263 (E be exper mplo ienc yeee Be d by al nefl r it Researc etired ho h Institute, Novemb useholds, or experi er 200 ence3). d to the same extent, they can retirement income adequacy. Haviland, A.M., N. Sood, R.D. McDevitt, and analyses, this care plans had don article e. B focuses ut some analysts on thThe Em e Gen X warned that plo e M.S. Marquis. “T r cohort yee Benefi (bor t Research Institut con n betwe sumers lacked the he Effects en 19 of 65– e Cons (EB 19 disci RI) was founded in 1978. Its 74 ume ) ip r-Dir nlin ae nected Health Plans on Epis attem and sopphistica t to assess the impact tion to mission is to odes of Partici VanDerh ei a pation in a 401(k) Plan, nd Copeland (2008). p. 9 Subsequent 15 Sept. 20 to the rele 11. ase of the Oregon study, it was decided that the approach could be applied to other states as generate Either defi of tcits. he a bHowever ove , of the 32.1 percent of simulate 44 d retir 44*ement 43 pa * ths 43* for single 41* male 3Gen 9* Xers 42* that do income to had The de lenducti gth pay of bletime for t s of at h ine sim divi least dual ula $1,0 s ted had hel 0ex 0 for penses, d indi the vidual the n accounts coverage or ew meth had od co a statistically s $2, mpute 000 fo d t r family h igni e perce ficant cover n tage impa age. of ct To on acc househol be assigned ess ds that issues in to t woul he 20d m 11. CDHP eet in this manner to allow additional analysis on the impact of future years of 401(k) eligibility on the at-risk ratings. The contribute to, to encourage, and to enhance the development of sound employee benefit have catastrophic financial 0% consequences for the futureFigure 5 retirement income adequacy of the household. Many attempts Health Care.” Forum for Health Economics & Policy, Vol. 14: Iss. 2 (Health Policy), Article 9. 2011. that eli successfully n gib Shor ility tfall avigate for participatio Amount an increasingly n in a 40 com 1(k)p plan lex h has on ealth ca th re sy ese valu stem an es. d un derstand what care c is truly necessary. They EBRI explores the breadth of employee benefits and related issues. well. 20 Kansas and Massachus 0% etts wer 0e chosen as the next 1 ? 91 states for analysis. Results 0 ?19 CDHP of the Kansas 20study w + ere generate . “Kansas Future Retirem Shor defi tfallcits, Amount approximately ent Income A 1 in 4 generate ssessment Pro an RSS ject.” A project of of less than $50,000. the EBRI Educatio This represents n and Re 8.4 search F percen unt d a ofnd all Who we are a Among individuals with accounts for programs and so less than a und public policy year, 42 percent through objective reported that th resear ey or ch and a family educati mon. EBR ember di I is the only d not fill that requir group, Copela they nd a em m n ent more than u dst also have VanDerhei (2 a specifi had a 010).ccounts, 0ed percentage of such as HSAs times in t 1 ? or HRAs wit91 he sih mulation. a rollover0 ? 19 provision that the20 in + dividuals could 100 Van p De . “T erh rcent he Importanc ei (February of deemed 2 e of De 011 adeq ) descri fined Be uate in bes Access Issues Among Individuals With CDHP, come nefit Pl how ho th ans for Retire reshold useholds show (who ment Income A s thse heads at more th are curr deq an uac 60 y.” perc ently EBRI Notes, ent agof es 36–62) ar Gen no. 8 (Emplo Xers wi e tracked thro thout ye future e Benugh efit to model retirement income 0% adequacy either ignore this risk or make the assumption that all households purchase $1 ?$50,000 13.4% 7.4% 5.3% 12 3.8% saw the Not init f Shor illed a pr iati EBRI tfallve as an Amount estudie scripti oppo on due to s the worl rtunity for cos d tof health and retirement ben o em r skiployers to tr pped doses to ansfer a groefit wins g portion — issue of s risi such a ng costs to s 401(k)s, employees IRAs, retire (Jaffment e the Milbank Memorial Fund. July 16, 2002. Single Male Single Female Family presented to $1 t ?$50,000 he state’s Long-Term C 12.2% are Services Task Force on 8.4% July 11, 200 7.2 8% , and the results o 4.f4% the Massachusetts private, nonprofit, nonpartisan, Washington, DC-based organization committed exclusively to simulated retirement paths for single male Gen Xers. Another 5.7 percent of this group generates an RSS u pres se to cript pa Rese ions y f $50,001 o,r arch Institute, August 20 sme kippe ?$100,000 dicd al ex dospeesnse to make s or 7. th 3% 11): 7–1 med e abiilcations ity to ta 6. las ket th lo 6.e nger, 1% ir accounts or delay wit ed h them or avoid 4.6% shoul ed gettin d they c g health hange j 2. 7% care obs. Individu due to coal sts 21 by Level of Employer Contribution to Account, 2006–2011 Jaffe, Jim. "Ex 401 retireme (k) elnt a igibg ilie, an e ty cuti are simu ve Summary d how t lat heir ret ed ." In to ibe at reme Consu nt risk; howev m income/wealt er-Driven He er th alth Ben h is is simulate drops efits: A Contin to 18 d fpercent or theuin follo for g Ev win those oluti g compo on? with b y 20 or n P ents aul F more years of : ronstin. The article also provides a comparative analysis of the importance of nursing home and home health care costs on long-term car make m $1 incom edi ?e $50,000 insura catie on l ade n as ce tq at long uacy, retirem er consu ent. 8. m 4% er-driven benefits, 30 Socia 14 l .9% 31* Security, 24tax treatment of both retireme ^ 23 31*9. ^8% 28 25^ nt and health $50,001 ?$100,000 13.5% 13 7.4% 7.0% 4.6% VanDerhei (2009). 2002). public policy research and education on economic security and employee benefit issues. study were presented on Dec. 1, 2002. WithA T the assistance o A G L A N C f the Kansas Insuran E ce Department, EBRI was able to As explored in $101,000 the ? June $200,000 2011 EBRI 16 Issue .3% Brief, the RSP12 M. allow 1% ed retirement-incom 8.1% e adequacy to4. be 6% assessed at between $50,000–$100,000, while 11.5 percent have an 2006 RSS between 2007 $100,0 200800–$200,000 2009 . Only 2010 6.5 per 2011cent of ® (Figure 6). Ho $50,001 wever, ?$100,000 among those with 5.7% the accounts for one to two 8.4% years, 33 percent reported 10.0% some type of access with o . “Massachusetts F nly a flexible spending account uture Retirem (FSA ent Income Assess ) were not incl ment Project.” A uded in the CDHP project of the group. EBRI Education and Research DelW aya ed $101,000 shin or a gton, D v ?$200,000 oided Cgetti : Emplo ng hy eal ee 11 th Benefit .6% care due Res to earc costh Institute, 200 6.6% 37* 2. 38* 29* 6.3% ^ 26 22* 2.7% 23* 21 eligibility. Whe benefits, n the thresho cost manage ld for ad ment equac , worker a y is relaxe nd d f employe rom 100 r perce attitude nt of s, the policy reform p deemed aderq opo uate sals, income and p to on enslion y 90 asset per- s retirement income adequacy. Figures EBRI’s member 1–6 below are based o ship includes a ncross-section of the EBRI Retir pension funds; businesses; trade associations ement Security Projection Model (RSPM) ; TM More Than $200,000 29 9.8% 6.7% 4.2% 1.9% 22 Employer Contribution . “Capping Tax-Preferr Below $1,000 ed Retirement Contributions: Preliminary Evidence of the Impact of the National Commission on ? Social Security. create Retirement Readiness Ratings $101,000 ?