At a Glance | January 6, 2022 Employers Have Enhanced Health Benefits Under New IRS Rules Since July 2019, high-deductible health plans can provide pre-deductible coverage for certain items and services to help manage chronic conditions without jeopardizing a participant’s health savings account (HSA) eligibility. COVERAGE EXPANDED Employers Have Embraced Pre-Deductible Coverage and Expressed Interest in Expansion of Benefits If Permitted Since July 2019, IRS Notice 2019-45 allows HSA-eligible health plans the flexibility 6% to cover 14 medications and 81% Don't Know services used to prevent 76% of Employers Added the exacerbation of chronic Would Add 3 in 4 18% Pre-Deductible conditions prior to meeting Employers Pre-Deductible Did Not Coverage Expanded the plan deductible. As a Expand Coverage for Coverage Coverage Additional Health result, a significant number Care Services If of employers have added 7676+ 18+66+J18 Allowed by Law pre-deductible coverage. COVERED AND AT NO COST Percentage of Services or Medications Now Covered as Well as Those With Zero Cost to Employees as a Result of IRS Rule 2019-45 Health care services least likely to have pre-deductible Percentage of Employers coverage include peak Service / Medication Managed Condition That Offer Coverage... ...at Zero Cost to Employees flow meters and INR testing. 43% 26% Inhaled corticosteroids Asthma Those most likely to have such 25% 34% Peak flow meter coverage are blood pressure and insulin. 25% 30% INR Testing Blood / Liver 35% 25% SSRIs Depression The percentage of employers that eliminated cost sharing 66% 30% Insulin and other agents Diabetes for the pre-deductible services 61% 36% Glucometer ranges from a low of 25 50% 36% Hemoglobin A1c testing percent to a high of 40 percent. 35% 36% Retinopathy screening 39% 25% ACE inhibitors Diabetes / Heart 38% 40% Statins 54% 33% Beta-blockers Heart health 44% 36% LDL testing 66% 38% Blood pressure monitor Hypertension 29% 40% Anti-resorptive therapy Osteoporosis SOURCE: Fronstin, Paul, and A. Mark Fendrick, “Employer Uptake of Pre-Deductible Coverage for Preventive Services in HSA-Eligible Health Plans,” EBRI Issue Brief, no. 542 (October 14, 2021). This study was conducted with the funding support of the National Pharmaceutical Council. © 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.