After a slight drop during the recent recession, health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are showing renewed growth, with the average account balance increasing over the past two years, according to new research by EBRI.
• Asset levels growing: In 2012, there was $17.8 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 11.6 million accounts, according to data from the 2012 EBRI/MGA Consumer Engagement in Health Care Survey, sponsored by EBRI and Matthew Greenwald & Associates. This was up from 2006, when there were 1.3 million accounts with $873.4 million in assets, and 2011, when 8.5 million accounts held $12.4 billion in assets.
• After leveling off, average account balances increased: After average account balances leveled off in 2008 and 2009, and fell slightly in 2010, they increased in 2011 and 2012. In 2006, the average account balance was $696. It increased to $1,320 in 2007, a 90 percent increase. Account balances averaged $1,356 in 2008 and $1,419 in 2009, 3 percent and 5 percent increases, respectively. In 2010, average account balances fell to $1,355, down 4.5 percent from the previous year. In 2011, average account balances increased to $1,470, a 9 percent increase from 2010. It increased to $1,534 in 2012, a 4 percent increase.
• Total and average rollovers increase: After declining to $1,029 in 2010, average rollover amounts increased to $1,206 in 2011 and remained there in 2012. Total assets being rolled over increased: $9.7 billion was rolled over into HSAs and HRAs in 2012, up from $6.8 billion in 2011. The percentage of individuals without a rollover was 11 percent in 2012.
• Healthy behavior does not mean higher account balances and higher rollovers: Individuals who smoke have more money in their accounts than those who do not smoke. In contrast, obese individuals have less money in their account than the nonobese. There was very little difference in account balances by level of exercise. Very small differences were found in account balances and rollover amounts for individuals who used cost or quality information, compared with those who did not use such information. However, next to no relationship was found between either account balance or rollover amounts and various cost-conscious behaviors.
• Differences in account balances: Men have higher account balances than women, older individuals have higher account balances, account balances increase with household income, and education has a significant impact on account balances, independent of income and other variables.
• Differences in rollover amounts: Men rolled over more money than women, and older individuals had higher rollover amounts than younger individuals in 2012. Rollover amounts increased with household income and education, and individuals with single coverage rolled over a slightly higher amount than those with family coverage in 2012.
Accounts (millions) Accounts (millions) References Between 2007 and 2012, the percenta The Cost-Consciou Rollovers Figure higher 13, With Acc ac both count ount Ba vari balanc lancess ables, very Behaviors es, by H foun small diff d amon — ealth A number o ge Behavior and H g wieren ol th der at least $3,000 i ces f individuals may also cost-conscious in accou ealth Stat nt n bal th behaviors us, 2012 ances w eir account i be due ....................................................... ewer re to t fo e nund. e crea hxe amine fact that sed from Individua d to they see i 16 ls who percent fare allo individu partic in we ipated als who 2007 to d to ........ 14 make in a Paul Fronstin is director of the Health Research and Education Program at the Employee Benefit Research Institute Health Savings Accounts and Health Reimbursement Figure 1 exhi “catch 23 perce bit mor -up” co welln nt in e c 2 ntributio ess pro o0 st-conscious 12, w gn hile ram had a s tha the tdecision those u percenta high maki neder r avera ge ng wit age h a had hi g55 are no e ac zero count gher accou Figure 14 Figure 10 Figure 2 Figure 22 Figure 28 Figure 12 Figure 26 Figure 32 Figure 30 Figure 34 Figure 16 Figure 20 Figure 24 Figure 8 Figure 6 rollover t a balanc llow nt ba a ee d to m amou lance than those f nts than t ake. Howev ell from b wh10 h o di ose perc er, d not. who the ent i regr di Th n 2 d eession e not e average acco 007 to xhibit such 5 quation percunt ent co a balanc in ntrolled 2012 e (EBRI ). This Issue Brief was written with assistance from Figure 18 the Institute’s research and editorial staffs. Any views Employers have a tremendous amount of flexibility in designing health plans that incorporate an HRA. Leftover funds at Length of Time With HRA Figure 4or HSA, 2006–2012 Arrangements: Assets, Account Balances, and Rollovers, a b Figure 14, Account Balances, by Use of Cost and Quality Information and Use of Wellness Program, 2012 ................. 16 Account Balances, Acco To unt tal A Balances, by ssets by A and nnu Number al Household Use of of Cost and Adul Income, ts A Quality ges 2007–2012 A Rollov Rollov cco A unt A cco v e eerage HRA r r Balances, by unt Balances, A A A Rollov Rollov A m cco m cco Rollov ou ou Rollov Rollov unt Balances, nt, nt, unt Balances, e er r A a by by A er A e e or HSA m m r r V Health Behav A A ou ou Length of a m by m m rious Cost Conscious nts, ou nt, ou ou b Gender nt, nt, by nt, by Rollov by Aby m by Education, by Plan on T Gender Lev Race, iA me and g Indiv er A ig or e, 2007 Te With y and A l of m pe, 2007 2007–2012 g ,ou e 2007–2012 iduals With 2007–2012 A Health Status, 2012 A Combined, nt, ? n ccou 2012 nBehav 2006 u ? al 2012 nt, ?2012 2007–2012 iors, 2012 2012 (Fi decis for in gur ion divi e 5 -maki was $ dual ). ng contributio 1,67 proces 0 amsong those ns . T,he and t ques hus w tions h ol o part der A rcco e age gar icipat unt d wo ine g cos Balances, d u in ld n a t-o we ct b ons llnes ec a ious by fs a Lev program, ctor decie in sl of ion making the ob an And $ n se urved 1 al w ,573 e re d amo ifdes feren n cri g t ce bed h s. ose w above. ho did not Differences in Fronstin , Paul. "Findings From the 2012 EBRI/MGA Consumer Engagement in Health Care Survey." EBRI Issue the end of eac expressed in this report are h year can be th carried over to A ose of verage HRA the author an the follo or HSA d sho wing A uld ccou year (at th not n be t Balances, ascribe e employer’s d to t 2006–2012 he officers, trustees, or other discretion). Employers can, spo however, nsors 45% a b 2006–2012 $2 $3 $2,00 ,00 ,000 0 0 Information 21–64 With and an HRA Use of W or HSA ellness Program, 2012 , 2006–2012 $2,000 AccoEmploy unt Indiv for More Than One idual Contribution, er Contribution, Y 2007–2012 ear 2007–2012 , 2006–2012 $2 $2,00 ,500 0 $2,000 rollover amounts b participate (Fi y various cost- gure 14). conscious decision-making questions were relatively small (Figure 32). of EBRI, Brief, no. 380 EBRI $2,00-ERF, or 0 (Employee Benefit Resear their staffs. Neither EBRI nor ch Institute, December EBRI-ERF lobbies or takes p 2012). ositions on specific policy proposals. place restrictio $2 $2 $2 ,00 ,00 ,00 0 0ns on th 0 e amount that 42% can be carried over. When it comes to HSAs, any money left in an account at the $2,000 Figure 15, Account Balances, by Various Cost Conscious Behaviors, 2012 ................................................................ 16 January 2013 35 $2 • % ,00 No. 382 0 $2,500 $20,000 41% $1,865 12 Whe n examin $2,00i0ng differences in account balances for men and women by age, men are still found to have higher Male Female $1,825 2006 2007 2008 2009 2010 2011 2012 EBRI invit end of the yea es cor automatical mment on thlis research. y rolls over an d is available in Ye the s follNo owing year because there is 11.6 no use-it-or-lose-it rule, 2007 2008 2009 2010 2011 2012 20 20 20 07 07 07 20 20 20 08 08 08 20 20 20 09 09 09 20 20 10 20 10 10 20 20 11 11 201120 2012 12 2012 $1,800 2007 2008 2009 2010 2011 2012 $1,800 $1,800 39% $1,766 40% $1 $1,80 ,800 0 $1,772 account Cost-Consciou balan Length $1,80c0es than of Tim wom es With Behaviors en Account but t —h Ae number o —The 20 differences 07 2006 len 2007 20 gf 20 th c 08 07 narro o 20 of time st-conscious 0820w with o 20 08 Ye 20 09 s that 092009 a 20 No lbehaviors 20 n 10 der 20 in 10 20 07 a 10 dividual 20 g 20 11 es 08 20 20 (Fi 11 wer 11 20 ha 20 g 12ur 09 e 20 s held th e e 8). 