Findings from the 2015 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey

Consumer-driven health plans appear to be succeeding at getting people to pay attention to their health costs and behavior, according to new research by EBRI.

The 2015 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS) finds that 13 percent of the privately insured population was enrolled in a consumer-driven health plan (CDHP); 11 percent was enrolled in a high-deductible health plan (HDHP); and 76 percent was enrolled in more traditional coverage. Overall, 26 million individuals with private insurance were enrolled in a CDHP—a health plan associated with a health savings account (HSA) or health reimbursement arrangement (HRA), or an HSA-eligible health plan.
The 2015 CEHCS also finds that among individuals enrolled in CDHPs, 63 percent (16.3 million) had opened an HSA, 13 percent (3.3 million) was in an HRA, and 24 percent (6.2 million) was enrolled in an HSA-eligible health plan but had not opened an HSA.
This study finds evidence that adults in a CDHP and those in an HDHP were more likely than those in a traditional plan to exhibit a number of cost-conscious behaviors. Specifically, those in a CDHP or HDHP were more likely than those with traditional coverage to say that they had checked whether the plan would cover care; asked for a generic drug instead of a brand name; talked to their doctors about prescription options and costs; asked a doctor to recommend a less costly drug; talked to their doctors about other treatment options and costs; developed a budget to manage health care expenses; and used an online cost-tracking tool provided by the health plan.
There is also some evidence that adults in a CDHP and those in an HDHP were more likely than those in a traditional plan to be engaged in their choice of health plan. Specifically, those in a CDHP were more likely than those with traditional coverage to say that they had talked to friends, family or colleagues about the plans; attended a meeting where health plan choices were explained; and consulted with their employer’s HR staff about health plan choices. Those in an HDHP were more likely than those with traditional coverage to say that they had visited the health plan’s website to learn about their plans; talked to friends, family or colleagues about the plans; used other websites to learn about their choices; and consulted with an insurance broker to understand their plan choices.
The survey also finds that CDHP enrollees were more likely than traditional-plan enrollees to take advantage of various wellness programs, such as health-risk assessments and health-promotion programs, as well as biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan enrollees.

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HD ection and Afforda g hHP an ranges a ams if t healt d tra hre o h plan. ere diti ften suspect, w o b nal-plan le as some type Care Act o enro tak fllees e201 of fi n to 0 nancia were gether, t (PPACA el i qn u)), h c ally e ey ntive Figure 5 Fronstin, Paul. Employers and insur Consumer ers of -Dri fer a n ven Healt umber of h Be dif nefits: A ferent typ Conti Figure 14 es of nuin wel g Evolutio lness benef n? Washin its—progr gton, DC: ams de Employ signed ee B to promote health enefit Research Definitions The Consumer Engagement in Health Care Survey findings presented in this Issue Brief were derived from the 2015 EBRI/Greenwald & Associates Consumer Association, Optum, In 95-percent confidence Percentage of c., an ) of what the resu d Prudential Indiv Fi lts woul a nancial, iduals d be if the entire Inc. Re b porting That poThey pulation a Would gesProbably 21–64 with private health Figure 5, Length of Time With CDHP, 2005 ?20 Ty 15 pes of ........................................................................................... 9 Cost Information Sought, I have other health insurance (specify _______________) .................... 4 Ever Employ Cost-Conscious Reasons Used Premium er AnOffers W y for Not Participating Kind HSA Increases of Online V Decision and HRA ellness Program, Am Making, o iEnrollment Rates, deo Chat, ng Employ in Employ by by T by T yers With y pe er pe T'y of Health Plan, 2015 s pe of Wellness Program 2015 Health of 10 Health or Plan, 2015 More Plan, 2015 related to cost indicat which likely to is e that report waive growth is sharin d that t if the o h gey h occur for wner of ad atten r of t fice visits ing.h e H ded a Length Sand A di mes, becom e prescript etin of T g wher ime With CDHP ion es disabled, e t drh ugs. On eir choices or e in ,* is e ce 2005 were ntive u ligib ? explain le 2015 for M nique t eed; dicare. o consulted CDHP was a witlso foun h their em d to ploy be er’s Employer Offers Cash Incentive or Reward for Participating and to Institute, 200 prevent disease. 2 The 2015 CEHCS examined availability and participation in three types of wellness programs: a Engagement in Health Care Survey (CEHCS), an online survey that examines issues surrounding consumer-driven insurance coverage weParticipate re surveyed wit in Employ h compler eteW ac ellness Program, by curacy. There are also othe Various Cost- r possible sources of error in all (Percent of by priv T ately ype of insured adults ages 21–64 Health Plan, 2015 The remain 50 der % of this report examines the findings from the 2015 CEHCS as they relate to differences and similarities I do not have health insurance curr Amo Employ ng Those Offered but Not ees, Worker ently Earnings and ................................................. Participating Inflation, 1988–2014 in Program, 2015 5 12 in Wellness Program, Among Workers Whose Employer potential HR staff abo ly e 70% fu ft healt ective: h84 plan per ccent of hoices; asked CDHP enrolle healthes said plans tth o send them ey would pa in rticipate formation in in a welln the mail; ess pro ang d ra that they m if their ha em d ployer talked 70% health-risk assessment, a h 70% ealth-promotion program to address a specific health issue, and a biometric screening. Consumer-Driven Health Plans (CDHPs) surveys that may be more seriou Sharing Incentiv s than t who receiv heo (Among indiv retical cal es ed health and T iduals seeking culat care ype ions of samplin in last of Health cost 12 months information) Plan, g error. These in ) 2015 clude refusals to be Figure 6, Fami health care, includi liarity With ng the co Cost of insur nsumer-Driven Healt ance, the cost of h Plans care, , 2015 satisfacti ....................................................................... 9 on with health care, satisfaction with health care December 2015 • No. 421 Paul Fronstin is director of the Health Education and Research Program at the Employee Benefit Research Institute among i Indivi duals ar ndividuals enro e able to roll lled i on ver fu traditional Offers W nds fro h m e ellness one HSA i alth plans, Program, by nC to another DHPs, and HDHPs. The repo HSA Type witho of Plan, ut subjecting t 2015 rt also examin he distries consumer bution to inco me and 20% ________. “Health Savings Accounts and Other Account-Based Health Plans.” EBRI Issue Brief, no. 273 (Employee increased th to their doctor eir HSA contr or other healt ibution. h professional about t 2005 20 he 06plans. 2007 2008 2009 2010 By Paul Fronstin, Ph.D., Employee Benefit Research Institute, and Anne Elmlinger, Greenwald interviewed and other form 63.0% s of nonresponse, the effects of question wording and question o 63%* rder, and screening. 90% plans, reasons for choosing a plan, and sources of health information. This Issue Brief also presented findings from the 54% CDHPs refer to health plans that have a deductible of at least $1,300 for individual coverage and $2,600 for family [IF Q1 = 1,5, SKIP THE (EBRI). An 90ne % Elmlinger is vice pr OTHER 2 QUESTI esident, Healthcare O Pr NS] actice lead, with Greenwald & Associates. Any views expressed in enga penalty geme taxnt es more genera as long as the lly. It ex rollover amines occur healt s withi h car n 6e 0 decision maki days of the date ng, cost an funds are d rece quality in ived. formati Rollover on, parti contributio cipatin os f n in rom Length of Time in Health Plan 18.6% The survey fo Benefit Resear und that C ch Institut DPr Hes P enro cr e, iptiS one d llees ptem rug we ber 20 re more likely 04). than traditional-plan enrollees to report that they 60% had the Where the world turns for the facts on U.S. employee benefits. & Associates a c b c While attem 60%pts are made to minimize thes ae facto brs, it is impossible to quantify the errors that may result from 18% Premium In 20 cr11 ease 2012 W20 ork 13 er Ea 59%* 20 rnin 14 gs Inc 20 reas 15 es Overall Inflation 46% Figure 7, Cost-Conscious Decision Making, by Type of Health Plan, 2015 ........................................................ 47% . 10 60% Traditional HDHP CDHP 60% Traditional HDHP CDHP c 2005 ?2007 EBRI/Commonwealth You canFun make d c Co hanges nsumerism in on your own a Health Ca 32%re Survey, and the 20 36% 08 ?2014 CEHCS. The 2015 b coverage in 2015, and include either a health savings account (HSA)-eligible h 79%* ealth plan, with or without the HSA, or a this report are those o Chec f th ked wh e aethe uthors an r plan would sh d cover ould care not be ascribed to the officers, trustees, or other sponsors of EBRI, 55%* welln Archer M ess pro edica grl Savin ams, opinio gs Acco ns unts (MSAs about provider ) are also engagement, Trad permitt itional e cost-sharing i d. Ear HDHP nings o CDHPn n contri centives r bution elat s are also ed to plan ty not pe, an subject to i d ncome 17.1% The option to them. survey fo part 80% iund that t cipate in all he th am ree ty ount of pes of time w individu ellness progra als have been ms. Speci enrol ficallle y, 46 d in a pe CDH rcent P was shorter of CDH 52% P enroll than the ees reporte time ot d thers hat 39% 40% 80% Office visit 54%* 51% CEHCS was conducted within the United States between Aug. 4 and Aug. 21, 2015, through a 12-minute Internet 2. Which of the following 75%* best describes your health plan's de 51%*ductible: health reim 16 bu % rsement arrangement (HRA), described in more detail below. ___ Employee Ben _____. “Sources of efit Research Heal th Insuran Institute-Educa ce Coverage: tion and Rese A Look at Cha arch Fund nge (EB s Betw RI-ERF), een or th 2044% 13 a eir staffs. Neit nd 2014 from the her EB March RI nor 20 EBRI- 14 telemedicine. taxes. 