At a Glance | July 7, 2022 Coverage Expansion in HSA Health Plans Shows Little Impact on Premiums IRS Notice 2019-45 allows HSA-eligible health plans to cover 14 medications and health services prior to meeting the plan deductible. DIAGNOSES AND DEDUCTIBLES Prevalence of Diagnoses Pertaining to IRS Notice 2019-45 and Percentage of Diagnosed Users Meeting Deductible Overall, 14 percent of enrollees had a diagnosis pertaining All Enrollees Overall to the IRS Notice and 7–8 % Diagnosed % Meeting Deductible 14% 7–8% percent of all enrollees met their deductible. Diagnosed Enrollees Medication / Service % With Diagnosis Meeting Deductible Heart Disease Beta Blockers 7% 25–37% The percentage of users Statins 20–26% meeting their deductible was ACE Inhibitors much higher among those using 19–25% the health care services listed in LDL Testing 17–25% the IRS notice. Hypertension Blood Pressure Monitor 5% 41–46% Depression SSRIs 4% 23–30% Diabetes Glucometer 33–34% 3% Retinopathy Screening 22–28% Insulin 24–26% HbA1c Testing 20–25% Asthma Inhaled Corticosteroids 1% 21–29% Peak Flow Meter 21–27% Osteopororsis Antiresorptive Therapy 0.3% 28–30% Bleeding Disorder INR Testing 0.1% 39–42% NEGLIGIBLE INCREASE Impact of Expanding Pre-Deductible Coverage in HSA-Eligible Health Plans on Premiums in Differing Scenarios The impact on premiums of expanding pre-deductible No Change in Usage of Health Care All Enrollees Diagnosed Enrollees coverage for 14 services No Additional Cost Sharing +0.6% +0.3% in HSA-eligible health plans Coinsurance Imposed +0.2% +0.03% as allowed in IRS Notice 2019-45 is small. Estimated premium increases range Increased Health Care Usage All Enrollees Diagnosed Enrollees from virtually zero (0.03%) No Additional Cost Sharing +1.5% 0.9% to 1.5 percent. Coinsurance Imposed +1.0% 0.6% SOURCE: Fronstin, Paul, M. Christopher Roebuck, and A. Mark Fendrick, “The Impact of Expanding Pre-Deductible Coverage in HSA-Eligible Health Plans on Premiums,” EBRI Issue Brief, no. 558 (May 19, 2022). This study was conducted through the EBRI Center for Research on Health Benefits Innovation (EBRI CRHBI), with the funding support of the following organizations: Aon, Blue Cross Blue Shield Association, ICUBA, JP Morgan Chase, National Pharmaceutical Council, Pfizer, and PhRMA. © 2022 EBRI This report is copyrighted by the Employee Benefit Research Institute (EBRI). You may copy, print, or download this report solely for personal and noncommercial use, provided that all hard copies retain any and all copyright and other applicable notices contained therein, and you may cite or quote small portions of the report provided that you do so verbatim and with proper citation. Any use beyond the scope of the foregoing requires EBRI’s prior express permission. For permissions, please contact EBRI at permissions@ebri.org.