12 x 20 20 amine 10 12 20 e acc d to 11 see i o 20 unt ha 12 f individu d a 31%n im als who pact on Fronstin, P $1 a ,80 ul0. "The Use of Health Savings Accoun 6 ts for Health Care in Retirement." EBRI Notes, vol. 31, no. 4 $1 $1,80 ,800 0 $2,563 By Paul Where the world turns for the facts Fr $1on ,800stin, Ph.D., Employee Benefit Research on U.S. employee benefits. Institute $1,735 as is the case with flexible spending accounts. $1,697 Figure 16, Acc $1,80$1 o 0 unt Ba 8,000 lances, by Length of Time With Account, 2007–2012.............................................................. 17 2007 2008 20 Ye09 s 20 No 10 2011 2012 $1,800 $1,647 30 $2% ,500 exhi rollover amou bit more cnts. The ost-conscious analysis found that decision maki ng people had hi holdi gher ng an account account balan fo cr one to two es than those y who ears ha did d an not e av xerage rollover of hibit such a (Employee Benefit Research Institute, April 2010). $1,600 36% $1,670 About the 2012 EBRI/MGA Consumer Enga $1,620 gement in Health Care Survey $1,600 $1,632 $1,607 $1,607 $1,600 $1,957 10 $1,600 $1,587 $2,320 $1 $1 $2 $1 ,60 ,60 ,00 ,60 0 0 0 0 35% $1,949 Copyright Inf Race—In ormation: 2009, 20 1This re 0, and port 2012, is minoriti copyright ese with d by the Em an HRAploye or HSA e Be had nef hi it R gher ese account arch Institut balanc e (EBRI es than $1,534 ). It whites may be with $1,600 $1,589 $1,600 decis $93 352 i %ion n -maki 201 $12 ,60 ng (Fi 0 g proces ure 33 s). . T In he comparison, questions re tgar hose hol ding cos dintg a -cons n acccou iousn de t for cis ion making three to fo a ur y re as ears ha follows $1,573 d an : average rollover of $16,000 $1,525 $1,951 $2,231 Over time, $2 the ,000 percentage of individuals with a rollover has increased. In 2006, 23 $1,526 percent of individuals with an HRA Figure Retirement 17, Acc $1,60o 0 unt Ba and health benefits are at the heart of w lances, by Level of Annual Employer Contributio orker n, 2007–2012 s’, emplo .............................................. yers’, and our nation’s .. 17 $1,470 $1,915 $1,600 $1,477 $1,470 $1,890 $1,476 The Employee $1,400 Benefit Research Institute (EBRI) and Mathew Greenwald & Associates (MGA) created the one of these accounts. However, in 2011, $1,456 whites had higher $1,419 account balances than minorities. On average, mi 25% 25% norities used Taylor, H without umphrey. "Do permission es I but citation nternet of t Rese harch ‘W e source $1,454 ork’? Comp is requiredaring . Online Survey Results With Telephone Surveys." $1,444 $1,766 $2,109 Introduction 8.5 Health Savings Accounts an $1,214, and those with an account at least five years old Health Reimbursement d had an average rollover of $1,627. Average rollover amounts economic security 25% . Founded in 1978, EBRI is the most authoritative and objective source of $1,742 or HSA did not $1 $1 ,40 ,40 0 roll ove 0 r any money Asse (Fi ts (m gure illion 20 s) ). By 2012, only 11 per $1,775 cent did not have a rollover. $1,403 $1,356 $1,355 $1 $1,40 ,400 0 31% $2,028 $1,754 $2,010 $1,386 $1 $1,40 ,400 023% $1,366 $1,350 $1,400 Established in 1978, the Employee Benefit $1,320 $1,400 $1,346 $1,295 Consumer En $1,40$1 0 4,000gagement in Health Care Survey (CEHCS) to e 30% xamine $1,351 issues surrounding consum $1,643 er-directed had a In the n acco last unt bala 12 months or sin nce of $1,65ce you join 4 in 2012, whi ed your curre le whites nt h had a ealth n acco plan, un did you t balance o do any f $1,60 of the 0 in follo 2012 win (Fig g:ur e 9). International Journal of Market Research 42, no. 1 (August 2003). $1,334 $1,321 $2 $1 ,00 ,40 00 $1,180 Figure in 201218, fell Acc amoong those unt Balances holdin , by Lev g acco $1,275 el o unt f A s less than nnual Individu five years a al Contri nbution d increased amon , 2007–2012 g those ............................................ holding accounts at least ... 19 Employers firs information on these critical, complex issues. $1,400t started o $1,301 ffering account-based health plans in 20 $1,01, 608 when a $1,646 handful of em $1,896 ployers $1, $1, 288 606 began to $1,243 offer health $1,174 $1,152 29% $1,156 30% $1,200 $1,147 $1,145 8 Arrangements: Assets, Account Balances, and Rollovers, $1,137 $1,144 $1,134 $1,577 $1,206 $1,136 $1,579 $1, $1,206 257 $1,111 Accounts (millions) Recommended Citation: $1,240 Paul Fronstin, “Health $1,107 Savings Accounts and Health Reim28 bursement % Arrangements: Assets, 28% 28% $1,187 health care, including the co $1,223 st of insurance, the cost of care, satisfaction with health $1,172 care, satisfaction with a $1,101 Minorities experienc $1,073 ed an increase in account balances in 2012, while whites saw th $1,173 eir account balances decline. $1,200 $1,069 $1,161 20% The number o $1,200f peopl Re esear with ch Institute (EBRI) is the only a rollover, as well as the total level of assets being rolle $1,066 d over, has been increasing. In $1,200 $1,044 $1,166 $1,139 $1,185 $1,063 five years. ? Checked whether my health plan would cover my care or medication? 27% reimbursem $1,20 en 0t arrangement $1,163 s (HRAs), employer-funded h $1,453 ealth plans that reim $1,727 burse workers for $1,217 qualified medical $1,200 $1,208 20 $1 $1 $1% ,20 ,20 ,500 0 0 $1,147 $12,000 $1,188 $1,130 $1,200 $1,121 26% $1,411 Account Ba $1 $1 lan ,50 ,20 0ces, and Rollo 0 vers, 2006–2012,” EBRI Issue Brief, no. 382 (January 2013). $1,106 2006–2012 $1,200 $1,105 $1,667 $1,104 $1,100 Figure health care plan, reasons for choosing a p 19,$1 Acc ,200ount Balances, by Rollover Level, lan, and sourc 2007–2012 .................................................................................... 19 es of health in $1,029 $1,116 formation. The 2012 EBRI/M $1,368 18% GA $1,000 $1,631 $1,066 2006, EBRI focus 500,000 individu es solel als rol yled on emplo over $276. yee 2 mill benefits research — no lobb $1,000 ion (Figur $1, e 2 359 1). By 2012, 8.1 million ying indivi or advocacy duals rolled ove . r $9.7 billion. $1,057 $1,066 $1,023 expenses. In 2004, employers were able to start offering health plan$1,073 s with health savings accounts (HSAs), tax-exempt EBRI Employee Benefit Resea$1,066 rch Institute Issue Brief (ISSN 0887 ?137X) is published monthly by the Employee Benefit Research Institute, independent nonpr 24% ofit, nonpartisan $1,303 $999 $1,076 $1,528 $992 25% ? Checked the price of a docto$948 r’s visit, medication, or $1,020 other health care service before I received care? $1,000 $1,527 $1,003 $1,000 Household 16%Income—According to Figure 10, account balances for HSAs and HRAs in $995 crease with household $1 $1,00 ,000 0 $1,246 CEHCS is comparable with findings from the 2005, 2006, and 2007 EBRI/Common $944 $946 wealth Fund Employer and Individual Con $969 tributions$1,020 —Annual contribution amounts from individu $979 als had a strong impact on 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- The averag $1 $1e r ,00 ,500 0ollover increased from $592 in 2006 to $1,206 in 2012 (Figure 22). Average rollover amounts increased $1,000$10,000 $993 $933 $1,209 6 By Paul Fronstin, Ph.D., Employee Benefit Research Institute $1 $1,00 ,000 0 $986 5.4 trusts or custodial $1,000 accounts that in $938 dividuals can use to $927 $1, pa 358 y for $1,356 health ca$927 re expenses. The theory behind these accounts $1,000 $1,166 $921 22%$1,178 14% $926 Report availability: $1,000 This r $879 eport is available on the Internet at www.ebri.org $959 $800 $956 15 $1% ,000 14% 14% income. I Figure cals20, pos n Rollover Amounts, 2 tage 012, t rate pai he av d in erage accou Washin Among Individuals gton, DC n,t and bala $1,125 addi nce tional m was $ With ail $849 1 ing Ac ,2 o 4 count for ffi 6ce amon s. POS g i Mor TMAS ndiv eT Than O iduals ER: Send with n ad e Year, 2006–2012 dr les ess c s than hange$5 s to: 0,00 EBRI 0 in ......................... Issu house e Brief,hol 11d 00 20 organization committed 13% exclusively to data $1,332 $1,324 ? Checked th organization. e quality rati It analyzes a ng of a doctor or nd repo h $834 rt os spital resea befor rch e data I received car $867 without spin o e from r unde them? rlying agenda. All findings, Consumerism in Health Care$1,100 Surveys, and the 2008 -2011 EBRI/MGA $823 Consumer Engagement in Health overall rollover amounts, 13% $882 whereas employer contributions were not found to have a s 13% tatistically significant 13% effect on $812 $810 4.8 $17,786.1 between 2010 and 2011 but re $799 $837 mained at $1,206 in 2012. $800 is that 13th S givin t. Ng W i,n S divi uite 8 duals mor 78, Washin eg control ton, DC, over 200 20% 05 $1, -4 funds 035 051. C allocat opyright e 20 d 13 for by h Ee m alth $780 ploy ca ee B re services enefit Researc wil h Il cause t nstitute. Ah ll em t rights r oe spen served. d th No.e m 382. o ney $809 $800 $806 $849 Endnotes $757 $800 $826 $787 $777 $992 income; $1,359 wheth $8 among ,000er on fi indnan ividu cial als data, with $50 option 19%,000 19 s - % , $9 or tre 9,999 nds, , and are reve $1,957 aling amon an gd th reli 19 ose %able with — the re $100,00 aso 0 or more n EBRI informatio . Account n is 20% Care Surveys. $8 $800 00 $69611% 11% 4.2 11% rollover amou $1$8 ,00 00 nts. Indivi 0 duals with an employer contribution of less th 11% an $111% ,000 had an average rollover of $1,076 in $1$6 ,00 00 0 $924 $8 $8 $8 00 00 00 dissemination, resear $1, ch, and education on 081 ? Talked $800 to my doctor a $717 $912 $903 bout the prescription options and costs? more respo$8 nsibly, especial 00 ly 10% once th 10% ey 10% become more educated about the actua 10% l price of health services. Furthermore, Figure 21, Total Rollov $651 er Assets and Number of Adults Ages 21–64 With10% a Rollover, 2006–2012 ............................... 