16.7% Availability and Use of Cost Information Telemedicine 71%* their employer offered a health-risk assessment, compared with14.7% 35 percent of traditional-plan enrollees and 37 percent Figure 8, have Retirement been I e nfor nro m lled in ed Decision Making for and health benefits are at the heart of w traditional coverage. Health Among in Plan Cdivi hoice, by duals Type o with tra orker fd Health Pla itional s’, emplo covera n, 2015 ge, ye20 r................................ s’, and our nation’s percent have been in 10 their 51% 70% 70% 50% 69% 33% 36% 70%* 14 survey. The national or base sampl 69%* e was drawn from Ipsos’ online panel of Internet users who have agr 47%* eed to 50 70 % % Lab or radiology This survey was made possible with support from: 47%* and 2015 Curr 50% Asked forent Po generic pulat drug insiton ead o Survey. f br 46%* and name ” EBR drugI Issue Brief, no. 419 (Employee Benefit Research I 68%* nstitute, October ERF lobbies or takes positions on specific policy proposals. EBRI invites comment on this research. 68%* 52%* Findings from the 2015 EBRI/Greenwald & Associates Permitted insurance al 70% so includes work 34%ers’ compensation, tort liabilities, and liabilities related to ownership or economic security. Founded in 1978, EBRI is the most authoritative and objective source of 65% In 2015, th plan The of HDHP ince for t en nhtives ree 14 e C rol % lto four of C E ees HCS added a (Fi DHPs ar years gure 12). eand desi series o When 40 percen gned f asked a to ques promote he t for tions about bout t five or he av ight m tel oened aila re emedic years. Thi bilsensitivit ity of health-promotio ine. Th s y to cost in compared wi e survey foun inth n dividual’s d that, pro 27 percent and 27 grams, 51 percent regardl decisions about ess of plan percen of C th type, eir D t, HP 39% You do not need it because you are already h64% ealthy 28% 33% 47%* [A deductibl partici pate in r e is the amount you have to pay before esearch surveys. Over 2,000 adults ages 21 42% -your insurance plan 64 who had health insurwill start pay ance through ing any part of an employer, Fin Health Savi dings fromngs Accounts this survey are compared with findings from the 2005 ?2007 EBRI/Commonwealth Fund Co 32% nsumerism in 29% a Health Rei 201 5). mbursement Arrangements 60% Figure the use 9, Avai of property (such lability and Use of Cost In as automobil for e insuranc mation, 2015 e). ...................................................................... 60% ........... 11 information on these critical, complex issues. 31% 61%* 60% enrollees, 38 percent of 60% HDHP enrollees, and 42 percent of traditional-plan enrollees reported thatT their raditiona em l ployer respectively, health very fe care. w adult Y ae s with m t the ong Outp ability t privat ati peo ent pr ple oc e i edu ohealth n make i a C re/surD ger insuran HP ynform (Figure ed ce thou decisio 4). While ght n it s is was extr still low highly de eemely r th pen an d or very the ent35% percenta on impor the exge o ttent ant to h f i to whic ndivi ave a du h people have als with teleme traditi dicinea ooption. ccess nal Consumer Engagement in Health Care Survey 58% 60% 30% 30%30% 30% 38% Blue 40 12 Cross a % % nd Blue Sh 12.1% iel 57% d Association National Rural Electric Cooperative Associ 30% ation 30% your medical bills.] 60% 32% 30% Health Ca purchased re dir Se uctly from rvey, and th a ce 2008 arrier, or 37% ?20 pu 14 rc C hased t EHCS. hrough a government exchange were drawn randomly from the Ipsos 29% Suggested ci 30 Tal %ke tation: d to doctor Paul about p Fronstin an rescription options d An and cne Elmli osts nger. “Findings from the 2015 EBRI/Gr41%* een 36% wald & Associates 40% A healt h savings account 35% (HSA) is a tax-exempt trust or custodial account that an individual ca 55% n use to pay for health 28% 11.2% 35% coverage, Betwe A healt to usefu offered s en hl reimbursement a 4 in uc 40 the ? % for h a 10 m perc pro number ation. gent t ram. of hou pe Wh rra ght it ople en as ngement with was ked a a extr (HR bCD ouA emely im HP an t biometr ) is ad th n emplo porta ic-s e le cngth rnt, an yeer-fu enin of t d 9 n g ded prog ime t ?13 health plan ra h percent tho ey hav ms, 47 eperc bee that reimburses ught it en n enro t of C was very lle Dd i HP n a enr employees for quali CDHP important ollees have reporte (Figure been d that fied 48% 15 39%* 27% Dental care 27% b 27% Taylor, Humphrey. “Does Internet Research ‘Work’? Comparin 27% g Online Survey R 37%*esults With Telephone Surveys.” Figure sample 10, for this b Types of Cost ase sample. This sam Information So ple ught, by was stratifi Type o 50% ed fby gender, a Health Plang , e, re 2015 gi.................................................... on, income, and race. The response 12 rate Only Medicare enrollees ages 65 and older are allowed to pay insurance premiums from an HSA. A a Medicare 10.1% 26% 26% 10.1% 26% 26% 26% Consumer En EBRI focus 10%gageme es solel nt in You d Hy e o n alth C on emplo ot have en are oug Sur h tiy me vee ey .” to par benefits research — no lobb tiEB cipat R eI Issue B 23% rief, no. 421 (Decem 39% 33%y be ing r 20or advocacy 15). HDHP . HealthEquity, Inc. Optum, Inc. care expenses 50% . Contributions to the account are deductible from taxable income, even for individua Trls who aditional do not their Eemployer BRI E 50m %ploye offered such e Benefit Rese aa pro rch Instit gram, ute Issco ue B mpared with rief (ISSN 0887 25% 35 percent ?137X) is pu amo blished m ng tra 25%onthly dition 25% by the E al-plan mploy enrol ee B 25%en lees efit R and esear 36 percen ch Institute, t increasin medical 19). The eg. In high xpen e 2015, sst number o es. An HRA 27 perc fis typical respon ent of CDH dents ly com P enrollees was in bined the with report somewhat a hied t gh-de hat -impor d th ucti ey h ble tant cate healt ave been h gory, plan, in th accounti th e he ough al this th pla ng fo is n r 36 at not re ? least five 43quire percen d. years, An HRA t. No deductible 29% 24% 30% 43% International Journal of Market Research. Vol. 42, no. 1 (August 2003). was 3 enrollee unde 4.4 percent. As a r age 65 cann non-proba ot use an bility sa HS mple, tr A to pay in aditio sur nal su ance premiu rvey marg ms. in-of-error estimates do not apply. However, had 1100 13th S EBRI t. NW, S stand uite 8s 78, alone in em Washington, Dpl Coyee , 20005ben -4051, efits at $3 rese 00 per ar ych ear or i as san inclinde uded as pend part eof nt, a m nonprofit, and no embership subscription. npa P rtisan eriodi- By Paul Fro Asked doc nstin, Ph.D tor to rec 23% om 23% mend l., Em es Vi ssi co on stl ca 23% yplo pr re esy crie ptie on Benefit drug Research Institute, 23% and Anne Elm 40%* linger, Greenwald The survey asked if participants tried to find the cost of health care services 34% before getting care and found that CDHP itemize their taxes, and tax-free distributions for qualified medical expenses are not counted as taxable income. Tax- Betwe can als up from 20 pe among H en o 25 be D 30HP % of ?31 percent fere enrollees. rcent d on in 200 a s reported t t 22% 6 (Fi and-a gur lone e hat a 5 bas ). telemedicine opt is or with comprie on was not to hensive insur 22%o important, ance t 7.5% hat doe as n not use d another a h 15 22% ig ? h 16 de p ducti ercent ble. 8% 8.0% 8.1% c 31%* Healt Individual or 30%hways Inc. Single Coverage Prudential Financial, Inc. 39%* 6.9% b Figure cals11, pos Ty tage pes of Cost rate paid in W Information ashington, DC,Foun and ad, by dditional m Type o ailingf o Health ffices. PO Plan, STMAS 2015 TER...................................................... 12 : Send address changes to: EBRI Issue Brief, 1100 Enrollment in CDHPs and HDHPs 21% 21% Copyright inf orga ormation: nization. It analyzes a This re 21% port is nd copyright reports ed by the Em research data ploye without e Benef spin o it Rese r unde arch Institut rlying ae gend (EBRI CDHP a. )All fin . It may ding be s , the survey 40 40 used a %% probability sample, the margin of error for the national sample would have been ±2.2 percent. 7.3% & Associates 18% HDHP enrollees and HDHP enrollees were more likely than traditional-plan enrollees to repor6.3% t that they tried to 20% find cost 6.1% 6.1% 6.1% free distri 13th St. N butio W, S ns are uite 878, also all Washio ng wed for ton, DC, certa 20005-4 in premiums. 051. Copyright 2015 24.1% by Employee Benefit Research Institute. All rights reserved. No. 421. Major reason reported th Employees ar at i e eli t was not gible for a at 19% Inpati al nl importa HRA only ent surgery n wh t. en their employer offers suc 24% h a health plan. 20% 19% My deductible is less than $1,000 31% whether Ton fi he prog nan ram icial s not co data, nvenient option ly located s for , or tre you nds, 14%are revealing 34% and reliable — the reason EBRI information is 5.4% 18% 6.1% 6.1% used Indiviwithout duals 20 6% en % permission rolled in a pla bun t citation with a dedu of thctible of at l e source is re eaquire st $ 18%1d ,30 . 0 for individual coverage or $2,600 for family coverage CDHP enrollees were more li Lincoln TalFina ked ton do cial ctor abo Group ut tkely than reatm ent opti t onradi s and tco ional-plan sts enrollees to 17% participate in health-risk assessments and biom 40%* etric information (Figure 9). Plan type had no impact on whether enrollees had found information from various sources, with c Figure 12, Employer Offers Wellness Program, by Type of Health Plan, 2015 ................................................... 14 30% My deductible is $1,000 or more 16% 5.5% 30%the gold standard 16% for private analysts and decision makers, government policymakers, the media, and Endnotes 20% 4.1% 36%* To examine the issues mentioned above, the sample was 4. divided into 2% three groups: those with a consumer-driven Mental health care 22% CDHP 20% 15% 15% 3.9% who also have an HRA, or who were enrolled 3.7%in an HSA-eligible health plan (regardless of wh 3.8% ether the HSA was The HSA is owned by the individual with the high-deductible health plan and is completely portable. There is no use-it- one e However, screenin Employers hav xcegs. Nearly 80 ption use :of the tec e HDHP a tremen enroll perc hnol do ent of CDHP ees w us amount o ogy did erenot a mor en fe p rollees flexi like pear to b ly tha ility in partici be a n de tr barrier p adit sig ated nin ional in a , as g h -plan h ea ma alth ealt enrolle pla h jority of res -risk assessment, compared with ns that es to inc hp ave fou ondents orporate nd in had pr an H Mino forrmation from rRA. For eeviously used ason 4.1% 66 exam perc tple, t hent of some e he Familiarity With CDHP 4% AT A GLAN 17% CE 3.2% the Don’t know amount of individual ded public. 