$200,000 11 based on .5% a full stochastic dec 20.6% umulation model that took 8.6% into account the retirement a Mo gres later e Than $200, than 65. 000 1.8% 1.0% 0.9% 0.3% all VanDerhe simulate Fund an i (April 2 d retirement d the 010). Milba pat nk Memo hs forrial F singl ue n dmale . Dece Gen mber 1, 200 Xers produce 2. an RSS greater than $200,000. Either of the above 48 49* 38*^ 35 41* 38* 36 Figure 7 provi issue, and am and d ong es fundi th those wit e distribution ng. There is wi h the accou of RS de n S (per individua spread ts for thr re ecog e orn l) more ition for that if employee be Ge years, n Xers 32 by gender a percent reported some ty ne nfits d family data exist, EBRI kno status pe similar to of access w Figu issue. s it. re 2; labor unions; health care providers and insurers; government organizations; and service firms. cent, the at-risk ratings drop for all groups but the impact of 401(k) eligibility is still quite pronounced: Now those This re which simulat Not filled a prescription due to cost or skipped doses to make port Fiscal Res exe amines th s 1,0 pon 00 alter sibil e im ityn a pact of ative r nd Re plan eform Recomme tirem type, ent paths for health ndati stat ons.” each us, and incom househol EBRI Notes, d e on to ex no. 7 (Emplo the use o plicitly model investm ye f h e Be ealth ne care services. It a fit Researc ent, lon h Institute, Jul gevity and lso y More Than $200,000 6.5% 13.0% 1.3% household’s longevity risk, post-retirement investment risk, and exposure to potentially catastrophic nursing-home Individuals So urce we : EBre as RI/Cos mign moed nwea to lth F the und C HDHP o nsum gro erisup i m ® in H f tea hey lth C did are Su no rv t have ey, 2005 an -200 a7; ccount use EB RI/M GA C d ofno sr healt umer Enh gag car eme en expenses t in Health Ca with re a Parente, S.T., R. Feldman, and Y. Xu. “Impact of Full Replacement with Consumer Driven Health Plans on Total Health Care 23 Source: EBRI Retirement Security Projection Model, ® version 1514. Note the percentages in each column do not add to 100 percent because individuals Access medication last longer issues appear to Source: EBRI Retirement Security have fallen Projection over t Model, ime version regardless of 1514. Note the percentages th 29% e number in each column 24% of y do not add to ears 23% with 100 percent an a 31% ccount, because indiv but 26% iduals year-to-yea 25% r however, ? Defi201 ned contri in th 1): 2–6. is case all bution nu bal rsing hom ances. e and home health costs in retirement are assumed to disappear or at least be without any years of future 401(k) 30eligibili ® ty are simulated be at risk approximately 50 percent of the time, while examin stochastic hea VanDerhe es dii a ffend Co lrth care ences i pel risks (i.e., n th and (201 e use of 0). nursin health g h services wit ome and hom hin the e he CDHP alth care population. costs). Fi Data gure from t 7 below he modif 2005i-2 es RSPM 007 by Sur . “Oregon F vey Source: EBR , 2008 -20 u I ture Retire R 11 e.tirement Security ment Income A Projection Model, version ssessment 1514. Note the percentages Project.” A project of the EBRI Educatio in each column do not add to 100 percent because n an indiv d Re iduals search F without und a TMnd Use of He wialth Care Services a thout shortfalls are not displayed. For example 53.2 percent nd Access I of single male ssues Gen Xers with by Type of Health Plan: Findings no future years of eligibility for participation in a 401(k) plan are In a July 2011 without EBRI N shortfalls are otes not display artic ed. leFor , it provide example 60.9 percent d prelimi of married nG aen ry evidence Xer households w of ith the no future y impact ears of eligibility of the for “ pa20/ rticipatio 20n in ca a ps 401(k) ” on plan projected Comparing the results for Gen Xer single females with single males in Figure 2 shows that females are more and home-hea Delayed or avoided getting health care due to cost lth-care risks. This was followed by the expansion o 37 f RSPM an 30 d the R 27 etirement 22 Readiness Ratin 23 23 gs to rollover provision or Cost and Use of Preventive S portability if they ervices.” changed jobs. T Insurance Mark his grou ets and C p includ oe mpa s indivi nies: A duals nalyses an with HSA-eli d Actuaria gible he l Co alth mputatio plans but ns, EBRI delive shortfalls simulated are not display rto hav s a stead e no shortfalls. ed. For exy ample, 67.9 percent Tstream of invaluable research and anal his increases EBRI’s work advances knowledge and unders to 67.7 percent of single male G for those w en Xers ith are simulated one to nine yto ears of future eligibility have no shortfalls. tanding of emplo This and 77.8 y numbe sis. percent r is 43.1 percent for for those w yee benefits and their ith single 10 ?19 female a borne by changes w anot e are simulated re her entity. Co statistically to have no shortfalls. significant mparin This increases g Figu onlyr e f to o 7 to 76.6 r those perc Figure ent for with those 2 provi tw h ith e one to nine y acco des unts a vi ears of vid il for future three or mor lustration eligibility and of 77.9 percent for ehow impor years.those w tant the correct ith 10 ?19 Trad the Milb itio nal = h ank Me ealth plan w morial F ith no de und. 2 ductib001 le ora. <$1,000 (individual), <$ 2,000 (family). those with 20 or more years have an at-risk rating of approximately 12 percent. Approximately 30 percent of Gen Xer EBRI/Common completely elim winating ealth Fun the d C nuorsing home a nsumerism in n Health d home healt Care S hu c rvey an are risks to d the illustrate 2008-20 the 11 E extent BRI/M of GA Consu the errors intro mer Enga du gem ced ent in 24 Gen Xers and 70.2 percent for families. years. For those with 20 or more years of future eligibility, 87.0 percent have no simulated deficits. from the EBRI/MGA Consumer Enga Either of the above years. For those with 20 or more years of future eligibility, 88.1 percent hav gement in Health Care Survey, e no simulated 48 deficits. 40 36 41 by 37 Paul Fron38 stin, retirement acc ? IRA ba . “Retirement Income A lances. umulations prdeq oposed uacy: Alter by the Natio native T nh alresh Commission olds and the Importanc on Fiscal Resp e of Future onsibility a Elin gd R ibilit ey in form. Defined Contribution likely to experience a retirement importance to deficit (56.9 the nation’s econo percent of the my simulated among policy lifepaths makers, the news for single media, and femalesthe public. It vs. the a nationa VanDerhe b l mo i (Septemb del and the pr er 2010). esentation of the first micro-simulation retirement-income-adequacy model, built in part may also Vol. 1, No. 1, 2010. inc lu de indivEBRI iduals with high de publications include ductibl in-de es pwho th cove are rage not eli of key issues a gible to contribute t nd tren o HSAs. Tra ds; summd arie itional h s of rese ealth arch HDHP = high-deductible health plan with deductible $ 1 ,000+ (individual), $2,000+ (family), no acco unt. assumptions are. For example, with nursing home and home health care expenses modeled, 68 percent of single Employer Contribution $1,000 or More households with no future years of 401(k) eligibility are simulated to be at risk at an 80 percent threshold, while less in Healt models that hRetirement Plans.” Car ig e Survey nore these ris are used EBRI Notes, ks. for the a no. 4 (Emplo nalysis. yee Benefit Research Institute, April 2011): 10-19. 