20 $592 the gold standard for private analysts and decision makers, government policymakers, the media, and balances increased re $665 gar $694 dless of income level. While higher-income households may have contributed higher amounts 10% $831 $831 $607 9% $654 $967 9% 9% 9% 9% The remainder $600 of this section examines variAT A GLAN ation in rollover amounts. TCE he estimates in this section were 4 generated $962 2012, while those with $588 an employer contribution of at least $1,000 had an aver 16% age rollover of $1,208 (Figure 34). In 16% $1$6 ,00 00 0 $626 8% 8% 8% 8% 8% $12,430.1 these acco 1 unt $600 s can be used as tax-a 8% $898 dvant $886 aged vehicles 8% 8% to save for health care expenses in retirement. 15% $6,000 ? Talked to my the publi economic security and employee benefits doctor a c. bout other treatment options and costs? . $842 $849 $875 See www.mer $400cer.com/pressrelease/details.htm?idContent=1491670 7% 7% 7% The 2012 survey $6 $6 $600 00 00 was conducted within the United States between August 8 and August 17, 2012, through a to their HSAs than lower-income households, the regression equation controlled for contribution levels and educational 7% from a regr$6 $6 ession e $6 $6 00 00 00 00 quation that also controlled for how long an individual has held an HRA or HSA, employer contrast, individuals 15% $600 who contributed less than $1,000 had an average rollover of $900, while those who contributed at $740 6% 6% 6% 6% 6% Figure 22, Average HRA or HSA Rollover A The Em 2.5 plo mount, 2006 yee Benefit Research Institut ?2012................................................................................. 21 e (EBRI) was founded in 1978. Its mission is to $701 $400 $694 5% 7 15-minute Internet survey. The national or base sample was drawn from Synovate’s 5%online panel of Internet attainment. The difference in account balances by household income may have been due to higher-income households ? Used an $400 online cost-tracking tool provided by my health plan to manage my health expenses? 12% contributions to the account, and individual contributions to the account. As with the detailed data on average account 5% contribute to, to encourage, and to enhance the development of sound employee benefit least $1,000 $4 h 00a $4 d an ,000 average rollover of $1,308, a difference that is statistically significant (Figure 35). 2 By 2011, 32 percent of $581 employers with 500 or more workers offered either an HRA or HSA-eligible plan, covering Table of Contents ? Asset $200 levels growing: In 2012, there was $17.8 billion in health savings accounts (HSAs) and health 11% $500 3 $7,343.5 The term “ass EBRI explo $4 $400 00ets” is used loosely as it relates to HRAs. An HR res the breadth of employee benefits and related issues. A is typically set up as a notional arrange ment and exists only $400 3% $500 $6,829.8 2 Who we are $4 $4 $4 00 00 00 users who hav $4 $400 0010% e agreed to participate in research surveys. About 2,000 adults (n=2,004) ages 21 -641 who being less likely to take distributions programs and so from the acco und public policy unt. (This is an through objective empirical question resear t ch and hat is educati worth on. EBR explorin I is the only g as data Fig balanc ure 23, es, 2 Roll 006over data for Amount, by Gen roll 1.3overs are der, 20 not shown 07 ?2012 ............................................................................................... for the different variables because of small sample sizes. 21 $500 $5,697.2 13 perc ? Develo ent o $2 f p 00 that po ed a budg pulatio et to m n, up a from nage my 23 hea perce lth nt of care feri ex ng suc penseh a s? plan and 1 9% 0 percent enrollment in 2010. 9% As a result, 10% The Institute seeks to advance the public’s, reimbursement arrangements (HRAs), spread across 11.6 million accounts, according to data from the 2012 EBRI studies the world of health and retirement benefits — issues such as 401(k)s, IRAs, retirement Introductio on paper. Employees may vie n .................................................................................................................. w the HRA as if money was actually being deposited into an account, and ........................................ 4 they may carry a debit $200 8% private, nonprofit, nonpartisan, Washington, DC-based organization committed exclusivel 8% y to 8% had health ins $2,000urance through an employer or purchased directly from a carrier were drawn randomly from the 0% become availa $0ble.) $200 7% $3,336.8 these plans co 0% $2incom 00verede about adeq 2 uacy, 5 mill co ion nsu peo mp er-drive le in 2012, n benefits, representin Socia g a l b Security, out 15 perce tax treatment of both retireme nt of the privately insured mar nt and health ket EBRI/M $200GA Consumer Engagement in Health Care Survey, sponsored by EBRI and Matthew Greenwald & $200 Checked Checked prpublic ice Ch poli eckedcy res Tal earch ked toand Usedu ed onl cat inion on e Talkecon ed toomic s Devecuri elopedty and em Asked foplo r yAee sk b ed doc enefi tort issues. $2 $2 00 00 card that can b ? Asked for $2 $2 00 00 e used to pay for health care a generic 6%drug instead of a services at the brand name point of service, but employers do drug? not incur expenses associated $200 the media’s and policymakers’ knowledge Assets and Account Balances .................................................................................................................................. 4 Gender an$0 d Age—Men rolled over more Less Than $100 $100–$299 money than $300–$499 women. In $500–$999 2012, men $1,000–$1,499 ha$1,500–$1,999 d an average rol $2,000 or lov Mer of $1, ore 224 Figure Synovate sam 24, Roll $0 over Amount, ple for this ba by Age, 2 se sample. This sample 007 ?2012 .................................................................................................... 22 was stratified by gender, age, region, income, and race. Conclusion whether pla$873.4 n of service quality rating of doctor about cost tracking doctor about budget to generic drug to 5% recommend benefits, cost management, worker and employer attitudes, policy reform proposals, and pension assets (Fronstin 201$0 2). As the number with EBRI’s member account-based pla ship includes a ns grow cross-section of s, total assets in t pension funds; businesses; trade associations hese plans can be expected to grow. ; Associates. Th $0 is was u 2006 p from 20 20 07 06, when20 there 08 were 1. 203 mill 09 ion acco 20unts wit 10 h $87 2011 3.4 million in 20 0 12 assets, and 4% with the arrang 5% ement until an would cover before g employee incurs a claim. etting doctor/hospital treatment tool provided prescription manage health instead of less costly Education $0 —Education has an impact on account balances independent of income and other variables, as they 2006 2007 2008 2009 2010 2011 2012 while About the 201 ?The response rate w wom Asked my en$0 had 2 EBRI/MGA doc $1,t036 or to recomm as 37 (Fi Consumer En gure p 2 ercent (32 percent for the base sample or national sample, and 43 percent for the 3 end ). Aver a lgagement in Health Care Survey eage ro ss costllover ly pres acri mounts incr ption drug? ea sed for ............................................................... both men and women between 2011 and 5 Rollover Amounts 3% and $0 fundi and under ng. 2006 There is wi standing of employee benefits and labor un 2007 despread ions; he20 alth re 08cog care prov nition 20 iders and insur that if employee be 09 20e 10 rs; government org n20 efits 11 data exist, EBRI kno anizations; 2012 and service firms. ws it. $0 care care options and by health plan options and care expenses brand name prescription Employers firs $0 $0 t started offering health reimbursement arrangements (HRAs) in 2001, and they were able to start $0 $0 $0 $0 $0 High school graduate or less Some college, trade or business College graduate or some Graduate degree 2011, when 8.5 million accounts held $12.4 billion in assets. $0 Less Than $1,000 $1,000 or More Smokes cigarettes Exercise Obese Figure 25, Rollover Amount, by Gender and Age Co co m stb sined, 2012 .................................................................. costs drug drug ......... 