2.7% uctible 2.9% 3.0% Report availability: This report is available on the Internet at www.21% ebri.org health plan (CDHP), those with a high-deductible health plan (HDHP), and those with traditional health coverage. 12.9% 13% opened) were assigned to the CDHP group in the CEHCS. Everyone else enrolled in a plan with a deductible of at least 10% 3.7% 3.6% 3.8% 2.3% or-lose-it rul 20% e De associated veloped budget to wit mana h an ge h HSA, as ealth care exany money penses left in the account at the end of the year automatically rolls over traditional-plan enrollees (Figure 13). About three-quarters (76 percent) of CDH 28%* P enrollees participated in a biometric health kind o Figure amount of f pla on 13,n line In 20 mo P ’s c % hydividual s ney that video c iu castomer servic l therap Partic y/ hr is at. C ehab pla ilipates in ita Dced tHP an io e departm n sein t rvicThe Em d HDH es h Welln e a ecc nt. P ess Program O plo o Other enrolle unt, the yee Benefi w es w ise C levt Research Institut e ere D lf of fere HP, more 3.4% th d HDHP e by Empl de likely t ducti and traditio e h oyer, Among b an traditional le, (EBand the RI) was founded in 1978. Its nal-pla c Thos o -plan mprehe n enro e O enrol ffer llees nsive le ees d a we ness of t to have re e Welm q lness Pr iually ssion is to he previo he like ogram, alth lusly y to 3.4% 13% The survey found that most You just do no peo t kp now le eno wit ugh h a ab CDHP out the pr we ogram re famili 13%ar with it. Over two 35% -thirds (69 percent) of those with a 1 Family Coverage 2% 9% 27%* Indivi Calculated fr duals were as om Figure 1. signed to the CDHP and HDHP 2.5% groups if they had a deductible of at least $1,300 for individual 10% $1,300 for individual coverage or $2, contribute to 600 2.1% for family , to encourag coverage e, an wa d to enhanc s assignede the developmen to the HDHP grou t of sound empl p. Individuals oy ee ben enrolleedfit in a and is availa 10bl %e in the following year. 2.0% have fo used a screenin insurance nun on g, co by Ty 10 are d in line % mpared with fpe o all subject o video rmation from f H chat. ealth Plan, to v Fi 66 percent fty-one various sourc ariation. Em 2015 percen of tr .................................................................................................. pladitional e oyers often t of tra s. 11% d -ition plan co aenrollees. HDHP enrol lver -placertai n enrolle n pre esv had previo entive servic lees were also mor usly used onli es in full, not ne e likely tha subjecting the video c ......... 14 hnat, m to My deductible is less than $2,000 for 1.6% me and my family CDHP EBRI explo were extremely, very, res the breadth of emplo or somewhat familiar yee ben with it (Fi efits and related issues. gure 6 1.6% ). In contrast, 37 percent of individuals with 1.8% Alternative medical care 15% Who we are ? The 10% 2015 EBRI/Greenwald & Associates Consumer Engagement 18% in Health Care Survey (CEHCS) finds that coverage or $2,600 for family coverage. To be assigned to the CDHP group, they must also have been eligible to programs and sound public policy through objective research and education. EBRI is the only 10% plan with no deductible or a deductible below $ 8% 1,300 for individual coverage and $2,600 for family coverage were Introduction 0% 0% Used online cost tracking tool provided by health plan 27%* traditional 2 -plan enrollees to report that they had participated in the biometric screening program (82 percent HDHP vs. compared wit the deductibleh. Employers c 59 percent aan of mong fer H compre DHP enrollees and hensive heal 63 percent th insuran amo ce thn at covers g CDHP enrol 100 percent lees (Fig of h ure 20). ealth c are costs after EBRI My deductible is $2,000 studies the world of health and retirement ben or more for me and my f efit amily s — issues such as 401(k)s, IRAs, retirement traditional coverage were extremely, very, or somewhat 0.2% familiar with a CDHP, and 39 percent of individuals with an Table of Contents More information about HRAs and HSAs can be f private, nonprofit, nonpar ound in the box tisan, Washington, DC-b on pg. 22 ased organi and in Fronstin (2 zation committed exclusivel 002 and 2004). y to 13 percent of the privately insured po 6% pulation was enrolled in a consumer-driven health plan (CDHP); 11 per- You are worried that He yo alt urh Ri emsk plo A ye ss r es wilsl k me no nt w your personal healthHealth Promotion Program 23%* Biometric Screening contribute to an HSA or had a health reimbursement arrangement (HRA) with a rollover provision that they could use to In order to qualify for tax-free contr ibutions to an HSA, the i Figundivi re 9 dual must be covered by a health plan that has an Out of network care -0.4% assigned to th Figure 14, Employer O e “traditio ffers nal” Cash Incentiv coverage category. More de -1.1%e or 3% Reward for tail a 14% Partici bout th patine g methodolo in 26% Wellness Program, gy is provided in t Among Workers Whose he appendix. 0% income adequacy, consumer-driven benefits, Social Security, tax treatment of both retirement and health 66 Employment-based h the perc deductible ent tra 0% has ditional been e ) or alth met th benefits are the most common form e he or th alth ey may promotion pro offer covera gram ge (67 withperc cost sha of ent H healring after th insura DHP vs. 5 n the 0 ce pe i n deductible rcent tra the Unite dition d is S met. If tal). ates. In emplo 2014 yers , Don’t know amount of family deductible informationpublic poli 3%cy research and education on economic security and employee benefit issues. -2% HDHP were fa 0% miliar with a CDHP. 0% cent was enrolled in HS a h A igh-deductible he 0%alth H pl SA-an Eli10 gible (HDH % Without P); and 7 Ac 20 co %unt 6 perce 30% nt was 40 enroll % HRA ed in 50 more % traditional 60% pay for medical expenses or Health Risk the Assess abi me a ntlity to take their acc Healo th Pro unt mot w ion ith t Progra b he mm should they chan Bioge met j ric o Scree bsc. nin Indivi g duals with only a Introductio annual deduct n .................................................................................................................. ible of not less than $1, Av30 ail0 afboilit r self y a-only co nd Useverage of Cos an t In d $ for 2m ,600 atio for n, 2 family 015 coverage ........................................ 4 (minimum deductible Despite 3 the Employer O finding that ffers Wellness Pr very few respo ogram, ndents think by Type of Pla it is extreme n, 2015 ly or v ................................................................. ery important to offer a telemedicine optio 15 n, benefits, Reduced cost drug T r co manage adi st tish ona arling ment In, cworker a reased drug cnd ost shar employe ingHDHP Re r duc attitude ed office v s, isitpolicy reform p cost sharing IncreasCDH e rd opo ofP ficsals, e visit coand p st sharine g nsion assets EBRI’s membership includes a cross-section of pension funds; businesses; trade associations; 161.6 mil Don't know if have deductible lion individuals under age 65, 0% or 60 perc 10%ent of that po 20% pulatio 30%n, had em 40%ployment- 50%based h 60 e % alth ben70 efits % choose to See http:/ pay /w less than 100 perc ww.mercer.com/con ent o tent f health car /mercer/glob e expenses al/all/en after /new the sroom/m deductible odeshas been m t-health-benefit et, they then hav -cost-growth e t - he 0% coverage. Overall, 26 million individuals with private insurance a were enrolled in b a CDHP—a hea clth plan This survey found that in 2015, 13 percent of the population was enrolled in a CDHP; 11 percent was enrolled in an flexible spendi -4% Source: ng acco EBRI/G unt reenw (FSA) ald & Associates were C not onsum in er cluded in Engagement in H the ealth C CDHP are Surv grou ey, 2015. p. amounts are i and ndexed to i funding. nfl There is wi ation). Cert labor un de ain spread ions; h preventive ealth recog car se 0% e prov nrvices can ition Tra 10 iders and insur dthat if employee be it % ional be 20% covere e 30 rs; %d in full and are not government org HD 40 HP n %efits 50data exist, EBRI kno % anizations; 60% subject to CDH and service firms. 70 P % the 80%ws it. CDHP and HDHP enrollees were also more likely than traditional-plan enrollees to report that their employer offered a there is strong inter Source: EBRest in I/Greenw ha ald & Associates ving a tel Consum eme er d Engagement icine visit in Health C in various situations. Between are Survey, 2015. 48 ?55 percent of respondents were Source: EBR Le I/G ss reenw Than ald & Associates One Year Consumer Engagement 1 ?2 Year in H sealth Care Survey, 2015. 3 ?4 Years 5 Years or More Enrollment in CDHPs and H a DHPs ............................................................................................................................ 5 (Fronsti option on 2 f des 0Source: 1 Source: i5 gnin ) 19 T. In r88 aditional = EBR EBR g th 19 ne 89 I/G I/G reenw 19 e reenw arly ev health plan 90 plan 19 ald & Associates ald & Associates 91 with ery year 19 w 92 ith 19 no or 93 deductible C 19 Cwitho onsum since onsum 94 19 er 95 or er u Engagement Engagement 19 <$1,300 (indiv t a ma 199 96 19 8, 97ximum premiu 19 in H in H 98 idual), ealth C ealth C 1999 <$2,600 (family out-o m increases a 20 a re Surv re Surv 00 2001 ey f ey -pocket , , 20 2015. 