14 Ph.D., EBRI does this by conducting and publishing policy research, analysis, and special reports on c 32.1 percent for single males), but the conditional likelihood of having a large RSS is essentially the same as for What we do .CDHP “A Behavior = co nfinding sum al Mod er-drs ive e and nl for Predicti healpolicy th plan wdevelo ith ng E dedu m cplo p tibments; ley $ e1e ,0 Co 00+timel (ntri indibutio vid yu a factsheet lns to 401( ), $ 2,000+ (fs ak) Plans.” m on ily),hot topics; with acNorth America co unt. regular n up Actuari dates aon legi l Journal slative and 25 from administrative 401(k) data at the EBRI December 2003 policy forum. The basic model was subsequently coverage includes a broad range of plan types, including health maintenance organizations (HMOs), PPOs other Conclusion ? Defi Not filled a prescription due to cost or skipped doses to make ned benefit annuities and/or 31 lump-sum distributions. male Gen Xers are projected to have no financial shortfall in retirement. On the other hand, if these expenses are VanDerhei (October 2010a). than 5 percent of those with 20 or mor employ eee benef years of its issues; holding educational br 401(k) eligibility are simulated iefings for EBRI memb to be at risk. ers, congressional and The August 2011 EBRI Notes article evaluated the importance of defined benefit plans for households, assuming (2001). Parente, S.T * Differen ., cR. F e be regul tw eeen ldman, a atory HDHP /nd S. C de CDvelopment HP and T hen. “E raditio s; ffects of a Consumer-Driv na comp l is statre isthen ically s si ignif ve ic refere ant aten p nce = 0. Healt 05 resou o rh be Plan ttr er ces . ono Pharmace n benefit pro utical Spe grams ndi an ng a d wo ndrkforce single males. For example, 20 percent of the simulated retirement paths for single males that produce deficits medication last longer 32 25 25 33 35* 26 modified for testimony for the Senate Special Committee on Aging in 2004 to quantify the beneficial impact of a managed care plans, and plans with a broad variety of cost-sharing arrangements. The shared characteristics of this . “A Post-Crisis Assessment of Retirement Income Adequacy for Baby Boomers and Gen Xers.” EBRI Issue Brief, no. ? In 2011, 30 -40 percent of re federal agen spondents, de cy staff, and th pending o e news n the media; question, and sponsoring public opinion survey reported some type of health s on emplo care accy eee ss ignore There d, mor is a gro ew than ing 90 volum perce e ofn t of literature this grou thap is t nonet now h simul eless d araws ted tomi have xed n co onclusions shortfalls. wh Sien milar results it comes to a re pro the impact duced f ofo r 26 ^ Estimate is statistically different fro m the prior ye TM ar sho wn at the p = 0.05 o r better. individuals retire at age 65, while demonstrating the impact of defined benefit plans in achieving retirement income Delayed or avoided getting health care due to cost issues; and major surveys of public 15 attitudes. 39 26 27 22 25 20 ? Net housin Utilization.” g eqHe uity. alth Servic es Research 43, no. 5 (October 2008): 1542–1556. VanDerhei (October 2010b). Prior Research Retireme have an 354 (Emp RSS nt Readiness Ratings value lo ye grea e Benefit Rese ter than $200,000. arch Institute, Febru Th e samea value ry 2011). for single females is 23 percent. mandatory contribution of 5 percent o benefit issues. f compensation. EBRI’s Ed ucation and Research Fund (EBRI-ERF) performs the charitable, group are that members either have no deductibles or deductibles that are below current qualification thresholds for issue for either themselves or family members. Individuals in high-deductible health plans (HDHPs) were more VanDerhei, Jack, and Lori Lucas. “The Impact of Auto-enrollment and Automatic Contribution Escalation on Retirement single CDHPs fema on pre le v and ma entive rrie and d screenin Gen Xers. g se Phras rvices, ed a althou nother gh wa this y, re ignori search ng the finds impact that acces of nur s sing hom to health ecar aned hom services e he is alth an Either of the above 51 34 36 40 42 33* EBRI meetings present and explore issues with thought leaders from all sectors. adequacy for Baby Boomers and Gen Xers. Figure 1 CHECK OUT EBRI’S WEB SITE! educational, and scientific functions of the Institute. EBRI-ERF is a tax-exempt organization 27 Figure 5 Figure 3 Income Adequacy.” EBRI Issue Brief, no. 349 (Employee Benefit Research Institute, November 2010); and DCIIA HSA The Van literat Dtax pre erhei ure (f M er ais mixe ence and y 2012) d whe p that rovid n members it comes es update to th do n d infe impact of o ot rm have ation on th HRA- CD bHPs on as e e perc d plans enta prev .ge of entive househo and scrlds simulate eening servd t iceo s be . One stu at-risk of dy Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005 -2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008 - 2011. VanDerhe likely tha i (Fnebruar those with y 2011 tra ). ditional coverage to report acc Figure 7 ess issues. care costs in issue across t . Testimon r hee tirement y. U.S. Cong EBRI board.regula sign When ress. Senat ificantly rlit y comes to provides exaggerates th e H pla co ealth, Educ ngre n type, ssion e lik differe atio al en, Labor a lihood of testimony nces wer nd P achie , ean found ensi ving r d briefs p ons Comm betw etirem ee olicy e n n ittee. in tm income dividuals ake The W rs, adequacy. mem obbly Stool: in HDHPs ber orand ganizations, those Ro A househol we, J.W., d Tis conside . Brown-Steve red to nson, R.L. Do run short of w n money in ey, and J.P. Ne this mo wh del ous ife. “T aggre he Effect Of Consumer-D gate resources in retireme irected He nt are alth Pl not suf ans On ficient Retirement supported b Readiness y contributions Ratings and g for Gen rants. Xers, by Number of Future T The he same a distribu plan tion -typ of e di RSfS fe values rences ex per is t whe indivindual the for data are marr n ied ot house brokenh olds out by in healt Figure h status—individuals wit 2 appears to be quite h differ HDHPs are ent In an analysis Research Report to det Distribution ermine (Novemb Distribution the im of Retirement e pact o r 201of 0). f aRetirement nnuiti Sav zinig de ngs fi Sav Shortfalls ned contri ings 1 Shortfalls buti for on an Single d IRA for Female Gen balances at Xers, Gen retir Xers, ement age, CDHP = consumer-driven health plan with deductible $1,000+ (individual), $2,000+ (family), with account. 