22 were controlled for in the re 21–34 gression equation on35–44 which these estimates are 45–54based. In 2012, indivi 55–64 duals with a high <6 Months Used cost or 6 Mon quali ths ty to info Year 1–2 Years Us 3–4 Y ed wel earls ness program 5 or More Years 2012.oversample). The margin of error for the n Less Than $50,000 W Lhi es te, n s Th on- anHi $1 sp ,0ani 00$50,000–$99,999 c ational sample school was ±2.2 percent. $1 gr 00, ad000 uate wo or Mo rkre $1,0 Mi 00 no orri Mo ty re Declined Individua Ma l Co le verage Fam F ile ym Cov aleerage 21–34 35–44 45–54 55–64 Account Ba 3 While HRAslance Va have been riation arou ..................................................................................................... nd for just over a decade and HSAs since 2004, a growing percentag ................................. 6 e of the population has offering health pla Source: EBR n Source: EBR s wit I/Ch ommonw h I/C e ommonw alth savi ealth Fund ealth Fund n Consumerism gs a Consumerism ccounts (HSAs in Health C in Health C are Surv Annual Individual are Surv ) i eyn , 2006–2007. 2 ey0 , 2006–2007. 04. By Contr EBR ibuton I/M 201 EBR GA I/M 1, CG ons A32 umer Cons perc umer Engagement ent of Engagement in H em ealth C in H ploy ealth C are Surv ers with are Surv ey, ey, 500 or more See www.globalopinionpanels.com/home their importance to our nation’ s economy. Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2006 ?2007. EBRI/MGA Consumer Engagement in Health Care Survey, 2008 ?2012. Few differencSource: EBR es in 2008–2012. 2008–2012. account I/Commonw balanc ealth Fund es by Consumerism cost-conscio in Health Care Surv us decision ey, 2006–2007. maki EBRI/M ng wer GA Consumer e fo Engagement und (Figure 15 in Health Care Surv ). ey, 2008–2012. school de 0% gree or less had an average of $1,375 in their account, while those with a college degree had $1,627, and EBRI’s work advances knowledge and understanding of employee benefits and their EBRI delive a rs a steady stream of invaluable research and analysis. held them for H ealth reimbursemen a num a a ber of y t arrangement. ears. In 2006, 9 percent of the population with an HRA or HSA had held that account for N Source: Source: EBR ote: 2006 data w EBRI/M I/C G ommonw A as C capped onsumer ealth Fund at $1,500 Engagement Cor onsumerism more. in Health C in Ha ealth C re Surv aey re Surv , 2012. ey, 2007. EBRI/MGA Consumer Engagement in Health Care Survey, 2008–2012. Rollovers workers offered either ? After leveling off, average ............................................................................................................................... Health reimbursemen Health reimbursement an HRA or HSA-eli t arrangement. arrangement. acco giu bn let ba plan lances in , covering 13 crea percen sed: Aft t of t er ahvat erage pop accoun ulation, up t bala fr.............................. 15 om 2 nces l 3e pe veled rce off i nt off n ering Source: EBR Source: EBR Source: EBR Source: EBR I/C I/C I/C I/M ommonw ommonw ommonw GA Consumer ealth Fund ealth Fund ealth Fund Engagement C C Consumerism onsumerism onsumerism in H ealth C in in in H H Health C ealth C ealth C are Surv a a are Surv re Surv re Surv ey, 2012. ey ey ey, , , 2007. 2007. 2007. EBR EBR EBRI/M I/M I/MG G GA A A C C Consumer onsum onsumer er Engagement Engagement Engagement in H in H in Health ealth ealth C C Ca a are Surv re Surv re Survey ey ey, 200 , 200 , 2008–2012. 8–2012. 8 ?2012. b Source: EBR Source: Source: Source: EBR EBR EBR I/C I/M I/M ommonw G GA A I/C C Consumer ommonw onsumer ealth Fund ealth Fund Engagement Engagement Consumerism Consumerism in H in H ealth C ealth C in Health C a a in re Surv re Surv H aealth C re Surv ey ey, , 2012. a 2012. ey re Surv , 2007. eyEBR , 2007. I/MG EBR A C I/M onsum GA C er onsumer Engagement Engagement in Health in H Caealth re Surv Caey re Surv , 2008–2012. ey, 2008–2012. Figure 26, Rollover Amo Les Source: EBR s Tha Source: EBR n 6 Mo I/CI/C ommonw nths ommonw unt, ealth Fund by Rac ealth Fund 6 Mon Consumerism ths e Consumerism , 2007–2012 to Les in s Than H inealth C Health C 1 a................................................................................ re Surv are Surv ey, ey 2007. , 2007. 1–2 Y EBR EBR ears I/M I/M GA G A C onsum Consum er Engagement er Engagement 3–4 Y in in H He ears alth C ealth a C re are Surv Surveyey , 20 , 200 08–2012. 8–2012. 5 or M .................. 23 ore Years H Source: EBR ealth sav b bings account. I/Commonwealth Fund Consumerism in Health Care Survey, 2007. EBRI/MGA Consumer Engagement in Health Care Survey, 2008–2012. The oldest adults had th The sample Health sav was divided into Health sav ings account. e la ing rgest rollov account. three groups: those importance to er amounts in the nation’s econo 2w 012. I ith a c ndivi onsumer-driven health plan (CDHP), those myduals among policy ages 55m - akers, 64 hathe news d an avera media, and ge rollover the public. It with a of $1,350, those with a graduate degree had $1,939 (Figure 11). 4 EBRI publications include in-depth coverage of key issues and trends; summaries of research Year three to In theory, a ra four yendom sample of 2,000 yields a ars, and 3 percent for five years or more (F statistical precision of plus or igure 1). By 20 minus 2.2 percentage points (with 95 percent 12, 29 percent had held an account for three such a 200 plan 8 a an nd d 1 20 0 0 perc 9, an ent d fell enrollment slightly in in 2 2010, 010. t As a r hey inc esu reased lt, these in 2 pla 01ns covere 1 and 2012. d a In bou 20 t 25 06, millio the aver n peage ople ain ccount 2012,balanc e Conclusion .......................................................................................................................................................... 18 Length of Time With Account does this b —Not surprisi y conducting ngly, th and p e lenublishing policy re gth of time that sear an in ch, analysis, dividual has had an and special reports on account has a compared What we do with $969 for individuals 21 -34, $1,057 for those 35 -44, and $1,105 for those 45 -54 (Figure 24). high-deductible health plan (HDHP), and those findings and policy developments; wtimel ith tradi y factsheet tional health c s on hot topics; overage. Indiv regula iduals r up wda ere as tes on legi signed to slative and to four years, and 16 percen EBRI’s mission is to contribute to, to t for five years or more. As the length of time individuals have these plans increases, confidence) of what the result Figure 27, Rollover Amount, s would be by Anemplo nual Ho if the entire population ages 21– yee benef usehold Inco its issues; holding educational br me, 2007–2012 64 with ............................................................. iefings for EBRI memb private health insuraers, congressional and nce coverage were ...... 23 representing a was $696. bout It 15 perc increased ent of the priva to $1,320 in tely insur 2007, a 9 ed m 0 perc arket. ent increase. Account balances averaged $1,356 in 2008 and major impact on the amount of money in the account. The analysis found that people who held an account in 2012 for Refer Type Source: EB ences ............................................................................................................................... RI/Commonw of Cover regul ealth Fund atory age—In de Consumerism formu velopment lating account in Health s; comp Care Sre u bala rvhen ey, 2006 nces sive ?2007. for refere EBR people nce I/MGA with resou Consumer inrdividual cov ces Engagement on benefit pro in eHealth C rage and those a grams ........................... 