2015. ) in 022015; 20 h 03 limit. ave exceeded 2004 2005 2006 2007worker-earni 2008 2009 2010 2011 ng 20 s incr 12 2013e20 ases a 14 nd continues-as-consumerism-kicks-into-high-gear.html. aSource: EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, 2015. T a raditional = health plan with no deductible or <$1,300 (individual), <$2,600 (family) in 2015; a a Traditional = Health plan with no deductible or <$1,300 (individual), <$2,600 (family) in 2015; associated Trie Tb rd to aditional = fiwit nd th Hh ealth a e cplan w os health t of ith he no savi deductible alth c ngs accou are or s <$1,300 (indiv ervicen st (HSA) or idual), <$2,600 (family healt ) in h reim 2015; bursement arrangement (HRA), or an HSA-eligible HDHP; an Figure 15,d Rea 76 Traditional = perc sons for Part ent Health was plan w ic enrolle iipating in Employer th no deductible d in tra or <$1,300 (indiv ditional ’s Wellness covera idual), <$2,600 (family ge (Figu Program, by ) in r 2015; e 2). The Plan Type, 13 percen 2015 t of t................................ he population with a C 15 DHP dedu ctible. Th b e he HDHP = High-deduc alth plan’s tibl out-o e health plan f-pwith ocket deductible maximum $1,300+ (indiv ma idual), $2,600+ (family y not exceed ), not $6,4 HSA-eligible in 50 for se 2015; lf-only coverage and $12,900 for a Traditional = Health plan with no deductible or <$1,300 (individual), <$2,600 (family) in 2015; extreme cash ince ly or v ntive HDHP = High-deduc b or re ery inte war rested d for tible health partici in havi plan p wng a t iatin th deduc g i e tible n le a $1,300+ (indiv medic wellness pr ine idual), $2,600+ (fam visit for a ogram. fter ily Nearl ), not -hou HSA-eligible in y 70 percent rs urgent car 2015; (69 e (Figure percent) of CDHP 21). Betwee enrol n 43 ? lees and 49 per- bb 3. Do you have a specia Source: HDHP = High-deduc EBRI/Greenwald & Associates tible health l account or f plan w C ith onsum deduc er tible Engagement und you can use to pay for medical e $1,300+ (indiv in Health C idual), $2,600+ (fam are Survey, 2015. ily), not HSA-eligible in 2015; xpenses? The accounts are inflatio Cost- nC (Fi ons gur HDHP = High-deduc HDHP = High-deduc c e 1 ious Beh ). Health tib tib in le le health avior health surance plan plan w w ith ith premi deduc deduc tible tible u$1,300+ (indiv ms have $1,300+ (indiv idual), $2,600+ (fam inea dual), $2,600+ (fam rly triple ily ily d, ), not ), not wHSA-eligible in h HSA-eligible in ile worker 2015; 2015; earnings have increased 58 percent Source: c c EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005–2007; EBRI/Greenwald & Associates Consumer Engagement in Health b HDHP = High-deduc CDHP = Cons c Source: EBR um I/G er-driv reenw tib en le ald & Associates health health plan plan w wiith th deduc C deduc onsum tible $1,300+ tible er Engagement $1,300+ (indiv (indiv in H iidual), $2,600+ (fam dual), $2,600+ ealth Care Surv (fam ey ily ily , 2015. ), ), not with HSA-eligible in HRA, HSA, or HSA-eligible 2015; in 2015. Indivi Length of dualsTim be we cafor e re as CDHP = Cons in Healt e ges ttiign ng c ed um h a Pla r er-driv to e the n en ................................................................................................. health HDHP plan with gro deductible $1,300+ up if they r (indiv epo idual), $2,600+ rted 26 t % hat th (family ey wer ), with HRe A not , H4 SA, or H 2% eli * g SA-eligible ible for an in 2015. H............................... 8 SA. Th 40%* e group with c CDHP = Consumer-driven health plan with deductible $1,300+ (individual), $2,600+ (family), with HRA, HSA, or HSA-eligible in 2015. health CDHP = Cons H pla ealthn. savings account. umer-driven health plan EBRI’s work advances knowledge and unders with deductible $1,300+ (individual), $2,600+ (family), with HRA, HSA, tanding of emplo or HSA-eligible in 2015. yee benefits and their 4 represe EBRI delive nted a Source: M CDHP = Cons bout er 26 rcer, s a stead um millio Ner-driv ational en n in Survey of Em health y dividuals plan stream of invaluable research and anal ploy with deduc er-Sponsored with tible $1,300+ (indiv private Health Plans in idual), suran (www. $2,600+ (fam mece, rcer.cwhil omily /ne ), w w e s the ir th oo HRA, m/m 11 oHSA, de percen st-h or eaHSA-eligible lth-y besis. nt with efit-coin st- 20 g an r15. owt HDH h-continuP es re - presented about Care Survey, 2008–2015. family coverage, wit c CDHP = Cons 1 h th umer-driv e de en ducti health b plan w le counti ith deducn tible g to $1,300+ ward this (individual), limit. $2,600+ The (family min ), with HRA, HSA, or imum allo HSA-eligible wable dedu in 2015.ctible and maximum out- 75 percent of * Differenc HDHP e betw en een HDHP/CDHP rollees repand T orted raditional a cash is statis in ticc ally en signific tive ant or at reward for the p = 0.05 or better. participating in the health-risk assessment cent There See Appendi sometimes referred to as Health Savings Accou was e is no st xtre b atutory re * m x Differenc for more d ely or v e betw quir e een HDHP/CDHP ry i ement t entail on th terested in h and T at a e methodol raditional h n employ aving is statis a tel tic ee ogy. allyhav e sim gnific e edici ant a at nts (HSAs), Health Reimbursement Accounts hig ne visit the p h-de = 0.05 to du or better. ctible consult hea with lth a plan i physicia n order to n afte also have r being hospit an HRA. alized * H Differenc ealth reimbursemen e between HDHP/CDHP t arrangement. and Traditional is statistically significant at the p = 0.05 or better. * * Differenc Differenc e e betw betw een HDHP/CDHP een HDHP/CDHP and T and T rr aditional aditional is is s s tatis tatis tic tic aa lly lly s s ignific ignific ant ant at at the p the p = = 0.05 0.05 or better. or better. during that period. as-consume rism -kicks-into-high-gear.html), and Bureau of Labor Statistics. * C F onsumer-driv ound infor en m health ation: plan. 74 75 70 The theory be * Differenc hind CDHPs e between HDHP/CDHP and HDand T HPs is t raditional hat the is statistic cost-s ally significharing ant at the p structu = 0.05 or better. re is a tool that will be more likely to engage Figure 16, Reasons for Not Participati importance to ng in Employer's the nation’s econo Wellness Pro my among policy gram Among Tho makers, se Off the news ered media, and but Not Partici the public. It pating traditional health coverage included individuals in a broad range of plan types, including health maintenance EBRI publications include in-depth coverage of key issues and trends; summaries of research 22 million individuals. Familiar of-pocke ity Wit t limith are CDHP indexe ......................................................................................................... d to inflation. A network plan may impose a higher deductible and an................................... 8 out-of-pocket limit for for major sur compared However, (HRAs), Personal care a it is witg hery; 47 standard pract 60 percent a ?51 pem rcent ice amon ong tra ccounts, Per was e dg itio x em tr nal-plan emely or ployers that sonal medical funds, or enrol very a len intereste es; em 61 ployee percent of CDHP d in m hu aving st also choos Choice fund a tel en em rollees a e e a dicihigh-de s, and are different from ne visit nd 70 perc du if ctible it wou ent o hea ld take f H lth Dplan i HP more n Health plan's w ebsite 60 56 55 does this by conducting and publishing policy research, analysis, and special reports on individuals in their health care, compared with people enrolled in more traditional coverage. This study found evidence 5 What we do ? The 2015 CEHCS also finds that among individuals enrolled in CDHPs, 63 percent (16.3 million) had opened an organizations (HMOs), pre in Program, finding 2015 s and f.............................................................................................................. erred provi policy develo der organiz pments; ations ( timel PPOs y factsheet ), other manage s on hot topics; d care pla regula ns, anrd up plda ans tes with .............. 16 on legi a bro slat ad ive and Traditional plans include a broad range of plan types, including health maintenance organizations (HMOs), out-of-network services Health plan's . In cdividuals ustomer ser cv an h ice de ave para healt tment h plan with a de 35 ductible an4d m 8* aximum out-of-pocket 30 limit that enrolle In resp employer-provided Flexible Spendin es re onse, emp ported a loyers hav cash ine centive o been seeking emplo r reward yee ben ways to manag for g Accounts. efit issues; holding participatin e g in health educational br a health-pro care cost incr iefings for E motio eases. Durin n pro BRI members, congressional and gram co g th mpared with e past decade, 50 percent than one to order to have twan HRA. o hours to get to their doctor’s office; and 39 ?48 percent was extremely or very interested in having a Cost-Conscious Behavior ........................................................................................................................................ 8 regulatory developments; comprehensive reference resources on benefit programs and workforce that adults in HSA, 13 a CDHP perce an nt (3.3 d those in millio an n) was in HDHP were mor an HRA, an e lik d 2ely 4 pe than rcent th(6. ose in a 2 mill tra ion) diti was e onal nplan rolled to e in a xhibit a n HSA num -eligiber of ble he alth Among the 13 percent of individuals enrolled in a CDHP, 63 percent (16.3 million) had opened an HSA, 13 percent variety of cost-sharing arrangements. The shared characteristics of these group members were that they either had no Printed material from health plan 24 29 19 preferred provider organizations (PPO federal agen s), other managed care plans, cy staff, and the news media; and sponsoring public opinion survey and plans with a broad variety of c s on emplo ost-yee qualifies them to make a tax-free contribution to an HSA, but they are not required to make a contribution or to open among tra teleme employers dicin dhav e itio vie nal-plan sit duri turned thei ng ba enrol d weat r le attention es, an her. Ov d to co 68 percent erall, re nsumer-drive of C gardD les Hs P an n of th healt d e situati HDH h plans P enrollees o(CDHPs)—a n, aboureport t one combination -ed a third of cash respo incentive or of h ndents ealth cov wer rewar e erage d for a Figure 17, Percentage of In issues; and dividuals major survey Reporting s of That public That eytitudes. Would Probably Participate in Employer Wellness Program, cost-conscious behaviors. Specifically, among privately insured adults ages 21 ?64 who received health care in the past plan but had not opened an HSA. ded Health Plan (3.3uctib million) w le or C h a de e oice Decisions P re i rov ducti n id a ern 'sb HRA, o le ff t ichat was e and 2 .................................................................................................. benefit issues. be 4 perce low curre nt (6.2 EBRI’s Ed nt thr millio esholds n)uc were ation and Re fo 18 enro r HSAlle tax pr d in sear an c ef herenc F HSA-el und 21 e(EBRI-ERF) performs . igible health ................................ 