32 having insu examined four ffic employ iDistribution ent retireme ers th nat ado tof income Retirement pted f and ullassets to cover -replaceme Savings nt Shortfa CDHPs. retirem lls It ent expenses (per found t Indiv hat ev idual (based ery ) for one of the preventive m onGen the avera Xers, by ge ex penses o easufres Retireme and nt (In)security in America the media on employe (T-166). 7 Oct. 2010. r benefits. 28 EBRI’s S with traditio eptem nal ber covera 2011 ge. Sen Th ae te Financ survey has e tes fo timony und differ analyzed the pot ences between e th ntose ial im with pact o tradit f vional arious types coverage of tax-reform and CDHP The Use Of Preventiv Years of e And C Eligibility hron ic Illness S for Participation ervices.” Healt in a h Affairs 401(k) 27, no Plan . 1 (Januar and Percentage y/February 2008): 113 -120. to meet minimum retirement expenditures, defined as a combination of deterministic expenses from the Consumer nearly always * Difference between Employer Contribution Below $1,000 and Employer Contribution $1,000 or More is statistically significant a more likely than indivi duals with traditional coverage to have access issues, and, t p = 0.05 or better. while CDHP enrollees from VanDerhe ? Indivi that duals of i (April 2 single wit by by h 011). males hea Number Number lth an prob dof of single le Future Future ms are mor females, Years Years e likely tha but of of Eligibilit that Eligibilit nis tho toy y sbe e witho for for ex Participation Participation pec ut h ted e alth giveproblems n the in in a a implici 401(k) 401(k) to report t Plan div Plan e access issues. rsification VanDerhei and Copeland, 2004, were able to demonstrate that for a household seeking a 75 percent probability of In 2011, about 30 -40 percent of respondents reported some type of access issue for either themselves or a family Gender and Family Status: Assumes No Nursing Home or Home Health Care Costs 33 The or screeni those age error of n65 gs ignoring nursi or older thro had a EBR decreas I issuu ng home es g ehout in pre at l ss retire and ho erele ast o m as ennt i me he e e sfirm, n s on ne p alth c ecific but wsworthy tar hincome a ese d e costs is eve edevelopm creases nd agn wer e more grou ents, e n pin notice eand i ver gs seen determi able s among if in t one ned he sa the mo by foc me pr a uses on th proxy st eventive widely qu for th e e oted EBRI’s website is easy to use and packed with useful information! Look for options on retirement 25 incom % of e adequacy. T Deemed Adequate his was expan Income ded in the Required November for 20 Adequacy 11 EBRI Issue Brief and a new set enrollees in the past, but no statistically si EBRI Issue B gnificant riefs are period difference icals providing exp was found in 2 ert evaluati 011. ons of employee benefit issues and Expenditure Survey (as a function of income), and some health insurance and out-of-pocket health-related expenses, are existing sometimes in a two more l -person ikely t ho husehold. an those with In this traditional case, 70.2 cov percent erage to have access of simulated issues, the retirement dif pa fere ths nce for s betw families een the have m 29 . “Retirement Savi 16% ngs Shortfalls for Today’s Workers.” EBRI Notes, no. 10 (Employee Benefit Research Institute, retirement income adequacy, the additional savings that would otherwise need to be set aside each year until member. Findings from 30% the survey indicate that individuals in HDHPs were more likely than individuals with traditional sources on employee benefits by all media. 34 service Endnotes household’s re VanDerhe across all i and Co tirement four firms, and none pelan inco d (June 2 me) and un 011). of insured medical the firms exper cio ence sts for the du d a decrease in ration of their all preventive serv retirement. Th ices and screeni e Retirement ng perce ? Indivi ntageduals i of indivi n households duals with shortfal with less tha trends, as well ls (RSS valu n $as cr 50,0 es) itical analy 00 in in ann excess of sual es of in emplo $ come ar 100y,00 ee benefit po e more 0. Ignorin likely licies an g n t uh rsing hom an those d proposals. in e an h EB o d hom RI Notes useholds e his a ewit alth h 70% of sthese special features: urvey r Our esults were added to the model in the March 2012 EBRI Notes article. October 2010): 2 -9. plus stochastic expenses from nursing home and home health care (at least until the point such expenses are picked were not statistically significant in 2011. Over time, amo Figure 6 ng individuals with health problems, CDHP enrollees have no deficits. Focusing on families with RSS values in excess of $200,000, only 4 percent of family simulated TM retireme nt to achieve EBRI this o direct bs jective membe woul rs d decr and other constit ease by a me uen dian amo cies to u the informatio nt of 30 percent. Additional n they need an refin d unde ements rtakes were new coverage 1 to report that they or a fmonthly amily m period ember ical providing cu did not fill prescript rrent information on a variety ions, skipped doses to make of employ the me ee benefit topics. dication last care costs, fewer t measures. T Regar Readi 30 $50, n dess Rati les00 s of 0 or m h e decreases health ngsh oan re in wer pla 1 n ann e percent o ty w pr e pe, esented by ual re foun i i ndivi ncome to f sin d dua des g age cohort, le male or marri lsp ite t with repo h rt access issue h ee fact alth inco that pr ed m ob e quartile these serv Gen Xers lems s. are an h m ices were cov ave shor o d f re ulikely tha turetfal years ls en this large; ho red 100 of those 401(k without perc ) eligibility. ent wever healt by all wit h fo problems h th ur ose to See VanDerhei and Copeland (July 2010) for more detail. a 14% up VanDerhe by Medicai i (Jul Access Issues Among Individuals With CDHP, d).y This 2011). versio n of the model is constructed to simu by Length of Time WIth Account, 2006–2011 late retirement income adequacy based upon 16 experienc retirement ed declines path resea s with in rch repo a defic on a rting o n it ongoi (ofr ac 1.3 cess pro ng perce basis. nt blems, of allwh family ereas HDHP simulated enrollees retirement and th paths ose wit) hge tra nerate ditional cov a value erage this EBRI’s Fundamentals of Employee Benefit Programs offers a straightforward, basic introduced in 2005 to evalu 60% ate the impact 35 of purchasing long-term care insurance on retirement income adequacy. longer, • publications or EBRI’s entire lib delayed or avoide rary of research publicat d getting health care due to ions starts at the m cost. Overall, 42 perc ain W ent ofe those in b page. Click on HDHPs reported so EBRI me Endnotes . “Retirement Income Adequacy for Today’s Workers: How Certain, How Much Will It Cost, and How Does Eligibility for employers Finally, the Ma in th y 20 e stu 12 d20 25 y. EBRI Notes % % article provided 2012 updates for the previously published EBRI Retirement assumptions i report access n issues, cluded in and the individuals in hou model, approximately seholds 18 with percent less than of sin $50,000 gle males in and 1 annual 0income percentar of e fm amilies ar ore likely tha e now in n 2 explanation of employee benef 2006 it programs 2007in the pr 2008 ivate and 