28 re Surveyan , 2008–2012. with d wo fam rkforce ily the CDHP or HDHP group if they had a deductible of at least $1,000 for individual coverage or $2,000 for a federal agency staff, and the news media; and sponsoring public opinion surveys on employee surveyed with average Health reimbursement accoucomplete accur nt balances sh arrangement. aould cy. There are increase also other poss as well. ible sources of error in all surveys that may be more serious than $1,419 in 2009, 3 percent and 5 percent increases, respectively. In 2010, average account balances fell to When less than si examin x months ha ing issue differ encour ences sd a ; and nage avera in ro major survey , and to enhance the development llovers ge of $fo 849 r men s in of thei pu an blic d wo r ac at co men titudes. unt, an by a d t ge, homen hav se who he e h ld a igher average r n account at ole llover amou ast six mont nts than hs but coverage, b a number of factors need to be considered. While individuals with family coverage often have higher Endnotes Health sav ...................................................................................................................... ings account. ...................................... 28 family coverage. To be assigned to the CDHP group, the benefit issues. EBRI’s Education and Re y must also ha search ve an account Fund (EBRI-ERF) performs , such as a he the char alth itable, Accordin Figure 28, g to Rollover Amount, findings from thby Education, e 2012 EBRI/MGA Consum 2007–2012 ........................................................................... er Engagement in Health Care Survey, there was $1 ................ 24 7.8 billion in theoretical calculations of sampling error. These include refusals to be interviewed and other forms of nonresponse, the $1,355, dow n 4.5 perc EBRI meetings ent fr present an om the previo d explore i us year. ssues In 2011, with av thou erag ght e aleade ccount rs balanc from all se es increase ctors. d to $1,470, a women regardless of age. (Figure 25). less than a year had $967 (Figure educa 16). Itiona n comparison, i l, and scientifn ic func dividuals with tions of the Instit an accou ute. EBRI nt for one to two -ERF is a tax-ex years had an empt organizatio average n cumulative deductibles than th CHECK OUT EBRI’S WEB SITE! ose with single coverage, and are statutorily allowed to make higher contributions, they savings account (HSA) or health reimbursement arrangement (HRA), with a rollover provision that they can of sound employee benefit prFigure 13 Figure 33 Figure 21 Figure 23 Figure 31 Figure 25 Figure 15 Figure 35 Figure 29 Figure 19 Figure 1 ogr Figure 3 Figure 5 Figure 9 Figure 27 Figure 7 ams and 1 This report examines HSA and HRA assets, account balances, and rollover amounts, using data from the 2012 Figure 17 HSAs and HRAs in 2012, spread across 11.6 million accounts. In 2006, there were 1.3 million accounts with $873.4 effects of ques tion wording a EBRI regula nd question rly provides order, and scree congression nal ing. While attempts are testimony, and briefs p mad oe to minimize these factors, it is licymakers, member organizations, 9 percent increase from 2010. It increased to $1,534 in 2012, a 4 percent increase. supported by contributions and grants. of $1,528, those with an account for three to four a years ha bd an ava erage of $1,896, a b nd those with an account for at may also use more health care services and therefore have higher costs. This makes it difficult to predict whether Account Balances, by Age, 2007–2012 Figure 29, Rollover Amount A A Rollov cco cco Distribution of Rollov , by Rollov unt unt Pla e A r cco e Balances, Rollov Balances, A A n A r Rollov Type, n cco m e A Rollov A n unt r ou m T Rollov u cco A o unt al Grow ou m nt, e tal Rollov 2007–2012 Balances, er r HRA unt Balances, ou nt, by e A Balances, by by r A A by m e by nt, by m r ou Length m A V th ou Health Behav or HSA A m a ou nt, rious Cost Conscious Rate n e nt, ou Gender r n nt, ........................................................................... by by u A nt, by al Household sset Rollov of T by in Use of Cost and Quality Plan A by by Education, 2007 HRA Gender ccou is Lev me With and Race, and ier Lev T or y n e A or HSA pe, 2007–2012 t Balances, l of and Health Number of g , 2007 e Combined, 2007 el, 2007–2012 A Income, Accou n ? n ?2012 u 2012 A Behav ? al ssets n 2012 t, Status, 2012 2007–2012 2007–2012 2007–2012 i ors, 20122012 ................ 24 use to pay for medical expenses, or the ability to take their account Account Balances, by Level of wA ith nn them should t ual hey change jobs. EBRI/MGA Consumer Engagement in Health Care Survey (CEHCS). It then examines differences and trends in account million in assets, and and by the medi 2009, 4. a on employe 8 million accounts he r benefits. ld $6.8 billion in assets. Total assets in the accounts have sound public policy through objective impossible to q Race Figures —In uantify the most years, w errors that may re hites had lower sult from them. rollover amounts than minorities. However, in 2012, whites had least five year 25% s had an average account balance of $2,320. In 2012, the average account balance increased most for families wil $2 $2 $2 $2l h ,00 ,50 ,00 ,00ave hi 0 0 0 0 gher or lower a Information Account dul and the Number ts Indiv A balanc ges idual Contribution, and 21–64 With a es than Use of indivi of W Acco d euals. It llness Program, 2012 Rollov unt2007–2012 s, e was fou 2007–2012 r, 2006–2012 nd that both individuals with individual $2,000 Employer Contribution, 2007–2012 Account Balance Variation Individuals $3,500 with only a flexible spending account (FSA) were not included in the CDHP group. $2,500 balances by demographics, i EBRI issues ncome, contr press releas ibution es on ne levewsworthy ls, and engagem developm ent ients, n an in and i dividual s among ’s own h the mo ealth car st widely qu e using aoted EBRI’s website is easy to use and packe $2 $2 $2,00 ,00 ,000 0 0 d with useful information! Look for increased ea ? Total and average rollovers increase ch year, and average account balances ar : Aftere de growi clinin ng to g at a $1, slower 029 in rate. 2010, Th avera e avera ge rollover ge account balanc amounts incr e reeased ached EBRI Issue Briefs is a monthly periodical with in-depth evaluation of employee benefit issues slightly higher rollover $10,000 amounts than minorities. On average, minorities had a $1,106 rollover in 2012, wh 9 ile whites had $2,000 2007 2008 2009 2010 2011 2012 Yes No Figure Figure those who 1, Length of Tim 30,$2 Rollover Amount, h ,00 el 0d an accou resear e n Wi t for five years o ch and education. tby Healt h HRA or h HSA, Behavior and Hea r more. 2006–2012 Those wh ........................................................................... lth Status, o held an 2012 account ........................................................ for five years or more experienc ................ 6 e ........ 25 d an coverage and those with family coverage had an average account balance of $1,607 in 2012 (Figure 12). Those with 5 23% 30 $2 0% ,000 sources on employee benefits by all media. $1,973 and trends, as well as critical analyses of employee benefit policies and proposals. EBRI This sectio regression A regression equation is a sta equation. Ro n examines var llov iat eion in r amounts tistical model accou ar ne then examin t bala that allows resear $1,802 nces and ed. Ye tren s chers to determine the effec ds in No those balances by a num t of an independent variable o ber of different variables, n a $1,534 i to $1, n 2011 206 . in 2282% 011 and remained there i 2007 n 2012. 2008 Total 2009 assets bei 2010 2011 ng rolle 2012d over increased: $9.7 billion was rolled Our $2,000 these special features: 2007 2007 2008 2008 2009 2009 2010 2010 20112011 20122012 $1,774 22% a $1,121 rol $1,80 lover (Fi 0 gure 26). 20 20 07 20 07 07 20 20 08 20 08 08 2020 09 20 09 092020 10 20 10 102011 20 20 11 112012 20 20 12 12 8.1 $1 $1,80 ,800 0 $1,800 20072007 20082008 20092009 20102010 20112011 20122012 increase Because the b from $1,96ase sample (national sample 8 to $2,320 between 2011 a 2007 nd ) included only 20 2008 12. 2009 198 individuals in a CDHP, 2010 2011 2012 $1,729 an oversample of individual cov e rage EBRI e$1,693 xper direct ienced an s membe 11 pe rs rcent i and other constit ncrease Ma in t le uen heir Fem accou cie ales to nthe informatio t balance in 201 n 2, they need an while those with d unde fam rtakes ily new $1 $1,80 ,800 0 Notes is a monthly periodical providing current information on a variety $1,795 of employee benefit $1,800 $1,682 $9,000 such as demographics, income, health status, health behaviors, and v $1,676 arious measures of cost-conscious decision dependent variable while holding the effect of all other inde $1,653 pendent variables constant. For this analysis, the amount of over into HSAs and HRAs in 2012, up from $6.8 billion in 2011. The percentage of individuals with 8 out a rollover $1,800 $1,640 $1,633 Figure 31,$1 Rollover Amount, $3 ,80 ,00 00 by Use of Cost and Quality I Ye nformation and Use o s No f Wellness Program, $1,625 2012 $1,654 .................. 