While account-based health plans continue to expand, a shift in account types may portend a change in how the accounts are funded, according to new research from EBRI.
- Asset levels growing: In 2013, there was $23.8 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 11.8 million accounts, according to data from the 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS). The number of accounts was up slightly from 2012, when there were 11.7 million accounts. Total assets were up from $18 billion in 2012.
- HSAs growing, but HRAs contracting: For the first time since the survey was launched in 2005, the number of HRAs fell. In 2013, there were 4.7 million HRA accounts, down from 5.1 million in 2012. The number of individuals with HSAs increased from 6.6 million to 7.2 million between 2012 and 2013. Assets in HRAs fell slightly and were about $5.8 billion in 2013. Assets in HSAs increased from $11.3 billion to $16.6 billion between 2012 and 2013.
- After leveling off, average account balances increased: The combined average HRA and HSA account balance increased to $2,010 in 2013. It was $2,311 among HSA participants and $1,236 among HRA participants.
- Length of time with account has impact: Individuals with an HRA or HSA for five years or more had $3,491 in their account. Those with an account for less than a year had less than $2,000 in their account.
- Total and average rollovers decrease: Average rollover amounts decreased from $1,206 in 2012 to $1,165 in 2013. Total assets being rolled over also decreased: $9.2 billion was rolled over in 2013, down from $9.8 billion in 2012. The percentage of individuals without a rollover who had an account for more than a year was 10 percent in 2013.
Accounts (millions) Accounts (millions) The Figure 13, balanc num e. In ber o Average 2013, f peopl for i Ac ecount nwith stanc Balances, by a rollover e, individuals fell L fo with er the vel o an first tim f Annual Employer emploe yer contri in 2013.butio T Contribution, hen total l of less tha evel o 2007–2013 n f assets bein $1,000 had an ................................... g ro average acco lled over also fel unt l i14 n Health Savings Accounts and Health Reimbursement Figure 1 About the 2013 EBRI/Greenwald & Associates Figure 14 a b Paul Fronstin is director of the Health Research and Education Program at the Employee Benefit Research Institute balanc 2013. B e of etw $ ee 2,n 2 140, 012 wh an iled tho 2013, t se with he an number of employer co individua ntrib Figure 2 Figure 12 Figure 16 Figure 20 Figure 4 Figure 6 ls with ution o a ro f at lea llovs et $1,0 r fell from 00 ha8. d 2 mill an avera ion to ge 7. of9 mill $2,8ion, 89 in whil their e the Length of Time With Figure 10 Figure 18 HRA or HSA, 2006–2013 Figure 8 Consumer Engagement in Health Care Survey Arrangements: Assets, Account Balances, and Rollovers, a a b Figure 14, Average Account Balances, Average A by Level o ccoun f An at nual Balances, Individua b by l Co Lev ntributio e al of An n , n 20 ual 07– b 2013 ................................... 15 Total Assets and Number of Adults a Ages 21–64 b Average Annu AA al Grow cco v Rollov Terage Rollov oun tal HRA t th Balances, er in Am HRA and HSA ou er nts, A by A m ssets and Length of A ou m A n on cco ts, by g Indiv unt A Lev T s, 2007 cco ime iduals With eun l With of ts, 2008–2013 ?A 2013 nnual Account, 2013 amount account (EBRI). This roll (Figur ed over Issue Brie e 13). Distribution A fe Simil ll from $9.8 A f v was writte erage Combined arly, indivi bi n cco llion d with assistance from ua un ls to t who co $9.2 Balances, HRA bi ntributed llion. and HSA T Combined he aver the Institute’ less than Rollov age rol HRA $1s er A ,00 lover f research 0 and HSA m he ad an oll ufrom n an ts, average d ,2006 $1,2 editorial 2007–2013 0 ? 6 accou 2013 in staffs 20n 1t ba 2 . Any views to lance $1,165 of in $1,5 2069, 13. 50% Average Account Balances, Combined HRA and HSA, 2006–2013 a b The Employee Benefit Research Institute (EBRI) and Greenwald & Associates created the EBRI/Greenwald & Associates Individual Contribution, 2007–2013 2006–2013 30% With an HRA or HSA, 2006–2013 AccoEmploy unt for More Than One er Contribution, (millions) Y 2007–2013 ear, 2006–2013 expressed in this report are those of the author and should not be ascribed to the officers, trustees, or other sponsors while those who contributed at least $1,000 had an average balance of $3,196 (Figure 14). $4,000 2006 2007 2008 2009 2010 2011 2012 2013 14 $2 $2 0% ,50 ,000 0 8 Figure 15, Average Account Balances, by Rollover Level, 2007–2013 ....................................................................... 15 Janu Consumer En ary 2014 35 $3• % ,50 No. 395 gageme 0 nt in Health Care Survey (CEHCS) to examine issues surrounding consumer-directed health care, $25,000 130% 12 45% $2,000 of EBRI, EBRI-ERF, or their staffs. Neither EBRI nor EBRI-ERF lobbies or takes positions on specifi 11.8 c policy proposals. 11.7 By Paul Fronstin, Ph.D., Employee Benefit Research Institute 42% $3,196 7.2 including the cost of insurance, the cost of care, satisfaction with health care, satisfaction with a health care plan, It will be impo $1,80rtant to track 0 this trend over 20 time. Curr 07 2008 20 en 09 tly, account 41 20 %10 2011 bal 20ances are 12 2013 low and are therefore invested in References $3,491 EBRI invites comment on this research. 