2009 public sec 2010 tors. The 2011 EBRI meetin 31 g the a verage EBRI ex maintains an penses of those a d analy ge 6 ze5 s or the mo older t st hcomp rougho reut ret hensi irement ve databa in sse pec of ific 401(k) income -type and a prog geram gros u pi in the ngs large. have e See ? Length Van Howev xperien Derh of t ei (October 20 e ced r, ime given no ch individu that ange 10) for more detail. als ha or an thesed incr are been eper as w e in -iindividual th c some yea onsumer-drive RSS rs. values, n hea alth $200,000 plans (C DHPs) had family RSSan im would pact on involve access issues a sum of at 1 Participation i TM n a Defined Contribution Plan Help?” EBRI Notes, no. 9 (Employee Benefit Research Institute, Sept. Approximately 44 percent of the Baby Boomer and Gen Xer households were simulated to be at-risk assuming they typ VanDerh e of access issue, com Issue Briefs ei (August 20 and 11). pared EBRI Notes with 31 per for our in-depth and cent among those with nonpartisan periodicals. traditional coverage (Figure 1). Just over one-third See Parente, Feldman, and Xu (2010). Readi this ran those nin ess Rati ge. house The results h ngs olds as with we are $5 ll e0 v as the ,en more 000 or mor Retirem proen ie ounce nnt Savi annd u al for si ngs inco Sngle h m ortfalls. e f to r emales. e port Ignorin access g issues. nursing home and home health care Had account <1 year 12% Databook on Employee Benefits is a statistical reference work on employee benefit programs 50% world. Its computer simulation analyses on Social Security reform and retirement income adequacy determin201 ed by 0): 13– a proxy 20. for the household’s retirement income plus uninsured medical costs for the duration of thei 3 r The mode in 20l 11 wa . s next used in March of 2006 to evaluate the impact of defined benefit freezes on participants by least $400,000 between the two family members. 3 (36 percent) o Other stu retired at d age ies have fo 65 a f those with C nd retai und si nmilarities eD dHPs reported some type of any net bet hou ween H sing e RqA-base uity in d e retireme acces nrolle s is es nt u sue, but an nd til other pref therre e dif financi d fer pre ovider or nce betw al resourc gani een es w z a indivi tion ere de duals (PPO plete ) wit d.h 2 Not filled a prescription due to cost or skipped doses to make 32 At that point it was assumed that the house and work for would be sold, ce-related issuesthe retirees would move to an . apartment and any net proceeds expenses, fewer than 5 percent of are likely to experience shortfalls of more than $100,000, compared with See Rowe, Brown-Stevenson, are unique. Downey, and Newhouse (2008). VanDerhei (September 201 20% 1). Percentage of retirement; ho simulating the minimum wever, altern ema ployer-co tive versions o ntribution rat f the model a e that woul llow similar d be ne ana eded to lysis for replac financially in ement r demn ates, s ify the em tandar ploye d-of-living es for medication last longer • Visit EBRI’s blog. 28 27 25 33 30 27 15% 40% enrollees regarding the use of preventive, cancer-screening services and diabetic-monitoring services over the 2003– CDHPs an Among indivi d th dose with uals wit 10 h tradit %HRAs ional cover or HSAs, age very was few not statisti differences cally signific in access issues were ant. In some fo pr und ior years, th by whethe e r dif em fere ployers nce wo Income Differences uld be used as a lump s um (as oppo sed to annuitizing the proceeds). ? Among i . “The Impact of Automa ndividuals with C tic Enrollm DHPs for ent i less tha n 401(k) Pl n a yeans ar, 42 on F percent uture Retir report ement Accumu ed access issues, compared lations: A Simulatio with n Stud 33 y per- Based appro ximately Population 34 percent when this reality is modeled. 3 17 Delayed or avoided getting health care due to cost 33 38 26 29 20 26 28 calculations, See Buntin, Haviland, Mc 2and other ad Dev hoc thresholds. itt, and Sood (2011). 3 The the re follo ductio winn i g sensitivity ana n their expectled r ysis on the etireme ba nt income seline RSPM under by ag various rate e cohort- displays the of-return assum perp centage of tions. Later that year, an households expe cted VanDerhei (November 2011) on Plan Design Modifications Contact EBRI of Large Pl an Publications, (2 Sponsors.” EBRI Issue Brief, 02) 659-0670; fax publication no. 341 (Emp orders to loyee Ben (20 efit Re 2) 775-6312. search betw 200 contribut 5 perio eenExpected to CDH ed d,to including moderate r P the enro account Be at llees an od those r not or e wit du byctio h the trns in aditional leveluse of of cover contri preventive age bution. was statis servi Howev ces, tically signific er, fewer the length office visits, fewer emer a n of t. time individuals ha gency d ow r ne oom d The Impact on Retirement Savings Sh cent of those with CDHPs for one to two years, an ortfalls of Eligibility d 32 percent among those with in a Defined CDHPs for three or more years. Fig 4 ure EBRI make Either of the above 3 shows the s information freel percentage of individu y av als reporti ailable to al ng access issues by p l. lan type over time for those above and 48 38 38 42 39 42 30% ® It should be noted that these values are present values at age 65, expressed in 2012 dollars. If inflation were included in 4 • EBRI’s reliable health and retirement surveys are just a click away through the topic boxes at updated versi Percentage of on of the 15 model % was develo Subscriptions to ped to EBRI enha Issue Bri nce the 4 EBRI efs are included interactive as part of Ballpark E$timate EBRI membership, or as part of worksheet by a 5 to be below Institute, April 201 the percenta 8% ge 0). of deemed adequate income. The percentage of deemed adequate income for those See Charlton, Levy, High, Schneider, and Brooks (2011). visits, reduced breast 34 -cancer and cervical-cancer screening, and reductions in inpatient care and visits to specialists. the account EBRI had an assume impact s on a publi access issu c service re es in 20 spo 11. n si Fu bility rthermore, to make acits finding cess issues appear to s completely have acce fallen ssible over tim at www.ebri.org e for Contribution Retirement Plan Orders/ -2 years belo VanDer Had account w $50, hei (March 2012). 