8 pl 26 an but ha the char d itno able t , HRAs are typically set up as notional arrangements and exist only on paper. An employee may view the account as if sharing arr Yes angements. The shared characteristics of these plans are that they either have no deductibles or an account. biometric with high screenin deductibl g, com es (at le par ast $1,3 ed with0 55 0 inper 201 cent amon 5) and tag tr x-pre aditional ferred savings or s -plan enrollep es en(Fi ding acco gure 14unts t ). Theh main at work reers a asons nd their somewhat int e rested in EBRI having meetings a te present an lemedicine visit. d explore i Onlys 16 sues ?27with perce thou nt wer ght e leade not int rs erested in from all se a te ctors. lemedicine visit. by Various Financial Incent educa ives and Ty tional, and pe of Healt scientific func h Plan, tions of the Instit 2015 ........................................................... ute. EBRI-ERF is a tax-exempt organizatio 16 n Provider's w ebsite 19 29 17 12 months, those in a CDHP or HDHP were more likely than those with traditional coverage to say that they had opened an HSA (Figure 3). Thus, overall, 22.5 million w Figure 1 Figure 17 Figure 2 ere enro1 lled in an HSA-eligible health plan, and 3.3 million were Figure 21 Figure 8 Figure 4 Figure 13 Figure 6 Figure 19 money w deductibles that ar No as ac tually e below current thresholds th being deposited into an accoun at t, would qualify for tax-preferred but an employer does not incur e HSA contribu xpenses associated w tions. ith the Availability and Use of Cost Information ................................................................................................................ 11 EBRI regularly provides congressional testimony, and briefs policymakers, member organizations, enrolle families es part can uisce to pay ipated in the ani remployer out-of-pocket ’s wellness pro health car gra e e m wer Figure 15 xpenses. A ha e because ndfu they wer l of em eplo offer yers first start ed incentive ed o priz ffer es, ing CD to reduc HPs in e supported by contributions and grants. ? This study Othe fi rn wde s evi bsites dence that adults in a CDHP and tho 5 se in an HDHP wer 4 e more likely than 5 those in a Because the base sample (national sampT ley ) i pes of ncluded onl Cost yInformation 259 individuals in a Found, CDHP and 255 individuals with an HDHP, checked whether the plan Percentage of would cov Distribution er car Indivi e (54 percent of Indiv duals idual Re CDHP porting s Cov ane d 55 red by That percent HDH They Priv W ate Health ould P vs. 46 percen Probably t traditional); asked Individual Familiarity Interest Participates Number of Informed Decision Making for in Hav With Consumer-Dri ing in Wellness Program Offered Ya T ears elemedicine Covered ven by Health Plans, 2015 V iCurrent sit in Health Various by Employer, in an HRA-based plan. Importance of Having a Telemedicine Option for Both individuals and employers are allowed to contribute to an HSA. Contributions are excluded from taxable income if Not sure arrangement until a and n emplo the medi yee in a on employe curs a claim. By co r benefits. ntrast, if the employer sets up the HRA on a funded basis, the Reasons for Participating in Employer's Wellness Program, by Plan Type, 2015 premiums, 2001 Figure with 18, hea Per it was conve centage of In lth reimbursement arra nient, an dividuals d to Repor improve hea ngemen ting ts (HRAs That lth Th (Fi ).ey g In ure Wou 2004, 1 5l). d Proba CDH employers wer P enro bly Part llees icipat e we abere more le to start in Employer likely offering healt Well than tra ness Pro dition h pla ga ram, n l-pl s an Source: EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, 2015. Participat 6 traditional ion in Well pla ness Pr n to exhi ograms Participate bit a Insurance, ........................................................................................................................ 13 number in of by Employ cost-conscious T by y T pe of ype of er Health Wellness Program, by Health behaviors. Specif Plan, Plan, 2015 2005–2015 ically, those Various in a CDHP or HDHP were an oversample of indiv Am idua ong ls Those with a CDH Offered P or HDHP a Wellness was adde Program, by d. The oversample Type of Health Plan, 2015 included 1,026 individuals with a CDHP Plan Choice, by Health Situations, Plan, by by T T T yy y pe pe of pe of Health Plan, 2015 of Health Health Plan, Plan, 2015 2015 for a generic drug instead of a bra Getting nd name Medical (47 percent C Care, by DHP Ty an pe d of Health 52 percentPlan, HDHP 2015 vs. 36 percent traditional); talked See Figure 5 in www.mercer.com/newsroom/modest-health-benefit-cost-growth-continues-as-consumerism- made by tha e e mployer a EBRI issu nd d es educti press ble 2rele from as adj es on ne usted gros wsworthy s income developm if made ents, by thand i e indi svidual. among Th the mo e maximum a st widely qu nnual oted Conc employer lusio incu Traditional = n rs the H full ealth e p xlpense at an with no deductible or the time of <$1,300 the (ind con ividual), tribution, <$2,600 (f eve amily) in 2015; n if an employee has not incurred any expenses. EBRI Issue Briefs is a monthly periodical with in-depth evaluation of employee benefit issues (Among individuals seeking cost information) with enrollees to r health saving by Var 100% eport that ious Co s accounts ( st-Sharing I they partici HSAs) np cat .entives and By ed in 2014, order 2Ty to r 7 pe o perce edu f Health nt of ce pr emp emiums Plan, 2015 loyer or to avoi s with ..................................................... 10d –4 pr 99 emium i workers a ncreas nd e48 s. HDHP percent o enr18 fo llees Financial Incentives and Type of Health Plan, 2015 more likely th 60% an those with traditional coverage to say that they had checked whether the plan would cover A number of other surveys track enrollm Extremen ely t in C or Very F D aHPs. M miliar So ercer mewhat foun Famid th liar at 23 percent Not Too or Not at A lof work l Familiar ers with employment- and 560 in 90 divi % duals with an HDHP, resulting in a total sample (base plus oversample 30% ) of 1,285 for the CDHP group and to their doctors about prescription options and costs (39 percent CDHP and 41 percent HDHP vs. 30 percent 45 b% sources on employee benefits by all media. Telem kicks-into-hig edicine ............................................................................................................................... h50 -gear % .html ........................ 17 Whil contributio e pane 80 n is l I % HDHP n $3, ternet surv = H 35 igh-de 0 for ductible sel eys are f hea -only lth pl nonran covera and trends an with ded do guctible $1,300+ m, studies e, as an d well as $6,6 (i5 hav ndividual), 0crit fe oic de r family al $monstrated that anal 2,600+ ys cove (fes amily), of rage nem ot Hplo SA-elig in such y20 ee b ible 15. surveys, when c ein 2015; nef it policies and pro areful pos ly design als. EBRI ed, 90% Offered incentive prizes 3 48%* 50% Our 92% a 91% 6 b c were The employers 20 more 15 EBR lik witely than h I/Gr 500 or more workers o een tra wald diti & Associates Co onal-plan en ffer roe llees to nsumer En d either report angagement HR that they A- or HSA-eli in H part ealg ith Care Surv cibl ipated e plan. becau ey (CEHCS se they wer ) fou e offer nd th eat 13 d incenti perve cent 55%* a b c 45%* 82%* care; asked for a generic drug instead of Traditiona a bra l n HDH d name; P CDH talked to t P heir doctors a 84% bout prescription options 83% and 815 based for coverag the H c De w HP Ve group. isre ited h covere eal Af th pter factor lad n'sby a website t CDHP ing o o learn a iu n bou t the 2t th 014. eir base pl aT nsh sa e K mple—th aiser Fam e 2 ily Foundatio 59 individuals w n (KFF) ith a C fouD nHP d that 20 perc and the 2 61%* 55 ent indi ofviduals EBRI CHECK OUT EBRI’S WEBSITE! directs members and other constit Traditional uen HDH cie Ps b to CDH the informatio P c n they need and undertakes new traditional); asked a CDHP = Consumer-driven health doctor to recommen Notes plan with is a monthly de d ductible less costly pre 82% $1,300+ period (individual), ical pr scriptions (39 percent a $oviding curr 2,600+ (family),ent in with HRA, formation on a variety CDH HSA,P o and 40 r HSA-eligible percen in 20 of emplo 1 5.t HDHP yee ben vs. 29 efit per- HRAs can be 90% thought of 86% as providing “first-dollar” coverage until funds in the account are exhausted. Leftover funds at a c obtain results comparable with random-digit-dial telephon ae surveys. b b Taylor (2003), for example, provided the results Figure 19, Importance of H 80% aving a Telem 52% edicine Option Tradi fo tiona r Getti l HDH ng M P edical CDH c P Care, by Type of Health Pla 55% n, 2015 18 86% 79%* a Conclusion .................................................................................................................... Traditional HDHP CDHP 51% 40% ...................................... 