2007 2008 2009 2010 2011 2012 2013 Growth in Accounts 2007 2008 2009 2010 2011 2012 2013 Figure 16,12 Rollover Amounts, 0% Among Individuals With Account for More Than One Year, 2006–2013 ......................... 16 $3 25,50 % 07 $1,800 reasons for 40% choosing a plan, and sources of health infor 39% mation. The 2013 CEHCS is comparable with findings from the 2007 2008 2009 2010 2011 2012 2013 30% 6.6 relatively safe vehicles such as money mar 2006 ket fu 2007 nds 20(cur 08 re 20ntly, i 09 20n 10vestments are usu 2011 2012 2013 ally restricted to a money market $3,000 Fronstin, Paul. "Findings From the 2013 EBRI/Greenwald & Associates Consumer Engagement in Health Ca $2,010 re Survey." 10 $1,600 Growth in Assets $2,000 36% 200 Introduction 5–2007 EBRI/Commonwealth Fund Consumerism in Health Care surveys, and the 2008 -2012 CEHCS. fund until the savings account reaches a minimum threshold, such as $2,000 or $3,000). As account balances grow, the $20,000 35% Figure Suggeste EBRI Issue 17, Tot d cial Rollov tation: Brief no.39 Pau er Assets and Number of Ad 3 l Fronstin. (Employee “Hea Benef lth Savi it Researc ngs Ac ults Ah Inst g counts an es 21–64 Wit itute, d He Decem h alth R a ber 2 Rollover, eimbursement Arr 013). 2006–2013 angements: Asset ............................... s, 16 $1,600 35% 6 100% $3,000 Employers first started offering account-based health plans in 2001, when a 8.5 handful of employers began to offer health Health Savings Accounts an potential to invest in more risky investment vehicles (suc d Health Reimbursement h as mutual funds and stocks) will grow. The opportunities for 25% Account Ba 20 $1 lan % ,40ces, and Rollo 0 vers, 20 Asse 06– ts (m 20 illion 13.” s) EBRI Issue Brief no. 395, January 2014. $2,500 31% The 2013 survey was conducted within the United States between August 8 and Au $2,703 gust 20, 2013, through a 13-minute 97% $1,295 30% 30% Taylor, Hum phrey. "Does Internet Research ‘Work’? 5.1 Comparing Online Survey Results With Telephone Surveys." Figure reimbursem capital appreci 18, Average ent arran ation w Combin gement ill incre ed HRA s (HRAs), ase but or HSA so w empl ill Rollover Amou the oyer-funded h opportunities for nts, 2006 ealth plans capita ?2013 ............................................................... thlat reim losses, even burse workers for among indiv qu iduals wit alified m he h dic igh al levels 17 $1,400 30% 29% 8 Arrangements: Assets, Account Balances, and Rollovers, $1,206 $1,534 $1,206 4.9 Accounts (millions) 28% 28% Internet survey. The national or base sample was drawn from Ipsos’s online panel of Internet users who have agreed 5 $1,165 80% $1,470 $1,200 $2,500 4.7 C expenses. In opInternation yright Inf $1,50 2004, em 0ormation: al Journal o ploy fers wer Mark This re et Resea e port able is to start offerin copyright rch 42, no. 1 (Au ed by the Em g he galth pla ust 200 ploye n 3). s with health saving e Benefit Research Institut s accounts ( e (EBRI HSAs) ). It , tax- mayexemp be t of employer and individual contributions. $1,419 5 20% $15,000 26% $1,217 $1,208 $1,205 $1,356 $1,355 $1,188 $1,951 2006–2013 to participate in research surveys. Two thousand adults ages 21 -64 who had health insurance through an employer or Figure 19,$2 Average Rollover ,000 Amounts, $1,320 by Length of Time With Account $1,029 , 2007–2013 ................................................ $1,915 17 $1 15,20 % 0 24% $1,153 $1,890 used without permission but citation of the source $1,000 is required. 24% trusts or custodial 25% accounts that individuals can use to pay for health care expenses. The theory behind these accounts EBRI Employee Benefit Research Institute Issue Brief (ISSN 0887 ?137X) is published monthly by the Employee Benefit Research Institute, $2,090 $1,775 $948 $1,000 $1,076 $1,754 22% purchased directly from a carrier were drawn randomly from the Ipsos sample for this base sample. This sample was 4 Rollovers—Like contri $1,965 bution levels, annual rollover amounts are one of the biggest factors in average account 1100 1360 th S % t. NW, Suite 878, Washington, DC, 20005-4051, at $300 per year or is included as part of a membership subscript 6 ion. Periodi- $1,020 $1,646 is that giving individuals more control over funds allocated for health 5.4 care services will cause them to spend the money By Paul Fronstin, Ph.D., Employee Benefit Research Institute $2,000 $993 51% 3.5 $986 $1,569 15% $956 $959 Figure 20, cals posta $1 Average Rollover ,00 ge 0 rate paid in Was Amounts, hington, DC, an by d a Ld edvel itiono alf mail Annual Employer ing offices. POSTMAS Contribution, TER: Send ad 2007–2013 dress changes ................................... to: EBRI Issue Brief, 1100 18 stratified by gender, age, region, income, and race. The response rate was 37.2 19% percent (32 percent for the base 19%19% Report availability: Endnotes 20% This report is available on the Internet at www.ebri.org balances. Individuals with less than a $1,000 rollover ha 4.8 d an average account balan 13%ce of $1,561 (Figure 15). In more respo $1n ,50 $8 sibly, especial 00 0 ly once they become more educated about the actual price of health services. Furthermore, 13th St. NW, Suite 878, Washington, DC, 20005-4051. Copyright 2014 by Employee Benefit Research Institute. All rights reserved. No. 395. $1,000 $1,607 40% 17% 10% 39% $849 $10,000 $826 sample or 1 national sample, and 44 percent for the 4.2 oversample). As a non-pro 16%bability sample, traditional survey margin 3 2.8 comparison, individuals with a rollover of at least $1,000 had an average account balance of $4,472. 