000 of 1 annual ho usehold income. Just like the findings by health status, in every year for every plan type, Deemed Adequate The baseline version of the model $199 annual sub used for this an scription alysis to assumes all EBRI Notes workers re and EBRI Issue tire at age 65 a Briefs. Change of nd immediately begin Address: EBRI, these values, they would be increased (on an individual basis) by 70–122 percent. Conclusio the top of the page. n 10% p households roviding Monte at risk is de Carlo si fin mu ed lati as: 1– ons of (acc the ne umulated valu cessary repl e o acfe defic ment r its ge ates ne needed for rated at th specific e time all pro mem babili be ties of rs of th retirem e ent- Over time, 5 HDHP enrollees did not experience a decline in access issues. However, HDHP enrollees were more likely 20% — so that all decisions that relate to employee benefits, whether made in Congress or board rooms or those Not filled a prescription due to cost or skipped doses to make holding Income the accounts for one to two years and three or more years, but not for those with accounts for less See Haviland, Sood, McDevitt, and Marquis (2011). indivi d. “Falling Stocks: What uals in households with less tha Will Happen to Re 1100 13th St. NW, Suite 878, Washington, n $50,0tirees' Incomes? T 00 in annual income ar he Worker e always statistically signific DC, 20005-4051, (202) 659-0670; fax number, Perspective,” Presentation for antly more The Econ likelomic y than As noted in VanDerhei (May 2012), eligibility for participation in a defined contribution plan can have a significantly 35 to withdraw money from their individual accounts (defined contributio 18 n and cash balance plans, as well as IRAs) ® 6% 5 Subscriptions income a VanDer medication last longer d hei (May 201 equ or Low acy un er der 2). alternative-risk-management treatments. 35* 24 23 29 27 24 in 2 T Recent household hav he0 re al 11 updates to the EBRI tha so are mi n i families’ n 2 e died, 010 xed to r ho divi find m ep de ie ns, gs ab o d by t RSPM rt acces are ou h based e a t th sho s is ccum ew s iu on the highe m t es hat the p ulated valu with act of CD pr percen esHP cri st e o s p qualit tage o ftion on the prescri total dru y, f most depe Ge gs retir : n X p T tio hos en e r an dr ment e re ug use. O nda d portin Baby ex blpen e B g informatio d pres oom househol nitures for e stu cri dp y fo tion n. the un EBRI’s Web -dd that ds in rug ac household). 20 CDHP ces 12s is site sues po sts This material first appeared i 10% n VanDerhei and Copeland (July 2010). Retirement Readiness Ratings and Retire Crisis of 2008: What Will Hap (202) 775-6312 pen to Retirees ; e-mail: ’ Incomes? subs ment Savings Shortfalls for Gen Xers: 2009 APPAM Fall Confer criptions@ebri.org Membe ence (November 2009) rship Information: Inquiries . than 6 a year. 7 pos those in itive im house pacth on r olds ewith ducing $5 0 thes ,000 e s or mor avings e i shortfalls. T n annual inco he de me to r ficit values eport that they for those or a ass f umed to amily mem have ber n di o futur d note fi ye ll a ars of See • Parente, Need a number? Check out the Feldman, and 10% Chen (2008). EBRI Databook on Employee Benefits. whenever t Delayed or avoided getting health care due to cost he sum of their expenses and uninsured medical ex 42 penses e30 xceed the a 24*fter-tax22 annual i22 ncome from 19* all research findings, publications, and news alerts. EBRI also extends its education and public service enrollees continued to use brand-name and fewer generic drugs in the second year of program, but the generic-drug increased fro simulated to h mave adequate 28 percent to 31 percent. retireme regarding nt inc CDHP EBRI ome has i membership an enrol nlcre ees ased did not d/or con by 5 e to xperienc t8 ributio perce ns enta any to EBRI-ER ge statistically signi points since F should be dir 20 ficant 03. Ho ected increase wever, to EBRI in there The Impact of Eligibility for Participation in a 401(k) Plan, by Jack VanDerhei, Ph.D., 6 Either of the above 54 41 35 40 39 33* prescription, skipped dos 4% es to make the medication last longer, or delayed or avoided getting health care due to cost. 7 eligi The nomina bility (as if l cost of these e they wer 5%e nexver simulate penditures in d crto be eases em witploye h compon d in th ent-sp e future ecific inflatio by an or n ass ganiu zmptio ation that ns. See prothe app vides acc endi ess to x for Social Security and defined benefit plans (if any). If there is sufficient money to pay expenses without tapping into the RSPM This form was significant ulati role on provi to improving Ameri ly e des a nha relatively nced for the c simple ans’ Mfinan ay 20 way of cial 08 EBRI de knte owle rmining w podge licy forum thro hat ugh by allowi perce its a ntage wng aut ard of -win households omatic enro ning publi ar c llment of e close to service 4 cam 0 the 1(k paign ) . Testimony. Joint DOL/SEC Public H President Dallas earing on T Salisbur argy et Dates F at the above unds address, ( . How W 202) 659-0670; ould Target-D e-mail: ate Fu salisbur nds Like y@ebri.org ly Impac t See Greene, Hibbard, Murray, Teutsch, and Berger (2008). access issues use re is still a ductions signifiover time. cant percent did not persist. CDHP In afge o act, in f ho a n useho enrol umber of llds that ees w years, th ith c areh simulated to ronic con ey experi ditions enc be e at risk of did not d a decline use m not inbein o the re dr g a perce ugs t ble to nh tage re acover retir n those portin in ot eg ac me he nt cess r 0% Appendix EBRI ® 8 •Had account Instan3 or more years tly get e-m 5% ail noti?cations of the latest EBRI data, surveys, publications, and m 19 eetings (Statistical those pla more details. F nu s) is ap significan ture 401(k) proximat ce t Contri ests across incom elbutio y $78,00 ns? (T 0 -160). June 200 pere are 100 indivi % not sho dual. Th 9. wa n i t shortfall n the ta decr bl 90% e.) eases substantially for80% those with between ChoosetoSave and the companion site www.choosetosave.org tax-q participants ualified i with the pot ndividual acco ential for unts, automat the exceiss is assumed to c escalation of cobe ntr invest ibution es t d in a o be non incl-ud tax-a ed.dvantaged Additional account modifications where the were threshold: 8 plan designs. CDHP enrollees used more mail-order drugs than PPO enrollees in all three years. There was no issues. The ov expenses and erall uninsure percdenta mege o dicalf costs thr CDHP enrollees ough the report entiring e duration access issues was of their retirem nearl ey 50 nt years percent (for iex n 2 ample, 005 an 43. d 20 9 per- 06, See Ch Not filled a prescription due to cost or skipped doses to make en, Levin, and Gartner (2010). 2% 9 This Editorial Bo study is b ard: ased Dallas L on dat . Salisbur 0a from y, publisher the 2005 ; Stephen Blakely -2007 EBRI/Co , editor mmonwealt . Any views expr h Fun essed in this p d Consum ublicat erism ion and th in Healt ose o h fCare the author Surv s sho ey uand ld and seminars by clicking on the “Notify Me” or 60.7% “RSS” buttons at the top of our ho 49.5% 30.7% me page. one and nine years of future eligibility, to $55,000 and even further to about $39,000 for those with 10–19 years of 7 investment i ? The dollar value of retireme ncome is taxed as ordinary nt savings income. shortfalls for The individual ac Gen Xers varies co counts are tra nsidera 6 cked u bly wit ntil t h the he num point at ber whic of future h they are years added in 20Future 09 for a Pension Research Council presentation that involved a “winners/losers” ana ® lysis of defined benefit medication last longer 28 20^ 20 32 29 24 IRS tax tables from 2009 are used to compute the tax owed on the amounts received from defined benefit plans and Social and dif cen fere not be t of by . n the “ 2011 t ce bet Retirement Income A ascribed to