25 Figure 2, Total Assets and Number $1,800 of Adults Ages 21–64 With an HRA or HSA, 2006–2012 ....................................... $1,613 7 $1,616 $1,717 $2,869 research on an ongoi topics. EBRI ng basis. 20 F07 undamen 2008 tals Gr20 owth of Employee Ben 09 in As 20 s10 ets 2011 20 efit Pr 12 ograms offers a straightf $1,634 20%orward, basic individuals with a CDHP was added. The oversample included 1,218 individuals $1,597 with a CDHP. In $1,602 addition to $1,627 coverage had only a 1 percent increase in their account balance average. In contrast, the average account $1,697 balance of • publications EBRI’s entire lib $1,588 rary of research publicat $1,575 $1,600 ions starts at the m $1,584 ain W $1,578 eb page. Click on EBRI $2,017 $1,567 The number of people with a rollover as well as the total level of assets being rolled over have $2,773 been incr $2,778 easing. In $1 20,60 % 0 money an indiv Household making and heialth dual has in $1,541 engageIncome an ment. Both —Accordi HRA or HSA is determined by n th g to e accou Figuren t 27 bala , rollover nce estimat a number of amounts ge es and t factors. The regression equation allows researchers neral he statist ly increase ical signific with house ance tests w hold ine come. In re was 11 percent in 2012. $1,522 $2,000 $1 $1,60 ,600 0 EBRI has earned widespr explanation of emplo ead r yee b egar enefd as it programs in the private and $1,547 public sectors. The EBRI Employer a 25 $1 0% ,600 nd Individual Contributions—Annual contribution amounts, whether they come from th $1,939 e employer $2,00 0 EBRI maintains and analyzes the most comprehensive database of $1,531 401(k)-type programs in the $1 $1,60 ,600 0 $1,667 $1,600 $1,658 $1,508 being stratifie $8,00 d, the base sa 0 mple was also weighted by g Growth in ender, age, education, regio accounts $1,582 n, income, and individuals with family coverage increased between 2010 and 2011, while it was unchanged for those with individual Assets an Issue Briefs d Account Balances and EBRI Notes for our in-depth and nonpartisan periodicals. 2006, 23 percent of individuals with an HRA or HSA di $1,563 d not roll over any money, but by 2012, only 11 percent did not $1,600 18% generated fro $1 $1,60 ,600 m 0 a regression equation that also controlled for how long an individual has held an HRA or HSA, 7 employer Figure to determine the strength of 201 Figure 2, th 3, Annual 32, e ave Rollover Amount, rage ro Growt llover h Ra w each factor te in HRA or by Var as $951 Databook on E ious Co amon independently. Mo HS st Conscious Behaviors, 2012.......................................................... g in A Adivi ssets and the Number mployee Benefits duals with re information about th less than is a statis o $50, f Accounts, tical r 00 e0 in feren e regr ho ce work on em 2007–2012 ession equation is available upon usehold incom ................................... ployee ben e, $ $1,782 920 efit program amon ........ 26 g those s 7 $1,444 world. Its computer simulation analyses on Social Secu$2,494 rity reform and retirement income adequacy (in the case of HRAs and HSAs), or $1,562 from individuals (HSAs only) have a strong impact on overall a $1,778 ccount balanc $1,816 es. Not $1,791 $1,766 race/ethnicity t $1,400 an or o reflect the actual proportions in the popu ganization that “tells it like it is lation ages 21 ,” –64 with private health insurance coverage. $2,500 $1,387 5 $1,460 $1,406 A and work for ssets ($millions)ce-related issues $1, . 378 $1,508 have a ? rollove Healthy behavior does r. In 2006, 500,000 i not mean higher ndividuals rolle $1,441 d over account $276.balances and hi 2 million, but by 2gher rollovers 012, 8.1 million $1, : Individuals who smoke i 385 ndividuals rolled over According to t $1,400 he 2012 EBRI/MGA CEHCS, there was $17.8 billion in HSAs and HRAs in 2012, spread $1, across 1 357 1.6 million request from the author. with $5 contributio 0,00 $1 $1 n,40 ,40 0 s t - 0 0o $99, the99 account, 9, and $ individu 1,353 amo al co ng t ntributions hose with to t $10 he acco 0,000 or unt, a more in nd unuse house d bal hold ance rol income. $1,481 lover In 2 amounts. 012, rollov Unli er ke the are unique. $1,400 16%$1,403 $1,358 $1 $1,40 ,400 0 4 $2,292 $1,353 16% surprisingly, t $1,50h 0e more $7,000 that is contributed to an account, the higher th $1,318 e average account balance. In 2012, for instance, $1,634 $1, $1, 627 639 • Visit EBRI’s blog. $1,624 coverage. $1,400 The CDHP oversample was weighted by gender, age, income, and race/ethnicity. More $1,587 $1,599 $1 $1,40 ,400 0 $1,267 $1,344 $1,348 $1,350 Figure 33, Rollover Amount, by Length of Time With Account, 2007–2012 ......................................................... $1,594 $1,292 ...... 26 Figure $9.7 bihave more mo llion. 4, Aver The aver age HRA age ney in or HS rol their ac lover incr A Account counts than ease Balances, 2006–2012 d from th $ose who 59 15%2 in 2 do 006 ................................................................................... n to ot smoke. In c $1,206 in 2012. ontrast, obese individu als ha 6 ve less 8 accounts (Fi 200% gure 2)based on the f . In 2006, there wacts ere 1 . A .3 mill s the Bylaws state: ion acco 15% unts with $873 million in assets, and by 2011, 8.5 million overall data on account balances shown in Figure 4, 2006 $1, data ar 559 e not shown for the 5.6 different variables $1,308 because of the amounts increased for those $1,222 with less th Accounts (m an illi $5 ons)0,000 in household income, and for those with $50,000 -$99,999 in $1,200 $1,213 $1,214 $1,284 15% $1,224 $1,224 individuals with an employer contrib $1,490 ution of less than $1,000 had an average account balance of $1,563, while those Health Behaviors and Health Status—Individuals who smoke and those who exercise $1,501 have more $1,214 money in their 6 14% $1,201 $1,203 information can be found in Fronstin (2012). Contact EBRI 2 Publications, (2 $1,469 02) 659-0670; $1,192 fax publication orders to (202) 775-6312. $1 $1,20 ,500 0 Individuals are $1 $1 $1,20 ,50 ,200 0 0 also able to roll over funds from one HSA into another HSA without subjecting the distribution to income and money in their account than $1,142 the nonobese. There was very little$1, di 416 fference in account balances by level of accounts he EBRI make $1 $1,20 ,20 ld 0 0$12. $6s information freel ,00 4 0billion in $1,198 assets. Gro yw av th rat ailable to al es in $1,137 both assets and the l. number of accou $1,203 nts have been high, other small samp household inc $1le sizes. ,20ome, but 0 decreased sli $1,140 ghtly for thos $1,148 e $1, wit 405 h $100,000 or more in household income. $2,000 $1,397 13% $1,375 $1,149 $1, $1,105 386 13% $1,102 $1,890 $1,112 $1,200 “In all its activities $1,391 , the Institute shall$1,380 $1,091 $1,143 with •an emplo EBRI’s reliable health and retirem yer contribution of at l Subscriptions to east $1,000 h e EBRI nt surveys ar ad an Issue Bri average of $1, efs e just a click away through the topic boxes at are included 697 inas part of their account EBRI membership, or as part of (Figure 17). Similarly, a accounts than $1 $1,20 ,200 0 those who $1,104 do not smoke or exercise (Figure 13). In cont $1,144 rast, obese individuals were found to have less $1,100 $1,071 Figure Figure 5, 34,Distribution of HRA Rollover Amount, or by Level of HSA Account Bala Annual Em nces, ployer 2007–2012 Contribution, .............................................................. 2007–2012 ............................................... $1,106 ............ 8 .. 