16% See http://www.mercer.com/press-releases/1565095 15% these acco40 unt % s can be used as tax-advant 2.6 aged veh $1,209 icles to save for health care expenses in retirement. $1,178 46% Figure 21, Average $800 Rollover Amounts, by Level of Annual Individual Contribution, 2007–2013 .................................. 18 $1,500 $592 $1,125 2.5 15% $1,100 2.4 2.4 4 of error estim 10% ates do not apply. However, had the survey used a probability sample, the margin of error for the national $600 $694 $696 AT A GLAN CE 37% 12% $924 2 34% $1,000 11% $903 sample woul Table of Contents By 2 See 013, www.glo 23 d have bee pb ealopinionpanels.com rcent of n empl ±2.2 oyers with percent. /home 1 0–499 workers and 39 percent of employers with 500 or more workers offered 2 10% 1.7 2.5 $600 5% The Employee Benefit Research Institut 1.6 e (EBRI) was founded in 1978. Its mission is to 20% 9% 9% 10% 1 $400 10% $1,000 8% 8% 8% 8% either Rollovers an HRA $500 - or HSA-eligible plan. As a result, these plans covered about 26 million people in 2013, representing $5,000 5% 7% contribute to, to encourage, and to enhance the development of sound employee benefit Introduction .......................................................................................................................................................... 4 3 6% 2 This survey was made possible with support from Blue Cross and Blue The sample was divided into three groups: those with a consumer-driven health plan (CDHP), those with a high- In the Who we are 2012 CEHCS, 23 percent of respondents reported that they had “$3,000 or more” in their account. In the 2013 5% 0.9 1.3 programs and sound public policy through objective research and education. EBRI is the only about 15 pe $4 rc 00 ent of the privately insured market (Fronstin 2013). As the number of people with account-based plans Employers hav $500e a tremendous amount of flexibility in designing health plans that incorporate an HRA. Leftover funds at 1 4% $200 1% 5% Assets ............................................................................................................................... 0% .................................... 4 3% Shield Association, Chevron, Deseret Mutual, HealthEquity, National private, nonprofit, nonpartisan, Washington, DC-based organization committed exclusively to survey, respon deductible headents could report account balances in the “ lth plan (HDHP), and those with traditiona $5,000–$9,999” and “$10,000 l health coverage. Individual or more” s were assi ranges. It was found that gned to - t 1%he CDHP or expands, total assets in t 0% $500 hese accounts ca n be expected to grow as well. the end of each year can 2008 be carried over to 2009 the followin 2010g year (at the employer’s 2011 disc 20retion). 12 Employ20 ers can, 13 however, 0% public policy research and education on economic security and employee benefit issues. Rural Electri Nothing Less Th c an Cooperati $2 00 $200–$499 ve Associati $500–$999 on and Optum. $1,000–$1,499 $1,500–$1,999 $2,000–$2,999 $3,000 or More HDHP group $2 if 00 they had a deductible of at least $1,000 for individual coverage or $2,000 for family coverage. To be 11 percent had “$3,000–$4,999” in their account; 7 percent $0 Less Than $100 $100–$299 $300–$499 had “$5,000–$ $500–$9999,999”; and 10 $1,000–$1,499 percent had “ $1,500–$1,999 $2 $10,000 or more” in ,000 or More Account Balances $0 .................................................................................................................................................. 5 0% $873.4 also place restrictions on the amount that can be carried over. When it comes to HSAs, any money left in an account at 0 $0 $0 EBRI’s membership includes a cross-section of pension funds; businesses; trade associations -9%0 ; $0 2006 2007 2008 2009 2010 2011 2012 2013 Now that HRAsLe have ss Thabee n 6 Mo n a nths round 6 for ov Months ter o Les a sdeca Than de 1 and HSAs since 1–2 Years 2004, a grow 3–4 Yin eag rspercentage 5 or Mo of the re Yea po rs pulation has -20% HRAs HSAs their account. assigned to the CDHP 20 g 06r20 oup 06 , they m 2007 2007 ust also20 have h 2008 08 adHRA or a 2020 n 0909 account, suc HSA Balanc 2010 e 2010h as a 2011 hea 2011 lth savings account (HSA 2012 2012 2013 2013) or health Less Than $1,000 Rollover Amounts $1,000 or More labor unions; health care providers and insurers; government organizations; and service firms. the end of the year a $0 utomatically rolls over and is available in the following year because there is no use-it-or-lose-it About the 2013 EBRI/Greenwald & Associates Consume Year r Engagement in Health Care Survey ...................................... 