the officers, Gew his was n X een er ho CDH down useholds P anto 36 percent. trust deq d point are uac ees, y -of at r m After PPA and FAS 158: Part One e-m se isk under th bers, or rvice (POS In co other sponsors of the E ntrast, i e ) en baselin n rollees divie assu duals in mai m wit mptions for ploye lh — -order use. traditional Plan Sp e Benefit Research R ons SPM c o orverage were s' Reactions ). Institute, the EBRI Educ .”more likely in EBRI Issue Brief, ation and 2011 no. 9 Among CDHP enrollees there was no change in the percentage reporting access issues for the lower-income group, the 2008-2011 EBRI/M 0% GA 1Co ?9nsumer Engagement 41.1% in Health Care Surv 30.1 ey %. These are online surveys 16.3% of privately insured See Havila Ynd, Sood, McDevitt, and Marquis ears of (2011). EBRI is sup ported by organizations from all industries and sectors that appreciate the value of futureDelayed or avoided getting health care due to cost eligi Shor bilit tfall y. Ge Amount n Xers fortunate enough to have at least 20 years of future eligibility in those programs could find 0% 0 33 33 24 23 20+ 23 18^ deplete freez Resear e of el s, an d. At t ch Fund, igi d t bility h hat poi e e or fo their nhanc r 40 n staffs. t, a 1(k ed ny ) Nothin employer plans net ho g her , partic using e e cont in is to be co ularly ributions quity is fnstr or those i assumed to ued as an attem provid 1n th ?ed to 91 e be a p hig t to aid or defhine d est sever de d contribution d to r hindere the adoption ity category tirem0 ?19 e plans at th nt savings i of a (si nym pending le ulated e tim n the form to e gislat the ha ion, defi ve a short of re a l gulation, ned ump- f all Shortfall Amount 307 (Employee Benefit Research Institute, July 2007). Security (with the percentage of Social Sec 0 urity benefits subject to federal income tax proxied as a functi 20on of the vari + ous 0% 1 ?910 ?19 than in 20 Eligibility 10 to report in some type of access issue. ShortfallAmount 10 ?19 but thEither of the above e higher-income group reported decli Single Ma 30.6 lenes in % a number of43 years, m Single F 21.4 ema% le 36 ost recently 32^ for prescri 39 10.4 Fp am tion i% ly 37 drugs in 20 32^11. adults 10 or interpretative ages $1 21 ?$50,000 -64, rule, or as fielde legal, d 20 in acco August unting, 17.1% ofactuarial, o each year. r other such prof The su 10.1% rveys essional advice. were conducte 7.5% d to provide national 4.6% ly representative unbiased, reliable information on employee benefits. Visit www.ebri.org/about/join/ for more. There’s lots more! their average shortfall at retirement reduced to only $23,000. sum distributi People were defined as of $20$1 0,00 ?on (not a $50,000 0 or more): reverse annu havi 1ng health probl 3 percent 20.5% ity m of t ortgage). hose w ems if they sai ith If no f al 13 l the retirem .d 2% utu thre years o ey were in entf savings ar fair or poor h 401(k 9.8% ) eligi e exhausted an b eility alth or h have shortfa ad on d 5.e of eigh 5% if th llse Soc in tt ch his ran ial ronic ge bene Another stu fit plans a 401(k) d were y foun froz d then. at us e of prescription drugs to treat hypertension and cholesterol fell, whereas there was no A problem with simply classifying a household as “at risk” or not is that some households may be missing the retirement income components) as well as the individual account withdrawals. $1 ?$50,000 7.4% 14.9% 5.3% Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005 $50,001 ?$100,000 9.5% 7.0% -2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008 5.8% 3.5% -2011. 20+ 18.2% 11.7% 4.8% Among lo wer-income HDHP enrollees, reporting of access issues increased in 2011 and was unchanged in the higher- data re . “Measuring Retirement Income Adeq gard$50,001 ing th ?e $100,000 growth of CDH10 Ps .3% and HDHPs uacy: Calc and ulati th7. e ng Re 9% impaalistic Inc ct of thes oe me Re plans 7.0% plac and em cons ent Rates.” umer eng EBRI Issue Brief, 4.a 2% gement more no. health co a nditions ( Plan arthritis, asthma, emphysema or lung disease, cancer, depression, diabetes, heart attack or other heart Security CDHP = consumer-driven health plan with deductible $1,000+ (individual), $2,000+ (family), with account. vs. only 3 per and defin $101,000 $50,001 ? ? $100,000 e $200,000 cd be ent for nef those it payments ar with 21.0%1. 20 or mo 9%e not suff re years. icient 15 t .0% o pay bas 14.4% ic expens 11 es .4% , the entity is des 1.7% ig 6.n 9% ated as having threshold by change in th a e relative use of asthma ly sma, de ll amount. pression, Wh or ulcer en the thr meedic sho ations. Th ld is relaxed t e study o only foun 90 d tha pertc 17 ent of percent the sim of the ulated e highx er- penses 8 EBRI Notes $101,000 is register ?$200,000 ed in the U.S. Patent and T Visit EBRI on-line today: rademark Office. ISSN: 1085 ?445www.ebri.org 2 1085 ?4452/90 $ . 50+.50 297 (Employee Benefit Rese 26.0% arch Institute, Septemb 19.6% er 2006). 15.5% 10.1% Figure income group. disease, high cholesterol or hyperten Roth IRA and 3 provid 401(k) acco es the distribution o unts are not used sion f RS, h S figh o in this versio r Gen X blood pressu ers cn of ategoriz re, or stroke). the model ed by b the n ut wiu ll b mbe e incor r of futur porate ed ye into a f ars of el orthcomi igibility ng EB for RI gene Health St rally on $101,000 tatus Differences he behavior ?$200,000 and attitudes 0.3% of adults with private health 4.8% insurance coverage. More 0. 5% information about the Also in * Difference between Had Account <1 Year and Had Account 1 2009 a More T ne haw su n $200, brouti 000 ne was adde 13.1% d to the mo -2 Years is statistically significant at p del t 9.0 o % allow simulations of var = 0.05 or better. 5.7% ious styles of tar 3.2 g % et-date funds for “run short of money” at that time. deductible C Mo D rHP enrol e Than $200,l000 ees taking m 17.5% edicine to treat hypertensi 13.0% on in late 2003 7. w 9%ere no longer taking t 5.2% he medication in for example, the percentage of Gen Xer households simulated to be at risk drops to approximately one-third (33.8 per- More Than $200,000 0.0% 0.0% 0.0% ? Future eligibility for 401(k) plans makes a signific 21 ant difference in reducing the percentage of households with ^ Difference between Had Account <1 Year and Had Account 3+ Years is statistically significant at p ® = 0.05 or better. publication. 201 partici 1 EB patin RI/M Source: EBRI Retirement Se g iGA n a Consumer 401(k) pla Engagement n. Approximat curity Projection inely 3 Health Model, 9 perce v Ca ersion 1520. re ntS of urvey Gen Xers can be with found no in t future he years of December 40 201 1(k) el 1 EBRI igibility Notes ar e a comparison with participant-directed inve ®stments. In April 2010, the model was completely re-parameterized with Figure 2 shows the percentage of individuals reporting access issues by plan type over time for those with, and . “Define Source: EBR d Benefit Pl I Retirement Security an Freezes: Projection W M ho' odel, s Affected, How ®version 1514. The percentages Much, and R in each column epldo not add to 100 percent acing Lost Accruals.” because EBRI Issue Brief, individuals without no. 291 ce 200 nt). 