27 It might be expected that individuals who $1,272 are given mor $1,e 059 control over funds allocated for health care services would $1,061 5 Orders/ EBRI assume $1,279 s a publi $1,078 c service responsibility to make $1,323 its findings completely accessible at www.ebri.org penalty taxes a exercise. $1,000s long as the r Very small $1,102 differe o 12% llover does not exceed 60 da nces wer 12% $1,036 12% e foun 12% 12%d in accou ys $1,307 . Rollover contributions from Archer Medi nt b12% alances and rollover amounts for in cal Savings Acc dividuals who oused unts than in 2010. In 2007, assets doubled (101 percent) and 12% the 12% number of accounts nearly tripled (282 $1,036 percent) (Figure $1,026 $1,011 $1,015 $1,246 $199 annual subscription to EBRI Notes and E $1,018 BRI Issue Briefs. Change of Address: EBRI, $1,232 $1, $976 171 $999 indiviWhile panel In duals the top of the page. who contrib ternet surveys are nonrandom, studies hav uted less than $1,000 had an average account e demonstrated that such su balance of $1 $974 ,209, wh rveys, ile$984 tho w shen c e whoarefully contributed money in the 150%ir account than the nonobese. $962 $1 $1,00 ,000 0 $1,022 11% become more $1,000cost conscious, especi function strictly in an objective and ally once they become more educat $961 ed about the $957 actual prices of health services. $1,00 — 0 so that all deci $5,000 sions $951 that relate to emp $1,165 loyee benefits, whether made in Cong $946 ress or board rooms or Gen $1 $1,00 ,00 der 0 0 and Age—Men have higher $932 account balances th$1, an wom 160 en. By 2012, men had an average of $1,772 in Education (MSAs) are also permitted. —Education has an impact on rollover amounts $1,158 independent of income and other variables, as they cost or qu $1,000 ality information, c 1100 13th St. NW, Suite 878, Washington, ompared with those who $920 did not use such DC, 20005-4051, (202) 659-0670; fax number, information. $912 However, $9,740.4 next to no 3). While growth slowed in 2008 -2010, it continued at relatively high rates, accelerated in 2011, and continued to 10% $1,000 $1,000 10% $1,110 $890 Figure 35, Rollover Amount, 10% $1,083 by Level of Annual Individual Contribution, 2007–2012 ................................................ 10% 27 Figure at least Subscriptions designed, obt 6, Acco $1,000unt Ba had a ain results co $1, lances n ave 070 r, by Gender, 2007–2012 age $879 bala mparable with nce of $1,9 random-digit-dial telephone 51 (Figu .............................................................................. re 18). 10% surveys. Taylor (2003), for $874 example, ................. 10 $864 $1,051 $860 $1 $1 $8 ,00 ,50 families’ 00 0 0 homes, are based on the highest quality, most dependable information. EBRI’s Web site posts $846 $900 $843 $844 4 However, no evidence was fo $830 und to suppo (202) 775-6312 rt this. ; e-mail: Nor was there subscriptions@ebr eviden $834 ce that 3.6i.org hea Me lthy beh mbersh aviors ha ip Information: d any real Inquiries 10% their HRA are control or H led for in SA wh the regr ile womession equatio $811 en had $1,476n (Figure on $873 which t 6). A hm esong e estimates both meare based. n and wome Individu n, account als with balances incr a high school ease degre d e relationship was found between either account balance or rollover 9% amounts and various cost-conscious increase at nearly 40 9%unbiased manner and not as an advocate percen 9%t for both assets and t $988 he number of accounts in 2012. 9% 9% $977 $790 $795 $795 9% • Need a number? Check out the EBRI Databook on Employee Benefits. Use of Health $958 Information $767 $768 and Programs—Account balances were examined using two variables to measure an 7 $800 $766 $1 $1$8 ,00 ,00 00 0 0 $4,000 $757 provides the results from a number of surveys that $8 $8all 00 00 research findings, publications, and new ws ere alert conducted at s. EBRI also exte the same time using the sa nds its education and pu me blic service $8 $8 $800 00 00 regarding $740 EBRI membership and/or contributions to EBRI-ERF should be directed to EBRI More information about the regression equation is available upon request f 3.2 rom the author. 8% correlation with account balance; individuals who smoke have more money in the 8% ir account tha 8% n those who do not between 2007 and 2009, fell in 2010, and then increased in 2011 and 2012. or less had a $800 n average rollover of $9 $750 44, w $751 hile those with a college degree had an average rollover of $1,173, and those behaviors. $800 100% $685 Figure 7, Account Balances, by Age, 2007–2012 ................................................................................. $1,083 ................... 10 It will be impo $600rtant to track this trend over time. Currently, account balances are low and are therefore invested in individual’s en role gagem to improving Ameri ent $652 in health c President Dallas are. O cans’ ne considere finan cial Salisbur kn d owle y whet at th dge h e e ar a bove thro n iaddress, ( nugh dividual its a 202) 659-0670; used ward-cost and winning e-mail: qua publi lisalisbur tc y informatio service y@ebri.org cam n to paign or opponent of any position.” 7% 7% $647 7% 7% questionnaires both via telephone and online. He found $1,018 that the use of demographic weighting alone was $6,751.7 3 $675 $991 smoke, while obese i101% ndivi $959 $609 duals have less money in their account than the nonobese. Additionally, there was very little Despite growth in total assets and ® in the n $942 umber of accounts, average account balances have not increased at the with a graduate degree had an average rollover of $1 2.5 ,243 (Figure 28). • Instantly get e-mail noti?cations of the latest EB 71% RI data, surveys, publications, and meetings $1,000 6% 69% $600 $3,00 $560 0 6% relatively safe $6 $6 $6C 00 00 00 vehicles suc hoosetoSave h as money mar $878 and the companio ket funds n site (cur ww rently, i w.choo nvestments are usu setosave.org ally restricted to a money market choose a doct $6 $600 00 or. The oth $544 $597 er examined whether an individual participated in a wellness program, such as: $600 sufficient to bring almost all of the results from the online survey close to the replies from the parallel There is a general trend tow 5% ard higher account balances with age. In 2012, individuals ages 55 -64 had an average of differe ? n Difference ce in a $600ccount s in balanc account ba es by lelances: vel of exercise. Men have h igher account balances than 5% women, older individuals have same rate. Av $600 erage account balances leveled off in 2008, dropped slightly in 2010, and then increased in 2011 and Editorial Bo $400 ard: Dallas L. Salisbury, publisher; Stephen Blakely, editor. Any views expressed in this publication and those of the authors should Figure 8, Account Balances, by Gender and Age Combined, 2012 ............................................................................ 11 and seminars by clicking on the “Notify Me” or “RSS” buttons at the top of our home page. 5% fund until the savings account reaches a minimum threshold, such as $2,000 or $3,000). As account balances grow, the 43% 2 telephone survey. He also found that in some cases, propensity weighting (meaning the propensity for a not be ascribed to the officers, trustees, 66% members, or other sponsors of the Employee Benefit Research Institute, the EBRI Education and $1,816 in their account, compared with between $1, 391 among those ages 21 ?34, $1,559 among those 35 ?44, and Type 50% of Coverage—Individuals with single coverage had an average rollover of $1,137 in 2012, whereas those high (a)er acco $5 one 00 d $2e ,00 un sign 0t bala ed to nces, ac directly count improve balanc partici es increase pants’ heal wit $4,104.2 h th house (i.e., a hold i wein gcome, an ht loss, nutrition, d education stress manage has a signifment, or icant 2012. In 20$5 $4 06 00 00, the account balance average was $696 (Figure 4). They increased to $1,320 in 2007, a 90 percent $400 $4 $4 $500 00 00 1.3 $3,754.2 EBRI is sup $4 $4 $400 00 00 ported by organizations from all industries and sectors that appreciate the value of 56% potential to invest in more volatile investment vehicles (such as mutual funds and stocks) will grow. The opportunities Research Fund, or their staffs. Nothing herein is to be construed as an attempt to aid or hinder the adoption of any pending legislation, regulation, $4 $5 00 00 Very small certain type of person to be online) reduced the remaining gaps, but in di $4 $2ff 00 00erences were found in account balances and rollover amounts bet other cases it ween individuals did not reduce the who used cost or 20% Figure with $1,63family 9 for t 9, Acco co hoverage unt Ba se 45 ? ha lances, 54 d a (Fig $1,1 ure by Rac 7). 12 avera Th e, 2 is w 00g7a e rollover ? s foun 2012 ................................................................................................... 