6 $0 held them for Sources: EBR a number I/C of y ommonw eealth Fund C ars. In 2006, onsumerism 9 in perc Health ent o Care Surv f th eye , 2007; EBR population I/Greenw ald & with Associates an HRA Consumer or HSA ha Engagement d in H hel ead lth C an are account for reimbursement arrangement <6 Months (HRA), 6 with Months a to rollover Less Than provi a sion th 1–2 Y 7 ear at t s hey could use to 3–4 Year pay for m s edic 5 or Mo al expenses or re Years the Annual Individual Contributon Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Less Than $1,000 $1,000 or More rule, as is the Surv case wit Sources: EBR ey, 2008–2013. Sources: EBR h f I/Clex ommonw I/C ib ommonw leealth Fund C spen ealth Fund C din onsumerism g a onsumerism ccounts, or in Health in Health Care FS C Su are As. rvey Su , rv 2006–2007; EBR ey, 2006–2007; EBR I/Greenw I/Greenw ald & a Associates C ld & Associates C onsumer onsumer Engagement i Engagement i n n 4 Sources: EBRI/Commonwealth Fund Consumerism in H Year ealth Care Survey, 2006 ?2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, 2008–2013. Sources: EBR a Source: EBR I/Commonw I/Greenw ealth Fund C ald & Associates onsumerism Consumer in H ealth Engagement Care Surv in H eyealth C , 2006 ? are Surv 2007; EBR ey, I/M 2008–2013. GA Consumer Engagement in Health Care Survey, 2008 ?2013. Rollovers In theory, a r ? Asset lev ............................................................................................................................... andom sample els growof 2,000 yields a statistical prec ing: In 2013, there was $23ision of plus or minus 2.2 per .8 billion in health savings acc centage points (with 95percent ounts (HSAs) an .............................. 10 d health three to four y Sources: EBR H e H ealth reimbursement ars, and 3 percent ealth C Health C are Surv I/Commonw are Surv ey, 2008–2013. arrangement. ealth Fund C ey, 2008–2013. for five onsumerism years or more (F in Health Care Survey, 2006–2007; EBR igure 1). By I/MG 20 A Consumer Engagement 13, 24 percent ha in Health d Chel are Surv d a en accou y, 2008–2013. nt for three ability to take a their account with thEBRI’s work advances knowledge and unders em should they change jobs. Individuals with tanding of emplo only a flexible spendi yee benefits and their ng account (FSA) Surva ey, 200 a 8 ?2013. b Health reimbusement arrangement. Health reimbursemen a Health reimbursement a t arrangement. arrangement. NSources: EBR ote: 2006 data w Health savings account. I/Cas ommonw capped ealth Fund C at $1,500 or onsumerism more. in Health Care Survey, 2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008–2013. Health reimbursemen Health reimbursement t arrangement. arrangement. a Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008–2013. b b Heal Sources: EBR th re Health sav imburseme ings account. I/Commonw nt arrang ealth Fund C ement. onsumerism in Health Care Survey, 2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008–2013. Health sav b bings account. confidence) of what the result reimbursement arrangem s would be ents (HRA if the entire population ages 21– s), spread across 11.8 million accounts, 64 with private health insur according to data ance coverage was from the to four years, and Health sav 17 percen Health sav ings account. ings account. t for five importance to years or more. the nation’s econo As the lengt my h o among policy f time individuals makers, have the news these media, and accounts incr the public. It eases, were not bincluded in the CDHP group. Overall, th Conclusion .................................................................................................................... He ealth pe sav rcenta ings acc ge o ount.f individuals with a rollover had increased. In 2006, 23 percent of in ...................................... 10 dividuals with an HRA or does this by conducting and publishing policy research, analysis, and special reports on surveyed with What we do 2013 EBRI/Gr complete accur eenwald acy. There are & Associates Con also other poss sumer Engageme ible sources of error in al nt in Health Care Survey (CEHCS). The number l surveys that may be more serious than average account balances should increase as well. HSA did not roll over any money (Figure 16). By 2013, 10 percent did not have a rollover. employee benefits issues; holding educational briefings for EBRI members, congressional and References .......................................................................................................................................................... 11 theoretical calc Becauseof acc the base sample o ulations of sampling erro unts was up (national sam slightly from 2012, when there we r. These include refusals to be intervie ple) included only 180 indivi re 11.7 million accoun duals in a wed and other forms of nonresponse, the CDHP and ts. To 397 in tal divi assets were up from duals with an HDHP, federal agency staff, and the news media; and sponsoring public opinion surveys on employee This report examines HSA and HRA assets, account balances, and rollover amounts, using data from the 2013 Account Balances an oversample of individuals with a CDHP or HDHP was added. The oversample included 1,062 individuals with a CDHP. effects of ques Endnotes $18 billion in 2012. ...................................................................................................................... tion wording and question order, and screening. While attempts are made to minimize these factors, it is ...................................... 