17 of the 7 populat 80 Tradi % tiiona on was 45% l enroll 79% 17%ed in a CDHP; 20% 11 percent was enrolle 20d 05in a 20 n HDHP; 06 56% 2007 an 7 20 d 08 76 perc 2009ent 20wa 10 s enrolled in prizes, to avoid premium increases, because they Tradi want tionae l d to HDH learn P mor CDHPe about their 35%own health risks, because they 84% costs; asked 40% resea a d ro ch ctor to recommend on an ongoi topics. ng EBRIef baa less costly drug; sis. is a weekly 43% roundup of EBRI r talked to theire search doctors a and binsights, as well out other treatment optio as updates on ns workers were 80%enrolled in a68% CDHP in 2014 and 24 percent were enro 78%*lled in 2015. These surveys focus only on the 76%* with See Exhibit 5.1 in an HD 70HP % —there http://kf were 1,49 f82% .org/rep 0 indiviort-sectio duals in th n/ehbs-2 e sample015-section with traditio -fi nal h ve-marke ealth co t-sh verage. ares-of -health-plans/ cent tra To be publications eligibl ditiona * D ei ffor an fl); talk erenc 67% e b HSA, a eed to th tween HD nH individu 75% eir P/Cdoctors about other DHP an al ma d Tradit y not ional isbe statenroll is tr ticeat ally s ed m igni ent in oth ficao ntp attions and e th r ehealth covera p = 0.05 ocosts (36 percent r better. ge, such as 76%* CDH a spo P and 40 use’s plan, percen unless t Reduced premiums 49% 49% 44% the end of eac h 50 year % can be carried over to the following year (at the employer’s discretion), allowing employees to from a number of surv66% eys th 48% at were conducted at the same time using the same que38% stionnaires both via telephone and c 48%* Employers have been interested in brin a gingb aspects of consumer engagement into health plans for many years. As far 47% 47% 44%* surveys, studies, litigation, legislation and regulation affecting employee benefit plans, while were traditional require cov 80% d eto by th rage. Teir he em 13 perc ployer, a 78% ent o nfd t to he po addr pulat ess 72% ion specif with ic hea a CDH lth Pprob represe lemsn . ted about 26 million individuals with EBRI Talked to maintains an friendsT , f radi ami tily ona , col l d leagu analy HDH esP abo 72% zut t e CDH s he p the mo Plans st comprehensive database of 401(k)-type 48%* programs in the Appendix—Methodology and costs; develope .......................................................................................................... d a budget to ma 76%nage health care expenses; and used an online cost-tracking t ............................. 20 ool provided employment-based market 70% and include estimates for both HSA and HRA enrollment. An annual America’s Health that plan is also a high-deductible hea 70% 70% lth plan. However, individuals are allowed to have suppleme 70% ntal coverage without HDHP vs. 31 pe 40 rcent % traditional); dev 74%elop 74% ed a budget to manage health care expenses (27 percent CDHP and 28 per- accumulate Figure 20, Eve funds over r Used A time, ny Kind o and, f On in pri line n Vide ciple, c o Chat, reatinby g th Type e key of H ince 2011 ealt ntih ve for 20 Pla 12 n in , 2015 2013 dividu .......................................... 20als to make 14 2015 46%* health care purchases 19 60%* online. He 70 fou % nd that the use of demographic weighting alone 67%* was sufficient to bring almost all of the results from the back as 8 EBRI’s website is easy to use and packe 1978, they adopted Sec. 125 cafet EBRI’s Blog 72% eria supplements our regular publications plans and fled with useful information! Look for x67% ible spending 29% accounts , off (FSAs). Mor ering commentar e recently, y on questions employers 35 70 %% 67% world. 66%Its computer simulation analys43% es on So 37%* cial Security reform 66% and retirement income adequacy private insurance, while the 11 percent with an HDHP represented about 22 million individuals. In ad See ditio http://www.ahip.org/epub/2015-HSA-Cen n to being stratified, the base sample was a sus/ lso we ighted by 36%* gender, age, education, region, income, and 60% by the health To av plan. oid pr emium increase 41% 46%* Insurance Plans (AHIP) survey focuses on both the group and individual markets and found that 19.7 million people 27% Among i cent HDH a high deducti ndivi P vs. duals w b 21 le for suc percent ho sought cost in h tr thaditional ings as vision );form and that t ation, CDH care, dental hey h Pad used a care nd tra , spec a dition n on ifica di line l-plan seases, and in co enrol st-trac lees king surance t were tool p eq rovid ually hat ed li pays a fi kely to hav by the he xed am ae lth so p ount ught lan 70% 63% received from news reporters 63%, policymakers, and others. The EBRI Databook on Employee Definitions responsibly. ................................................................................................................... Employers can place restrictions on the amount that can be carried over. ....................................... 22 online survey close to the replies from the parallel telephone survey. He also found that in 39%* some cases propensity 39% 13 The survey als have begun to take a o asked r are broa uni eque. spo den r view dents of their cons reumer e asons for nganot gement in participati hen alth g in care. their em Some ploy em er’s welln ployers hav ess program. S e introduced m even ore out 32% these special features: 35 40A % % ttended a meeting where your choices were explained 8 30%* race/ethnicity to reflect the actual proportions in t 14 he population ages 21–64 with private, health-insurance coverage. Figure 21, Interest in Having a Tele Benefits medicine is a sta Visit in Various tistical referenc Situatio e work on em ns, by ploye Type of e benH ee fit prog alth Plan, rams and work force-related 2015 ............... 19 were enrolled in an HSA-eligible health plan in January 2015, which accounted for about 1 43%* 5 percent of the population cost informati per day (or 60 60 % ot %on on her perio a ran d) ge of for hospital healthizatio caren. services Individuals (Figure 1 enrolle 0). Howev d in Me edicare r, CDHP are en not rollees eligiwere ble to mak less likely e HSA than 9 (23 percent C 30% DHP and 27 percent HDHP vs. 18 percent traditional) (Figure 7). 29%* a 57% 38% weig hting (meaning the propensity for a certain type of person to be online) reduced the 31% remaining gaps, but in other of 1 workplac The 20 0 (6 15 8 e CEH perc wellness pro ent) CS conti resp nue g on ram de d td that s, usually i o find they that C n di th D d not e form HP enrol parti oflees heal cipawere te b th-recaus isk assessments or more e co they coul st conscious in d make biom chan their etric screenings. Emp ges decision on their o making than Traditiona wn l l ( oyers Figu t rh have e 1 ose in 6): See Table XI in http://www.cdc.gov/nchs/data/nhis/earlyrelease/i 48% nsur201511.pdf Consumer-Driven Healt 50% h Plans (CDHPs) ............................................................................................................ 22 ? There is also some evi Wanted to impr d ov enc e hea e lth that adults in 47% a CDHP and those in an HDHP were more likely 45% than those in a The CDHP an 60%d HDHP oversamples issue were s. w eighted by gender, age, income an27%* d race/ethnicity, using th 27%* e demographic 27% 46% 29% Distributio with private ns f he rom an H alth insuranc RA fo er qua . AHIP does not lified medical collect expe nses information on are made H on R a ta A enrol x-favore lmentd . The basis. Sinc National e unused f Health Intervi unds are ew 30% 39% traditional contributio • EBRI’s entire library of re -n pla s, n although th enrollees to ey have sought i are able to wit search publications starts at nformation hdraw mon on e y vision car from the HSA e. In the m most instanc for quali ain W fied m es, HDHP a eb page. Click on edical expenses and certa nd traditional EBRI -aplain n 50% cases it did no EBRI make t reduce t bs information freel he remaining gaps y av . Perha ailable to al ps the most l. striking difference in demographics betwee Tradin tiona te llephone traditional plaCo ns. CDHP nsulted with yo enro ur em llees ployer's H were R st mo aff abo re like ut y42% our c ly to hoicesuse resources to pick their 29%health plan and more likely to seek cost 32 often perc provi ent c ded fina ited this as a ncial inc m eajor reason, ntives to incre an ase worker d 36 percent pa cited it as a rticipation in m su inor reas ch programs. on for not A few partici employers have pating. About intro 6 in duce 10 d 50% 42% 27% traditional HDHP plan to be 25%* engaged in their14%* choice of health plan. Specificall 58% y, those in a CDHP were more likely than Health S avings Accounts .................................................................................................................................. 22 profile of the 25 50 15 % % CDHP and HDHP respondents to the omnibus survey described below. b 36%* 10 allowe Survey d to (NHI roll S) also coll over, an 30% em ects i pln oyee is a formation ble on to both accumul the gro ate u funds over p and individu timeal markets. It . An employ 25% 35%e r can found that allow 1 a 3f.o 3rmer em percentploy of ee to enrolle premiums. es we An re also e indiviq dually ual also likely to hav may not mak e sought e an HSA co cost infntribution ormation; ho if hw ee or she is ver, HDHP claim enrollees ed as a wer depen e less likely th dent on anan oth er Issue Briefs EBRI assume and s EBRI Notes a public service re for our in-depth and 23% sponsibility to make nonpartisan pe its findings co riodicals. mpletely acce HDH ssiP ble at www.ebri.org Kaiser fo 50 und % no increase in CDHP enrollment between 2013 and 2014. 40% and online surveys was th Co e nvunder enient to w -re orp kresentation of minorities in online samples. 44% (61 private, information perce healt nt) r before he-insuranc spondents sa gettin e gexc he id th h alth c anges. Th at th are ser ey di ese pro vd not ices. CDHP parti grams giv cipa enrollees te e work because th ers mor were more likely th ey were a e choices for lreaan traditional d y heal healththy (28 covera -plan ge a perc enrol n ent repor d more lees to take ted it 25% Contact EBRI Publications, (202) 659-0670; fax publication orders to (202) 775-6312. 21% b those with traditional coverage to say that they had talked to friends, 29% family or colleagues about the plans; 35% HDHP Health Plan Choice Health Reimbursement Arr Decisions angements ............................................................................................. .................. 23 use any individuals leftov witer money h private i in nsur tha e HRA nce wer to con e cov tinue ered to cover by an H S qu A-eli alifg ie ib d me le 20% heal dical e th plxan or penses. HRFun A-base ds can d plan be iused n 2014, for out while -o f - — so that all decisions that relate to employee benefits, whether made in Congress or board rooms or traditional person’s ta -pla 40 x r %e nturn. enro llees to have sought information on dental care and they were more likely to have sought 19%* Used other websitesSubscriptions to to learn about your c hoi EBRI ces Issue Briefs are included as part of EBRI 42%* membership, or as part of a 19%* advantage o 20%f various wellness programs, s uch as health-risk assessments, health-promotion programs, and biometric as a major rea transparency To efficiently 40% r id e senti on, and 33 gard fy inres g coverage pon percent dents who wo choices report a ed it uld qua nd t as a m he costs a lify for inorthe C ssociated with reason). DHP and HDHP ov Lack each of tim choic e was t ersample e. he ths, the stud ird-most-popul y used ar reason for Ipsos’ c 11 attended a meeting where health plan choices wer9e explained; and consulted wit 35% h their employer’s HR staff Orders/ 40% 31% families’ homes, are based on the highest quality, most dependable information. EBRI’s Web CDHP site posts • Visit EBRI’s blog. 20% pocket e Refer 23.6 percent See Table XI ences xpens ............................................................................................................................... were covered es and pr in http://www.cdc.g emiu by an ms for insur HDHP $199 annual sub ov/nc (without ance, lon hs/data/n an H sg cription -term his/earlyrelease/i SA). to care, The NHIS EBRI Not COBReA, s estimates are and and r nsur201511.p EBRI Issue etiree h 28% e much h Brie alth df. fsbe . iChange of gh nefits. An er th ........................... 