11 d despi (Figure te the 29 fact ). that older individuals use more health care on impact o smoking cessa n account b tion pro alanc gram es, ind ), or ependent of income and other variables. increase. Account balances averaged $1,356 in 2008 and $1,419 in 2 13% 009, 3 percent and 5 percent increases, unbiased, reliable information on emplo or interpretative rule, or as legal, accounting, actuarial, or other such prof yee b essional advice. enefits. Vis ww it w. www.e ebri.org b ri.org/about/join/ 37% for more. $2,480.5 There’s lots more! for capital appreciation will increase but so will the opportunities for capital losses, even among individuals with 1 high quality remaining gaps. Perhaps the inform $200 ation compared with t $1,000 most striking hose who did not difference in d use such emographics betw information. Howe ever, ne en telep xt to hone and online surveys no relationship was found average than younger ones. 0.5 It is possible that older individuals were saving the money in the account to use to pay for $2 $200 00 $2 $2 $2 $200 00 00 00 respectively. In 2010, the average account balance fell to $1,355, down 4.5 percent from the previous year, but in 15% 8% $1,278.5 $200 $0 levels of em (b) a 0% pl he oyer an alth-ri d i sk assessment pro ndividual contribut gram, ions. wh ere an individual fills out a questionnaire and then, in consultation $200 Figure 10, Health Account Ba Behavilances ors and Health , by Annual H Status ousehold Inco —Individuals me, 2007–2012 who smoke ha............................................................ d higher rollover amounts than individuals ...... 13 who betw ?een w a Dif s the under eit ferences i 0% her account -representation of minorities n rollov balance or er amounts: rollover amounts a Men in online sam rolled over nd various cost-c m ples. ore money onscious be than wom ha en, a viors. nd older individuals had higher Checked Checked price ofVisit EBRI on-line today: Checked quality Talked to doctor Used online costwww.ebri.org Talked to doctor Develo ped Asked for Asked doctor to health care expenses in retirement, but this could not be determined from the survey. Prior research has found that, 2011, th EBRI Issu e ave e Brief rage is r account e20 gister 07 ed in the U. balance S. incre Patent and T 2008 ased to radem $1 ar ,47 k 20 Office. 09 0, a 9 ISperc SN: 0887 ent ? in 20 13 10 crease. An 7X/90 0887 ? d i 13n 7X/90 $ . 20 2012, 11 the average 50+.50 2012 account $0 $0 $276.2 wNoth hether p ing lan se Les rvisc Th e befo an $r200 e rati$200–$499 ng of about treatm $500–$999 ent tracking tool $1,000–$1,499 about $1,500–$1,999 budget to $2,000–$2,999 generic drug $3 rec ,0om 00 m or en More d less with a medical $0 professional, examines his or her health history to identify any existing or potential 0 medical $0 do not smoke $0 $0(Figure 30). Those w Les ho e s Than x $1 er,cise ha 000 d slightly higher rollover amounts t $1,000 han those or More who did not. Obese rollover amou $0 nts than younger individuals in 2012. Rollover amounts increased with household income and $0 $0 $0 $0 would cover care getting care doctor/hospital options and provided by prescription manage health instead of brand costly while HSAs can be used to save for Used co hea st orl qu th alicare e ty info xpenses in retirement, they ar Us e ed far welfr lnes om suffic s program ient for that purpose 2006 2007 2008 2009 2010 2011 2012 balance increa $0sed to $1,534, a 4 percent increase. $0 21–34 35–44 45–54 55–64 Rollovers $0 —As with co Less Than $50,0 ntributi 00 White, n on levels, ann on-Hispani$50,000–$99,999 c ual rollover amounts are one of the bigg $100,000 or More Minority est f De actors i clined n average High school 21–34 gradu 1–2 Y ate ear or le s ss Male Some college, tr 35–44 co ad sts e or busin3–4 Y es health s pla earn sCollege op gr tion 45–54 adu s an ate d or s ca ome re expe Fense mas le5 or na Mo G me drug rradu e Ye 55–64 ate deg arspres re cre iption drug Figure 11, Account Balances, by E Ind divucation idual Cove,r 20 age07 ?2012 .......................................................................................... 13 Family Coverage conditions, in order to develop a program for early intervention, or Less Than $1,000 Rollover Level $1,000 or More indivi duals had lower avera Smg ok e ro es cig llover arettes amounts ($979) than th Exee no rcise nobese ($1,185). Obese educatio Source: EBR n, and in I/Commonw dividuals ealth Fund with si Consumerism ngl e in co Health C verage are Surv rolle ey, 2007. d ov EBRer a sli I/MGA Consumer ghtly costs Engagement higher amoun in Health Catre Surv than ey those , 2008–2012. with family Source: EBRI/Commonwealth Fund Les Consumerism s Than $1,0 in 00 Health C sca hre Surv ool ey, 2007. EBRI/MGA Consum graduat er Engagement e work $1, in H 000 ealth or Mo Carre Surv e ey, 2008–2012. because of statutory constraints placed on contribution levels relative to expected health care spending in retirement a account balances. Individuals with a rollover less than $1,000 had an average account balance of $1,083 (Figure 19). In aHealth reimbursement arrangement. Health reimbusement arrangement. th b Source: EBR Source: EBRI/C I/Mommonw GA Consumer ealth Fund Engagement Consumerism in Health C in Health C are Surv are Surv ey, 2012. ey, 2007. EBRI/MGA Consumer Engagement in Health Care Survey, 2008 -2012. Source: EBRI/MGA Consumer Engagement in Health Care Survey, 2012. coverage Health sav in 2 ing 012. account. 1100 13 Street NW · Suite 878 Source: EBR Source: EBR b I/C I/C ommonw ommonw ealth Fund ealth Fund CC onsumerism onsumerism in in H H ealth C ealth C aa re Surv re Surv ey ey , , 2006–2007. 2007. EBRI/M EBR GA I/M CG onsum A Consumer er Engagement Engagement in Hein H alth ealth C Care Surv are Surv ey, 200 ey, 2008–2012. 8–2012. (Fronstinc) 20 biometric 10) Source: EBR Source: Source: EBR Source: EBR Source: . EBR EBR sc I/C I/M I/C I/C I/M ommonw ommonw G ommonw G reenin A A C C onsumer onsumer ealth Fund ealth Fund ealth Fund g, m Engagement Engagement e C C C asurements onsumerism onsumerism onsumerism in H in H ealth C ealth C in in in H H H ealth C ealth C ealth C aa or re Surv re Surv bl a a a re Surv re Surv re Surv ey ey ood work , , 2012. 2012. ey ey ey , , , 2007. 2007. 2007. EBR EBR to EBR I/M I/M I/M determine h G G G A A A C C C onsum onsumer onsumer er Engagement Engagement Engagement ealth status, such in H in H in H ealth ealth ealth C C C a a a re Surv re Surv re Surv as bloo ey ey ey , 200 , 200 , 200 8–2012. 8 8–2012. ?2012. d pressure, Source: EBR Source: EBR Health sav I/C ings account. ommonw I/Commonw ealth Fund ealth Fund Consumerism Consumerism in H in ealth C Health C are Surv are Surv ey, 2007. ey, 2007. EBR EBR I/MG I/M A G CA ons Consumer umer Engagement Engagement in H in H ealth C ealth are Ca Surv re Surv ey, ey 20, 200 08–2012. 8–2012. Source: EBR Source: EBR Source: EBR I/C I/C I/C ommonw ommonw ommonw ealth Fund ealth Fund ealth Fund CC onsumerism C onsumerism onsumerism in in H inH ealth C H ealth C ealth C are Surv aa re Surv re Surv ey ey , ey 2007. , , 2007. 2007. EBR EBR EBR I/M I/M I/M G G A G A A C C onsum C onsumer onsum er Engagement er Engagement Engagement in in H in H Health C ealth ealth C a C a re a re Surv re Surv Survey ey ey , , 200 20 , 200 08–2012. 8–2012. 8–2012. Figure 12, Account Balances, by Plan Type, 2007?2012 .......................................................................................... 14 comparison, individuals with a rollover of at least $1,000 had an av erage account balance of $2,778. Washington, DC 20005 cholesterol, weight, and height. © 2013, Employee Benefit Research Institute (202) ?6 Educ 59-06 ation and Re 70 search Fund. All rights reserved. www.ebri.org www.choosetosave.org ebri.org ebri.org ebri.org ebri.org A monthl ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 ebri.org Issue Brief • January 2013 • No. 382 Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri y research report f e e e e e e e e e effffffffff • Januar • Januar • Januar • Januar • Januar • Januar • Januar • Januar • Januar • Januar rom th y y y y y y y y y y 20 20 20 20 20 20 20 20 20 2013 • No. 382 13 • No. 382 13 • No. 382 13 • No. 382 13 • No. 382 13 • No. 382 13 • No. 382 13 • No. 382 13 • No. 382 13 • No. 382 e EBRI Education and Re search Fund © 2013 Employee Benefit Research Institute 24 22 26 11 25 20 27 19 16 13 23 17 10 14 21 7 8 15 18 28 12 2 5 6 4 9 3 Assets ($millions) Assets (millions) 15% 10% $1,219 9% $1,103 11% $1,10% 011 $1,207 8% $1,519 $1,034 $1,308 10% 10% $1,822 $1,442 $1,013 $1,558 $1,166 $1,363 $1,968 18% 21%