11 The number of people with a rollover benefit issues. had been inc EBRI’s Ed reasing u ucation and Re ntil 2013, an sed t arh ch e total Fund le (EBRI-ERF) performs vel of assets being roll the char ed over has itable, EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS). educational, and scientific functions of the Institute. EBRI-ERF is a tax-exempt organization impossible to q Until 2 In additio 013n to , average bein uantify the g s accou trati err fn ieto d, th bala rs that may re e b nces h ase sa ad mple sult from them. not incr was a eased lso we at th ight e same ra ed by gen te as the num der, age, edb ucation, er of acco regi unt on, income, s and total ass and ets in increased in all years except for 2010 and 2013. In 20Figure 13 06, 500,000 individuals rolled over $276.2 million (Figure 17). By Figure 15 Figure 17 Figure 19 Figure 21 Figure 1 Figure 3 Figure 7 Figure 5 1 Figure 9 6 supported by contributions and grants. ? HSAs growing, but HRAs contracting: For the first time since the survey was launched in 2005, the a a a b b a b Average Account Balances, by Level of Annual race/ethnicity to reflect the actual proportions in the population ages 21–64 with private health insurance coverage. the accounts. The combi Distribution of ned average HRA A Av nerage nuA al Grow T A v o n erage Rollov tal A A n A cco A T u v o al Grow cco erage Rollov tal Rollov ssets th and H un aun in t Balances, t HSA S in Balances, th A acco eHRA r Rate eA r A m b A eunt sset r s sset oin A u by and HSA m ba nCombined HRA HRA s and t s o s, by lanc Rollov u and nt e l s, by or HSA A Lev Number of eccou s er Lev veled off , e 2007–2013 Length l n of ts, 2008–2013 el, A A in ssets nnual and HSA 2007–2013 2008, droppe , 2013 d slightly in 2010, but 2013, 7.9 million individuals rolled over $9.2 billion. The average rollover increased from $592 in 2006 to $1,206 in Average HRA and HSA Account Balances, 2007–2013 5 Assets Figures The term “ number of HRAs fell assets” is used loosely as it relates to HRAs. An HR . In 2013, there Employ were 4.7 millio er Contribution, A is typicall n HRA 2007–2013 accoun y set up as ts, down fr a notion om 5.1 million in al arrangement and exist 2012. The s only 40% Adul and the Number ts Indiv of T Ages iime With dual Contribution, 21–64 With a ($of A millions) cA coun cco Rollov unt t, 2007–2013 2007–2013 s, e 2007–2013 r, 2006–2013 then The CDHP increase 10 ove 0%drsample in 2011, 2 was 01wei 2, an ghte d 20 d by gende 13. In 2006, r, a the ge, i ac ncco ome, an unt balanc d race e/eth average nicity. M waso $ re in 696formatio (Figure 8 n can ). It incr be fo eased und in to 2011 and 20 $5,00 12 an 0 d then fell to $1,165 in 2013 (Figure 18). $2,500 EBRI Issue Briefs is a monthly periodical with in-depth evaluation of employee benefit issues $10,000 9 $3,500 on paper. Employees may vie In 2006number of in , th $2ere ,000 were 1.3 m dividuals with illiw on accounts the HRA as if money was a HSAs increased from 6. with $873 millio ctually n in assets, an 6 being d million to 7.2 eposited into a d by 2million be 012, 1n1 account, and .7 mill tween 2012 and ion acco they may unts hel 2013. Assets carry a debit d $18 billion $230 ,00 0% 0 ( Figure Fronstin 1, Length of Tim 2013). e With HRA or HSA, 2006–2013 $2,311 ........................................................................................... 5 $1,320 in 20 $18,000 07, a 90 percent increase. Account balances averaged $1,356 in 2008 and $1,419 in 2009, 3 percent 282% and trends, as well as critical analyses 89% of employee benefit policies and proposals. EBRI 2 35% Our 2007 2008 2009 2010 2011 2012 2013 $4,472 90% in assets. According to findings from the 201 20073 CEHCS, 2008 20 t 09here 2010 was 20$2 113.8 b 2012illion 2013 in HSAs and HRAs in 2013, spread card that can b in HRA $4 35,50 % 0e used to pay for health care s fell slightly and were about $5 services at the .8 billion in HSpoint of service, but employers do A 2013. Assets in HSAs in HRA creased not incur expenses associated from $11.3 b $16,594 illion to Length of Time With Account—The length of time that an individual has held the account had an impact on and 5 percent increases, respectively. Notes Inis a monthly 2010, the avera periodg ical pr e account oviding curr balance ent in fell formation on a variety to $1,355, down 4. of emplo 5 percent yee ben from efit the 2007 2008 2009 2010 2011 2012 2013 $9,000 8.2 $1,774 8 $1,800 $1,800 7.9 2007 2008 2009 2010 2011 2012 2013 across 11.8 Whil Figure with the arrang e pane 2, $16.6 billion Total Assets and Number $1l I 6,000 mi nternet surv llion acco ement until an between 201 unts eys are (Fi employee incurs a claim. gur nonran topics. of A e 2 2 and 2013. ). dGr do ults EBRIef owth rat m, studies Ages 21–64 Wit is a week es in hav both a ly e de rou hmonstrated that a ssets an ndup of EBRI r n HRA d th or HSA, 2006–2013 e ne such u search mber surveys, when c and of accou insights, as well ........................................ nts have been areful as updates on ly design high, other ed, 7 rollover amounts. The analysis found that people holding an account for one to two years had an average rollover of 2007 2008 2009 2010 2011 2012 2013 publications previous year. In 2011, the average accou Growth in Ac nt ba counts lance increased to $1,470, a 9 percent increase. In 2012, the average $3,000 80% $2,889 2007 77%2008 2009 2010 2011 2012 2013 $4 $2 25 ,00 ,00% 00 0 Growth in Accounts $1,634 surveys, studies, litigation, legislation and regulation affecting employee benef $1,627 it plans, while CHECK OUT EBRI’S WEB SITE! $1,614 than th obtain results comparabl e latt 30% er in 2013. In e wi 2007, th ran assets ne dom-digit-dia arly trip l telepho led (282 ne perc survent) a eys. Taylor (2003), for exam nd the number of accounts ple, pr doubl ovides th ed (10e res 1 perce ults nt) $887 in 2013 (Fig $8ur ,00e 1 0 9). In comparison, those holding an account for three to four years had an average rollover of account balance increased to $1,534, a 4 percent increase. And in 2013, the average account balance increased to $1 $1,60 ,600 0 6 $1,547 7 EBRI’s Blog Growth in Assets supplements our regular publications, offering commentary on questions $14,000 Figure 3, Annual Growth Rate in HRA or HSA Assets and the Number of Accounts, 2007–2013 ................................... 