24 an th Address: em e AHIP ployer i c EBRI, s not information on lab and ra There was als 30% o some eviddiology costs. ence that adults in a CDHP and an HDHP were more likely than those in a traditional plan to To maintain current health status 40% CDHP 20% not parti screenings. In cipatin addition, g, with 23 percent r financial ine cent porti ive ng s mattered mo it as a major re re ason, a to CDHP nd 33 percent enrollees than to reporting traditio it as a nal-pla minor reason. n enrollees. For the omnibus survey of more than 30,000 online panel members who met the stu 24% 25% dy’s crit 34% eria (having private insurance and about 30%health plan choices. Those in an HDHP were more likely than those with traditional cover 16% age to say that all resea 15%rch findings, publications, and news alerts. EBRI also extends its education 16% and public service Individuals who have reached age 1100 13th St. NW, Suite 878, Washington, 55 and are not yet enrolled in Medicare may mak DC, 20005-4051, (202) 659-0670; fax number, e catch-up cont 15%ributions. In 2015, a requir estimates, but ed to make the NHIS inc unludes HRA-based pl used balance availa ans and also i ble to a workn er w cludes in hen he divi or duals she lwith eaves HD . HPs that are not in HSA-eligible be engaged in their Ask choic ed healthe pl o ans f h toe salth end yo pla u info nr. mSpeci ation in fthe ically, mail those in a CDHP were mor 29%e likely than those with traditional 15 30% % This Subscriptions Issue Brief 30% presents findings from the 2015 EBRI/Greenwald & Associates Consu 21% mer Engagement in Health Care Endnotes ............................................................................................................................................................ 24 12 15% most part, th being ages 21 e–64 re w ). ere The no fol dif lofwing thr erences in ee th questions w e answ 13%* ers to t ere used his series o in the o f q m unibus surv estions by 23%30% ey runn plan typ ing from e. July 14 to Aug. 1, role to improving Ameri (202) 775-6312 cans’ financial ; e-mail: knowle subs dge criptions@ebr through its a i.org w ardMe -win mbe ning rship Information: public service cam Inquiries paign they ha Wanted t d vis o lear ite n m d th ore a e h boue t ow alth n he pl alth an’s website to learn about their plans; talked to friends, family or colleagues The sp • EBRI’s reliable health and retirem ecific question was: Does your employer ent surveys ar offer any of the f e just a click away through the topic boxes at ollowing wellness programs? 12% Among i $1,000 catch ndivi 20%- dup co uals sntributio eeking cno was st informatio allowed. The n, 66 catch ?68 perc -upent fo contribution und info irmation on s not indexed cost sharing; to inflation. 45%* 42 ?47 percent found health plans. Estimates from the CEHCS are right between the AHIP estimates for HSA enrollment and the 16% NHIS coverage to say that they had talk ® ed to friends, family or colleagues about the plans (46 percent CDHP vs. 38 percent risks Survey (CEHC 20%S). This c study was based on an online survey, of 3,590 privately insured adults ages 21 -64, that was 10%* regarding EBRI membership and/or contributio 28%ns to EBRI-ERF should be directed to EBRI 19% ChoosetoSave and the companion site www.choosetosave.org 2015, to identify likely CDHP and HDHP respondents: 14% CDHP 48%* 9% 21% 29%* about t 20% h 10e %plans; used other websites to learn about their choices; and consulted with an insurance broker to the top of the page. 10% 17% information 20 on % what insurance would and would not pay toward the cost of care; 46 ?60 percent found 12% cost information Consult 10ed w % ith an insurance broker to understand your choices 28%* estimate for CDHP. traditional); attended a meeting where health plan choices were explained (43 percent CDHP vs. 27 15% perce 15% nt President Harry Conaway at the above address, (202) 659-0670; e-mail: conaway@ebri.org Figures designed 17 to an pr d 1 ovide 8 conational ntain findin ly repr gs from esentati a series of ve data re qu gard estions relat ing the gro ed to the wth of CDHPs impact th and hi at fin gh ancial -deduct inc ible entives cou health pla ld ns have 24% 13% 21% 13% ? Health-risk assessment, wh ere you answer a questionnaire and then a medical professional examines Distributio10 ns % from an HSA can be made at any time. An individual ne11% ed not 11% be covered by a high-deductible health plan understand their Requi plan red b choices. y employer 11% 11% 40%* 10% on provider costs; 21-28 percent found information on the tota 9%l cost o 9% f health care services charged to their insurance 5% 9% Figures 8% 27% 8% traditional); and consulted with their employer’s HR staff about health plan choices (36 percent CDHP vs. 29 percent 7% 19% 7% on part (HDHPs) an [ALL THRE icipat 10 d t ion in %E QU he im wpact o ESTIONS TO ellness programs. As i f these 4% plans a BE n ASKE d consum n past y D OF ears, t er e 7%THOS nh gagement ere wE AGE 21 ere a few more genera di - ff64] eren lly ceon the s by pl 7% behavi an typeor and attitu . CDHP enrol des of lees were EBRI is sup your health history 5% ported bto identi y organizations from all industries and sectors that appreciate the value of fy any conditions you may have or that you might be at risk of developing. 5% • Need a number? Check out the EBR 5% I Databook on Employee Benefits. 5% 10% to withdraw money from the HSA (although he or she must have been covered by a high-deductible health plan at the Editorial B Talkeoar d tod: your Har doc ryt Conaway, or or other h publisher ealth profes ; Stephen sional about Blakely the pla, ns editor. Any views expressed in t 23% his publication and those of the authors should not Unlike the AHIP, Kaiser, and Mercer surveys, the CEHCS has found that enrollment 3% in CDHPs had fallen between 2013 plan; and 12 ?16 percent found the total cost outside of their insurance plan (Figure 3%11). There were no differences in 17% traditional) (Figure 0% 8). Those in an HDHP were more likely than those with traditional coverage to say that they had more likely th adults ? with Program prian traditional vate, hea s for improving your health lth-in -plan surance cove enrollees rto report age. , like for weight The that sam p they wo le was ra loss, walking or uld pr ndo 17% obably mly dra partic wn other exerci fro ipat m Ipsos’ on e if the em se, nutriti linpl e pa oyer incr nel on, of stress e mor ased e than unbiased, reliable information on employee benefits. Visit www.ebri.org/about/join/ for more. Figure be ascribed to the 1, Premium Incr 0% 0% To addr officers, trustees, ess spec eases Among Employers ific health pm roe ble mb mers, or other sponsors of the E With 10 or Mor mplo e Em yee Be ployees, nefit Research Institu Worker Earni te, the EBRI Educatio ngs and Inflation, n and Research ? The survey also finds that CDHP enrollees were more likely than traditional-plan 39%* enrollees to take advantage of time the funds were placed in the HSA). Distributions are excluded from taxable income if they are used to pay for 0% After h 10 our % s urgent c 20 ar % e Co 30ns %ult with ph 40 ys % ician after50% If it would ta 60 ke % you more t 70han % 1- 80Du % ring bad 90 wea %ther 100% and 2014, and 0% again between 2014 and 2015. It is possible that prior year estimates from the CEHCS were too high, 0% the type of cost information Cost sharing (Copay sought s, Amou by nt ipla nsurn an type, ce woul with o d or Avern age e e cox sts ce option: r21% range of HDHP e Total cost n ch rolle argee d tso were your more Total cos li t okely than utside of your traditional- If employer offered If employ aer offered If employer offered If employer If employer made If required to c If employer reduced Fund, or0% their staffs. Nothing herein is to be construed as an attempt to aid or b hinder the adoption of any pending legislation, regulation, or vis 1. ited th Which of the e health plan’s following be website to st describes your current health insu learn about their plans (61 percent HDHP vs. rance status: 50 percent traditional); talked to management, smoking cessation, beand s ing hospo ita on liz0% ed. fo r majo10 r % 2 hour20 s to % get to y30 ou% r doctor's40% 50% 60% 70% premiums 775,• 00 0 Int Instantly get e-m for 0% ernet users non-partici who pan T had a rts, or if adi il noti tiona ag l ree they ?cations of the latest EB d to w partici ere requ pate ired t in researc o partici HDHPRI data, h sur pate t veys. This sur o enroll surveys, publications, and m in the vey used preferred h CDH a ba P ese sample alth plan eetings of (Figur 2,004 e 17). to 1988 ?2014 .......................................................................................................................... Extremely Important Very Important Somewhat Important Not Too Important Not at All Importa........... 