4. Amon Reducing the Source: EBR g individuals thre I Retirement Security shold f who continu urther Projection t ed to o M only odel, take m version 80 per 1514. edicat cent of Note the percentages ions after the sim movi in ulated e each ng to column xdo not add to 100 percent pe CDHPs, nses decr there eases t was no because he at indiv observed re iduals risk rating to duction # Difference between Had Account 1 -2 Years and Had Account 3+ Years is statistically significant at p = 0.05 or better. shortfalls are not displayed. For example, 39.3 percent of Gen Xers with no future years of eligibility for participation in a 401(k) plan are simulated to have no shortfalls of $200,000 or more for all g ® ender/family status combinations, but single females 22 experience the 10 simulated to h Source: EBR without ave no shortfalls I Re shortfa tirement Security are not display lls, but ed. Projection For ex 1ample, 3M per odel, 25.8 cvent of ersion percent 1518. N this of singl ote the percentages gr e female oup is Gen X simulat ers w in each ith no future colu ed to mn years do not add to have of eligibility sh 100 percent ortfalls of for participation because mor in a 401(k) plan indiv e iduals than without $200,000. In ( 9 Fronstin(Emplo 2011)ye . e Benefit Research Institute, March 2006). 401(k) plan-design 7 parameters for sponsors that had adopted automatic-enrollment provisions. A completely without, health problems. In every year for every plan type, individuals with health problems are always statistically th Capital gain shortfalls. s treatment is no This increases to 58.9 percent t used in this v for those we ith rsio one to nine y n of the mode ears of future l. eligibility and 69.5 percent for those with 10 ?19 years. For those with 20 or in adherence. shortfalls are simulated are not display to have no shortfalls. ed. For example, 90.4 percent This increases to 46.3 of single percent for male Gthose w en Xers ith are simulated one to nine yto hav ears of e future eligibility no shortfalls. T and his numb 59.8 percent for er is 65.9 percent those w for ith single 10 ?19 less than 1 in 5 (19.4 percent). © 2012, Employee Benefit Research Institute 1100 13 Street ?Educ NW · Suite 878 ation and Re search Fund. All rights reserved. largest absolute reduction in the percentage of those with shortfalls in this range. more years of future eligibility, 81.8 percent have no simulated deficits. female G years. For those w en Xers and 92.5 ith 20 or percent for more years of families. future eligibility, 75.0 percent have no simulated deficits. Washington, DC 20005 ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org No No No No No No No No No No No No No No Nottttttttttttttte e e e e e e e e e e e e e es s s ss s s s s s s ss s s • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vo • June 2012 • Vol. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 l. 33, No. 6 16 13 10 18 17 11 20 21 19 3 2 6 4 9 8 (202) 659-0670 www.ebri.org www.choosetosave.org A monthl y newsletter from the EBRI Education and Research Fund © 2012 Employee Benefit Research Institute ebri.org Notes • June 2012 • Vol. 33, No. 6 ebri.org Notes • June 2012 • Vol. 33, No. 6 ebri.org Notes • June 2012 • Vol. 33, No. 6 ebri.org Notes • June 2012 • Vol. 33, No. 6 ebri.org Notes • June 2012 • Vol. 33, No. 6 14 15 12 5 7 Figure 2 Access Issues, by Type of Health Plan and Health Status, 2005–2011 Health Problem** No Health Problem** 2005 2006 2007 2008 2009 2010 2011 2005 2006 2007 2008 2009 2010 2011 a Traditional Not filled a prescription due to cost or skipped doses to make medication last longer 29% 27% 29% 28% 29% 28% 30% 14% 0 16% 13%^ 14% 18%^ 16% Delayed or avoided getting health care due to cost 20 23 18^ 23^ 17^ 16 22 13 16 14 21^ 12^ 9^ 15^ Either of the above 35 34 33 37 35 34 37^ 20 25 23 29^ 21^ 22 24 b HDHP Not filled a prescription due to cost or skipped doses to make medication last longer 40 35* 35 38* 36* 35* 38*^ 22 22 21 21* 15 20 21* Delayed or avoided getting health care due to cost 31* 37* 35 34* 34* 32* 31* 31* 28* 27 26 20* 19* 20* Either of the above 48 50* 49 49* 49* 46* 48* 39 38* 37 35 31* 32* 34* c CDHP Not filled a prescription due to cost or skipped doses to make medication last longer 39 38* 34 32 40* 36 31^ 20 25* 16^ 16 24* 21 19 Delayed or avoided getting health care due to cost 44* 42* 32^ 32 29* 28* 27 31* 35* 26^ 22 15 19* 16 Either of the above 58 55* 46^ 44 49* 48* 42^ 39 44* 32^ 29 32* 30 29 Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005 -2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008 -2011. a Traditional = health plan with no deductible or <$1,000 (individual), <$2,000 (family). b HDHP = high-deductible health plan with deductible $1,000+ (individual), $2,000+ (family), no account. c CDHP = consumer-driven health plan with deductible $1,000+ (individual), $2,000+ (family), with account. * Difference between HDHP/CDHP and Traditional is statistically significant at p = 0.05 or better. ** Health problem defined as fair or poor health or one of eight chronic health conditions. ^ Estimate is statistically different from the prior year shown at the p = 0.05 or better. Figure 3 Access Issues, by Type of Health Plan and Household Income, 2005–2011 Less Than $50,000 Yearly Household Income $50,000 or More Yearly Household Income 2005 2006 2007 2008 2009 2010 2011 2005 2006 2007 2008 2009 2010 2011 a Traditional Not filled a prescription due to cost or skipped doses to make medication last longer 31% 29% 33% 28% 29% 30% 32% 18% 19% 18% 17% 21%^ 20% 20% Delayed or avoided getting health care due to cost 24 29 26 35^ 18^ 18 27^ 13 14 12^ 16^ 14 10^ 15^ Either of the above 39 42 41 47^ 36^ 38 41 24 25 23 26^ 27 24^ 17^ b HDHP Not filled a prescription due to cost or skipped doses to make medication last longer 38 31 36 35 33 31 38^ 30 27* 27 28* 27* 27* 28* Delayed or avoided getting health care due to cost 41 36 40 37 39* 33*^ 36* 28* 30* 29 28* 25* 24* 22* Either of the above 53 48 53 51 50* 46 53*^ 40 41* 40 40* 38* 38* 37* c CDHP Not filled a prescription due to cost or skipped doses to make medication last longer 36 33 32 28 35 28 32 28 29* 22^ 22 31*^ 29* 24^ Delayed or avoided getting health care due to cost 49* 40 34 33 38* 30 33 31* 37* 29^ 25* 20* 23* 20* Either of the above 56 53 48 45 50* 44 48 45 47* 36^ 33 40* 38* 34*^ Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005 -2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008 -2011. a Traditional = health plan with no deductible or <$1,000 (individual), <$2,000 (family). b HDHP = high-deductible health plan with deductible $1,000+ (individual), $2,000+ (family), no account. c CDHP = consumer-driven health plan with deductible $1,000+ (individual), $2,000+ (family), with account. * Difference between HDHP/CDHP and Traditional is statistically significant at p = 0.05 or better. ^ Estimate is statistically different from the prior year shown at the p = 0.05 or better.