7 The CEHCS ? After lev undercounts the eling off, av number of HSAs and total HSA asse erage account balances increased: ts because the surve The combined average HRA and HSA y only examines HSAs among people (Fi from a gure 3 num ). Wh ber of surv ile growth eys th slow at wer ed in 2 e co 008 ndu -201 cted at 0, it $1,721 contin the sa Gued at r me time rowth in Ase s usin ets lative g the ly high same rates, que accelerat stionnaires ed in bo201 th via t 1, ae nle d con phon tinue e and d $1,1 98. And 70% those with an account at least five years old had an average rollover of $1,614. $2,010, a 31 percent increase, part rece ly attr ived from ibutable news to a reporters change , p in olic the ym su akers rvey. , and others. EBRI Fundamentals of Employee $1,440 $3,500 Assets ($millions) $1,632 with HSA-eligib accoun le health coverage. Indivi t balance increased to $2,010 in duals who have a 2013. It n HSA but not an HSA-elig was $2,311 among HSA partici ible plan are pnot counted in the sur ants and $1,236 among vey. $2,500 $7,000 $1,378 25% to increase at online. He foun nearly d that th 40 perc e use of ent for demogra both a pssets and th hic weightine g alone number was of suf accfo icient unts in to 20 brin 12. g almost all In 2013, t of he tnumber he resu of lts fro acc m o the unts Benefit Programs offers a straightforward, basic explanation of employee b $1,357 enefit programs in $1 $1,40 ,400 0 $1,350 EBRI’s website is easy to use and packe 200% $1,537 d with useful information! Look for $1,527 $12,000 $1,318 6 $1,308 $11,331 Figure 4, Total HRA and HSA Accounts, 2007 ?2013 ................................................................................................. 8 $1,284 60% $1,452 HRA participants. Accounts (millions) Employer a $1,500 nd Indivi $1,430 dual Con the priv tributions ate and —In public s dividuals w ectors. ith The an em EBRI Data ployer 5.6 book on Emplo contribution of yee Benefits less than $1, is a 000 statistic had an al grew 1 percen Whe online n survey examiniclose to th n t whi g avlerage ac e assets grew 32 e replies count from th balanc perc e eent. Part sparalle by type of l te of t leph a he ccount on reason e survey. , accou for t He also h ne differenc t balances founed t ar in e hi h the gro at in gher some c for wth o those with ases, propensi f assets compa an HS ty A than red $3,000 $2,869 $2,140 7 $1,213 $1,214 $1,203 $2,773 $2,778 these special features: $6,000 $1,198 Individuals are also able to roll over funds from one HSA into another HSA without subjecting the distribution to income and reference work on employee benefit programs and work force-related issues. 19% 20% average rollov $1 $1,20 ,200 0er of $49% 1,153 in 2013, while those with an employer cont $1,144 ribution of at least $1,000 had an average with t weightin he g gro (me wth of accounts aning the propwas due to ensity for a a c certain ty hange in the pe of pers survey. In on to be o prior nline years, “$3, ) reduced the 000 or mor remain e” wa ing ga s the h ps, but igh in est other for those wit $10,000 h an HRA, and growth has been higher in HSAs than in HRAs. In 2013, the average account balance in an $1,236 Figure 5, Total Assets in HRAs and HSAs, 2007–2013 ............................................................................................... 8 5 $2,000 46% 50% $2,494 penalty taxes a ? Length o s long as the r f time with acc ollover does not exceed 60 da ount has impact $1,059 : Individuals wi ys. Rollover contributions from Archer Medi th an HRA or HSA for five year cal Savings Acc s or more h ounts ad 150% $1,145 $1,138 $2,500 $1,130 $1,795 rollover of $1,205 (Figure 20). In contrast, individuals who contributed less than $1,022 $1,000 had an average rollover of • EBRI’s entire library of research publications starts at the main Web page. Click on EBRI account cases it did no HSA was balan $2,311, as ce cate t reduce t compar gory th he re ed at a r mainin with esponde $ g 1 gaps ,236 nt coul . Perha in HRAs d c ps th h (Fi oose. e gure mo In st 9). the 2013 survey, respo striking dif Average HSA $2,292 ferenbala ce in demographics betwee nces increased ndents $1,099 could r from just above $1, eport ac n tcount elephone 400 $5,000 41% $8,060 47% $1,717 15% $976 $974 $1,052 $1,697 $962 Contact EBRI Publications, (202) 659-0670; fax publication orders to (202) 775-6312. $1,000 (MSAs) are als $3,491 in thei $1,00o 0 permitted. r account. Those with an account for less than a year had less than $2,000 in their account. 