6 nt various wellness programs, such as health-risk assessments and health-promotion programs, as well as c $2 oi50 ca nsuranc sh e, ded incentiuc vetibles, time off would not pa dis ycounted cos inc tsr ch eas ar ed p gedr by emi th um e additio ins nal urance p pa larn ticipate to enroilns l urc anc onte p ribut lan ion to qualified medical ex Le pe ssns Tha es n O a ne s Y def ear ined under Int 1-ernal 2 Years Revenue Code (IRC) 3-4 YeSec. ars 213(d). Distrib 5 Yea utio rs o ns r Mor for e premiums for surgery office causing it to interpretative rule look like , or as legal, enroll Health Ri accounting, act ment ha sk Assessme d nt decl uarined w ial, or other hen such pr in He alt fact enrol ofessio h Promot nion al advice. l P ment rogram had not www.ebri. dec org lined. Biom Another etric Screeni re ng ason for the plan enrollees to have sought informa0% tion on the a 10v %erage or ra 20% nge of costs charged 30% by health 40% care provi 50% ders. etc.) premium for non- prov pia der rticipants contribution to in preferred health HRA/HSA frien ? d s, fam Biometric scr ily or colleagues eenings, whic about thh are measur e plans (48 perce ement nt s HDHP or bloo vs. 3 d work to determine your 8 percent traditional); used oth health er w status ebsites to including learn There draw inci wed re en no ce di rates for people with fferences between H acco DHP unt-based hea and traditional lth plans a -plan enrolle nd HDHPs, es. When it and t ca hme to th e base sample was e impact of complemented cost sharing, and seminars by clicking on the “Notify Me” or “RSS” buttons at the top of our home page. biometric screenings. In addition, financial incentives mattered more to CDHP enrollees than to traditional-plan HRA/HSA plan the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), long-term care insurance, health insurance while Source: Source: EBRI/C EBR ommonw I/Greenw ealth ald & Associates Fund Consumerism Consum in H er ealth C Engagement are Surv in H ey, ealth C 2005–2007; EBR are Survey, I/G 2015. reenwald & Associates Consumer Engagement in Health Care apparent decline in enrollment could be that the estimates were within the margin of error. This would mean that the Source: EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, 2015. Source: EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, 2015. blood pressur I have health insurance Source: EBRI/Greenw e, chol ald & Associates esterol Cthrough a g , onsum weight, heig er Engagement overnment p in H ht, etc ealth Ca. re Surv ey, l2015. an such as Figure 2, Distribution a Source: EBR of In I/Greenw di ald & Associates viduals Cov Consum ered er Engagement by Privat in H e H ealth C ealth I are Surv ney suranc , 2015. e, by Type of Health Plan, 2005 ?2015 ... 6 about their choices (42 perc Source: EBRI/Greenwald & Associates ent HDH Consumer P vs. Engagement 29 percent tra in Health Cd are Surv itiona ey, l) 2015. ; and that they had consulted with an insurance broker Surv Source: a Source: ey T , 2008–2015. raditional EBR EBRI/G I/G = H reenw reenw ealth plan w ald & Associates ald & Associates ith no deductible C Consum onsumor <$1,300 er er Engagement Engagement (indivin H in H idual), ealth C ealth C <$2,600 a are Surv re Surv (family ey ey, , ) 2015. 2015. in 2015; there with an a werd editi als Source: a EBR onal ran o just a few di EBR I Issu I/Ge reenw dom o Brief ald & Associates isv rffer e ersample o gister ences ed in the U. Consum by fer t plan type Engagement h S. ese t Patent and T wo in H (Figur grou ealth C radem ps ae re Surv . More s 1 ar8 k ). ey Office. CDHP , 2015.p Ieci S e SN: 0887 fn ically, t rollees ?13 hwer e ov 7X/90 ee 0887 rsamples w more like ?137X/90 $ . ly th ere an traditional : 1) those 50+.50 wit -plan h a Traditional = health plan with no deductible or <$1,300 (individual), <$2,600 (family) in 2015; enrolle a Traditional a es. = Health plan with no deductible or <$1,300 (individual), <$2,600 (family) in 2015; 10 a Traditional Traditional = H= H ealth plan w ealth plan w ith no deductible ith no deductible or <$1,300 or <$1,300 (indiv (indiv idual), idual), <$2,600 <$2,600 (family (family ) in 2015; ) in 2015; aT a a raditional b = Health plan with no deductible or <$1,300 (individual), <$2,500 (family) in 2015; receiving une Tb raditional = T mployment Tr raditional aditional = HDHP = High-deduc health plan = health health plan co plan w tib mpensation, ith w w le iino th no deductible th health no deductible deductible plan w or ith or <$1,300 or deduc a <$1,300 (indiv <$1,300 (indiv nd i tible n $1,300+ (indiv (indiv suranc idual), iidual), dual), <$2,600 (family e <$2,600 <$2,600 (family idual), $2,600+ (fam while (family el ) in igi ) ) in 2015; in b 2015; 2015; le ily f ), not or Medicare HSA-eligible in 2015; other than for Medigap, are also tax b Traditional = Health plan with no deductible or <$1,300 (individual), <$2,600 (family) in 2015; apparent decl HDHP = High-deduc ine was not a r tible health eal decli plan with ne. Ot deductible her surveys $1,300+ (individual), $2,600+ (fam have found select years with s ily), not HSA-eligible in 2015; tagnant growth or segments of bHDHP = High-deduc b tible health plan with deductible $1,300+ (individual), $2,600+ (family), not HSA-eligible in 2015; b Medicare, Medicaid, or V HDHP = High-deductible health plan with deduceterans ben tible $1,300+ (individual), $2,600+ (fam efits ......................................... ily), not HSA-eligible in 2015; 1 b b b c HDHP = High-deductible health plan with deductible $1,300+ (individual), $2,600+ (family), not HSA-eligible in 2015; to understand pla bHDHP = High-deduc n choices tible health (28 plan perc with ent H deductible DHP vs. 19 $1,300+ (individual), $2,600+ (fam percent traily ditiona ), not HSA-eligible in l). CDHP 2015; and traditional-plan enrollees were HDHP = High-deduc c HDHP = High-deduc HDHP = High-deduc CDHP = Consum tib er-driv ltib tib e health lle e health health en health plan plan plan wplan ith w wiideduc th th w deduc deduc ith deduc tible tible tible $1,300+ (indiv tible $1,300+ (indiv $1,300+ (indiv $1,300+ (indiv idual), $2,600+ (fam iidual), $2,600+ (fam dual), $2,600+ (fam idual), $2,600+ (fam ily), not ily ily), not ), not ily HSA-eligible in ), w HSA-eligible in HSA-eligible in ith HRA, HSA, 2015; 2015; 2015; or HSA-eligible in 2015. enrolle either an H es to RA cparticipate HDHP = High-deduc or an HSA, if th tib inc le ere health ludin was an plan g windividu ith deduc inc tible rease in als who $1,300+ (indiv dr w ug-c idual), $2,600+ (fam ere ost sharing, enrolled ilyin a ), not or a HSA-eligible in n HSA-eli decrease 2015; gible in of health ficeplan, -visit c but ost sharing for had not ope ned c CDHP = Consumer-driven health plan with deductible $1,300+ (individual), $2,600+ (family), w/ith HRA, HSA, or HSA-eligible in 2015. c CDHP = Cons c umer-driven health plan with deductible $1,300+ (indiv There’s lo idual), $2,600+ (fam ts more! ily), with HRA, HSA, or HSA-eligible in 2015. c CDHP = Cons CDHP = Cons umer-driv umer-driv en health en health plan plan with deduc with deduc tible tible $1,300+ (indiv $1,300+ (indiv idual), idual), th $2,600+ (fam $2,600+ (fam ily), w ily), w ith HRA, ith HRA, HSA, HSA, or HSA-eligible or HSA-eligible in 20 in 15. 2015. cCDHP = Cons c c umer-driven health plan with deductible $1,300+ (individual), $2,600+ (family), with HRA, HSA, or HSA-eligible in 2015. free. This mea CDHP = Cons CDHP = Cons CDHP = Cons * n Differenc s that um e betw um um er-driv distributions used to er-driv er-driv een HDHP/CDHP en en en health health health plan plan plan wand T ith deduc w wiith deduc thd educ raditional tible pay M tible tible $1,300+ $1,300+ (indiv is s $1,300+ (indiv tatise ticdi a(indiv llycare i dual), signific iidual), dual), $2,600+ $2,600+ (fam Part A or ant $2,600+ (fam at the p (fam =ily 0.05 B, ), w ily ily), w ), ior better. th Medicar wiHRA, ith th HRA, HRA, HSA, HSA, HSA, or e A HSA-eligible in or or HSA-eligible d HSA-eligible vantage 20 in in 20 15. 20 plan 15. 15. premiums, and the CDHP = Consumer-driven health plan with deductible $1,300+ (individual), $2,600+ (family), with HRA, HSA, or HSA-eligible in 2015. the population * Differenc where e betw dec een HDHP/CDHP lines have occ and Traditional urreisd. Most rec statistically 1100 13 signific eant nt St at ly, NHIS the p reet = 0.05 NW · Suite 878 fou or better. nd a decli ne in enrollment in both CDHPs and Figure 3, HSA * Differenc and H e betw RA Enrollment Rates, 2015 een HDHP/CDHP and Traditional is statistic .................................................................................. ally significant at the p = 0.05 or better. ........... 7 I have health insurance * Difference between HDHP/CDHP and T through my j raditional is statisticallyob or the job significant at the p = 0.05 or better. * Difference between HDHP/CDHP and Traditional is statistically significant at the p = 0.05 or better. * Difference between HDHP/CDHP and Traditional is statistically significant at the p = 0.05 or better. equally likely t * * Differenc Differenc o report e e betw betw that een HDHP/CDHP een HDHP/CDHP they visited and T and Trraditional aditional health is is s sttatis atis plans’ websites to l tic tica ally lly s siignific gnificant ant at at the p the p = = 0.05 0.05 earn or better. or better. about their plans; used other websites to learn * Difference between HDHP/CDHP and Traditional is statistically significant at the p = 0.05 or better. welln the HSA, ess pro and gr2) those i am particn ipa a plan nts. Overall, ho with an individual wever, cost-sh deductib aring ince le of at l neast $1, tives to partic 300 an ipat d ae still m family deduct attered to ma ible of at l ny e ast © 2015, Employee Benefit Research Institute 11 Washington, DC ?Education and Re 20005 search Fund. All rights reserved. employee share of the premium for employment-based retiree health benefits are allowed on a tax-free basis. HDHPs betweof another f en 2014 andamily me the first hal mb f oer (such as f 2015. Similar spouse or p ly, AHIP foarent) und a decli ...................... ne in HSA enrol 2 lment in the small-group Visit EBRI online today: www.ebri.org (202) 659-0670 www.ebri.org www.choosetosave.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org A monthl ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December ebri.org Issue Brief • December Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri y research report f e e e e e e e e e e e e e effffffffffffff • December • December • December • December • December • December • December • December • December • December • December • December • December • December rom th2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 e EBRI Education and Re 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 2015 • No. 421 search Fund © 2 015 Em ployee Benefit R e search Institute 11 3 4 25 2 23 21 22 20 17 5 13 24 8 12 15 18 10 14 19 16 6 7 9