15 $8% ,000 $932 3 14% $871, while those who contribute 14%d at least $1,00$900 0 had an average roll $969 over of $1,440 $1,582 (Figure 21). Issue Briefs 40% and EBRI Notes for our in-depth and nonpartisan periodicals. Figure 6, balanc and onlin es in e sur Annual Growt the “ veys was th $5,000h –$ in HRA e 9,under 999” a Assets and Accoun -re ndp “ rese $10ntation o ,000 or mor $1,563 fts, 2008–2013 min e”o ranges. rities in onli ................................................................. ne samples. ........... 9 in 2008 to $2, $1,000 311 in 2013. In contrast, av$887 erage HRA balances increased from $1,130 in 2008 to $1,236 2 4 013. Subscriptions to $873 EBRI Issue Bri $871 efs are included 3.6 as part of EBRI membership, or as part of a $1,890 $2,000 $1,460 $830 Orders/ $1,441 $1,500 $1,403 11% $4,000 11% $790 $199 annual subscription to EBRI Notes and EBRI Issue Briefs. Change of Address: EBRI, $1,344 $5,839 $1,348 $767 $768 $750 $751 $5,756 $800 3.2 ? Total and average rollovers decrease: $800 Average rollover amounts decreased from $1,206 in 2012 to 100% • Visit EBRI’s blog, or subscribe to the EBRI $6,000 ef e-letter. $1,561 9% The 2013 slow 30% down in grow 9% th in the num 9% ber of accounts can be attributed to a reduction in the number of HRAs and a 10% 9% Figure 7, Annual Growth in HSA Assets an 1100 13th St. NW, Suite 878, Washington, d Accounts, 2008–2013 ............................................................................. 9 DC, 20005-4051, (202) 659-0670; fax number, 33% Between 2007 and 2013, th $1,198 $675 ere has been a decline in the percenta 8% ge of individuals with a zero account balance and an 8% 101% 3 Subscriptions Length of $1,500 Time with Account 71% —Not surprisingly, the length of time that an individual has had an account has a $1,102 7% $1,165 in 2013. Total assets being ro 2.5 lled over also decreased: $9.2 69% billion was rolled over in 2013, down $4,267 $597 drop in assets in HRAs $3,000 (despite the(202) 775-6312 additional higher ; e-mail: -account-balanc subscriptions@ebr e categories 6%i.org note Membe d abrsh ove i ip Information: ntroduced in the Inquiries 2013 Conclusion $3,865 6% increase in the percentage of those with an account balance of at least $3,000. Th $3,717e p ercentage with at least $3,000 in • EBRI’s reliable health and retirem $600 ent surveys are just a click away through the topic boxes at $600 $3,512 5% $4,000 $1,083 major impact $1 20,00 % 0 on the amount of money in the account. The analysis found that people who held an account in 2013 for from $9.8 billion in 2012. $500 regarding The percentage of individual EBRI membership and/or con s with tributio out a r ns to EBRI-ER ollover who h F should be dir ad an accoun ected t for more to EBRI $1,018 4% $991 Figure 8, Average Account Balances, Combined HRA and HSA, 2006–2013 .............................................................. 12 survey). Be5% tween 2012 $959 and 2013, the n $942 umber of HRAs fell from 5.1 million to 4.7 million 45% (Figure 4), and the assets in $2,741 $2,763 15% Accordin their account g to fiin ndin creased from gs from t $878 h 16 e 201 percent 3 EB 66% RI/Gree in 2007 to nwal 28 d & pe 15% Arcent i ssociates Consumer En n 2013, while the gagement percentage in H with ealth Care a zero acco 2 Survunt ey $1,00 500 % the top of the page. $2,385 President Dallas Salisbury at the above address, (202) 659-0670; e-mail: salisbury@ebri.org less than six months ha $2,000 d an average of $1,965 in their account, and those who held an account six months to 32% less than than a year was 10 percent in 2013. $1,971 56% 1.3 HRAs fell from $400 $5.839 billion to $5.756 billion (Figure 5). Overall, there was a slight decline in HRA assets between $400 $2,000 (CEHCS), balance fe ther 10 ll fr %om 10 e was $2 percent 3.8 bi in llion i 2007 n HSAs to 5 6% perce and HRAs n20% t in in 2020 1313, (Fi spr gure e 1 ad acr 0). Indivi oss 11.8 m duals wit illiohn accou HRAs were nts. HRAs accounte more likely to report d for 13% Figure a year had $ 9, Aver 1,age H 607 (Fi RA an g $857 ure d 1HSA Account 2). In compari Balances, son, indiv20 idua 07–2 ls with 013 an ............................................................................... 12 account for one to two years 39% had an average of • Need a number? Check out the EBRI Databook on Employee Benefits. 0% $500 2012 a Editorial Bo nd 2013 ard: , an Dallas L d the .nu Salisbur mber o y, publisher f accou ; Stephen Blakely nts fell 9 perc , editor ent (Fi . Any gur views e 6).expr essed in this publication and those of the authors should $500 9% 1 4.7 mi that they llion ha acc d either ounts in a 20 zero 13, account down from balanc 5.1 mill e or diion d not in k 20 n12, ow th whil eire HSA balance. In s accounte 201d 3 , fo 9 percent r 7.2 millio ofn a HRA parti ccounts, up fr cipants om $1,000 Nothing Less Than $200 $200–$499 $500–$999 $1,000–$1,499 $1,500–$1,999 $2,000–$2,999 $3,000 or More Don't Know 0.5 $2,090. Those with an account for three to -1% four 15% years had an avera 8% ge of $2,703, and those with an account for at least not be ascribed to the officers, $200 trustees, members, or other sponsors of the Employee Benefit Research Institute, the EBRI Educ 1% ation and 0% $200 $0 0% $0 6.6 mi reported a • llion Instan in zer 201 o account tly ge 2. Assets i t e-m baln a ail noti HRAs f nce, com ? ell cations of the latest EB p sli ared with ghtly to $ 4 5 perc .8 bent amon illion in 2RI data, 0 g 1individuals 3, while assets surveys, publications, and m with an HSA in HSAs i(Figure ncreased from 11). Similarly, $ eetings 11.3 billion Figure Resear 10, ch Fund, Distribution or their 20 20 of staffs. 08 07 Acc Nothin ount Ba g her 2008 20 lances ein is to be co 09 , Combin nstr 2009 ued as an attem ed H 2010 RA an 20 p d HSA, 10 t to aid or 20 11 200 hinder 7– 20201 the adoption 11 3 .................................................... 13 2012 of a 2012 ny pending le20 gislat 20 1313ion, regulation, In contrast to the recent decline in HRHRAs HS As, growth i As n HSA assets and accounts has bee HRAs HSnAs increasing. Between 2012 and five years had an av $0 erage account balance of $3,491. HRA or HSA Balance $276.2 $0 0 or interpretative rule, or as legal, accounting, actuarial, or other such professional advice. www.ebri.org to $1 19 perc 6.6 ent o billio f n, thou HRA partic gh som ipants report e of that Less Tincre ed t han $1 hat they ase can ,000 di be d at no tribute t know d to their an account balan enhancement $1,ce, 0 00 in th ocompar r Mo e survey. re ed with 9 perc Overall acco ent u n among t and seminars by clicking on the “Notify Me” or “RSS” buttons at the top of our home page. $0 -10%$0 2013, the num $0ber of HSAs 20increase 06 d 20 fro 07 m 6.620 millio 08 n to20 7.2 09 million 2010 (Figure 4), 2011 and the 20 assets in 12 20HSAs increase 13 d from Less Than $1,000 $1,000 or More Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Sources: EBRI/Commonw 1–2 Y ealth Fund C ear Les s s Than onsumerism $1,000 in Health Care Survey 3–4 Y , 2007; EBR ears I/Greenwald & Associates $1, 0 C00 onsumer or Mo 5 Engagement re or More Year in H s ealth Care Figure 11, Dist Sources: EBR Sources: EBR ribution I/C I/C of ommonw ommonw Acc ealth Fund C o ealth Fund C unt Ba onsumerism lances onsumerism 4 , Combin in in H H ealth ealth C C are are ed H Su Surv rvey ey R Rollover , , A an 2007; EBR 2007; EBR d HSA, Level I/G I/G reenw reenw 201 ald & ald & Associates 3 Associates ............................................................. 13 C C onsumer onsumer Engagement Engagement in H in H eea alth C lth C aa re re balanc individuals es aver witaged h an HSA. $2,010 The in 2 se di 013. ffer ences are consistent in the historical CEHCS data (not shown in a figure). Employer and Individual Contributions—Annual contribution amounts, whether they come from the employer $11.3 billion tSurv o $1 Surv ey, 2008–2013. 6.6 ey, 2008–2013. billion (Figure 5). Growth in HSA assets increased 46 percent, while the number of accounts EBR Survey I Issu , 2008–2013. e Brief is registered in the U.S. Patent and Trademark Office. ISSN: 0887 ?137X/90 0887 ?137X/90 $ .50+.50 Survey, 2008–2013. Sources: EBRI/Greenwald & Associates Consumer Engagement There’s lo in Health Care Surv ts more! ey, 2008–2013. a a aa Health reimbursement Health reimbursement arrangement. arrangement. H H ealth reimbusement ealth reimbursement arrangement. arrangement. a H b ealth savings account. (in the case Sources: EBR obf both b I/C HRAs ommonw an ealth Fund C d HSAs onsumerism ), or fr in om individu Health Care Survey als (as t , 2006–2007; EBR hey a I/M p Gpl A y to HSAs Consumer Engagement only) hav in Health e C a are stron Survey, 2008–2013. g impact on overall b Health sav Health sav ings account. ings account. increased 9 pe Sources: EBR Sources: EBR Sources: EBR H rcent ealth sav I/C (Figur ings account. I/C ommonw I/C ommonw ommonw e ealth Fund C 7). As ealth Fund C ealth Fund C mentio onsumerism onsumerism onsumerism ned above, in in H in ealth HH ealth ealth Care CC are are Surv Surv on Surv ey ey , e of ey 2007; EBR , 2007; EBR , 2007; EBR the reaso I/M I/M G I/M G AG A C A onsumer C C onsumer n onsumer s for t Engagement Engagement Engagement he difference in in H in H in H ealth C ealth C ealth C are Surv are Surv are Surv the ey ey , ey 20 , 20 , growth 08–2013. 20 08–2013. 08–2013. of HSA assets H Sources: EBR ealth savings account. I/Commonwealth Fund Consumerism in Health Care Survey, 2007; EBRI/MGA Consumer Engagement in Health Care Survey, 2008–2013. Figure 12, Average Account Balances, by Length of Time Wit h Account, 2013 .......................................................... 14 Visit EBRI on-line today: www.ebri.org account balances. Not surprisingly, the more money that is contributed to an account, the higher the average account compared with the growth of accounts was a change in the survey. © 2014, Employee Benefit Research Institute ?Education and Research Fund. All rights reserved. ebri.org ebri.org ebri.org A monthl ebri.org ebri.org ebri.org ebri.org ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 ebri.org Issue Brief • January 2014 • No. 395 Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri y research report f e e e e e e efffffff • Januar • Januar • Januar • Januar • Januar • Januar • Januar rom th y y y y y y y 20 20 20 20 20 20 2014 • No. 395 14 • No. 395 14 • No. 395 14 • No. 395 14 • No. 395 14 • No. 395 14 • No. 395 e EBRI Education and Re search Fund © 2 014 Em ployee Benefit Research Institute 18 12 16 14 13 17 15 7 8 9 10 11 3 5 6 4 2 Assets ($millions) Assets (millions) 23% 10% 15% 9% 16% 6% 10% 7% 13% 7% 13% 5% 11% 10% 5% 7% 9% 10% 12% 9% 14% 10% 16% 11% 8% 13% 10% 8% $3,336.8 7% 10% $1,278.5 12% 10% 8% 20% 11% 8% 12% 19% 7% 12% 9% 10% $5,697.2 8% 12% 6% $2,480.5 7% 11% 9% 15% 6% 15% 8% 12% 8% $6,829.8 12% 5% $4,104.2 13% 6% 12% 6% 12% 7% 9% 12% 14% 10% 9% $7,343.5 10% 14% $3,754.2 28% 9% 11% 8% 8% 10% 10% 15% 8% 10% 11% 6% $12,430.1 7% $6,751.7 11% 8% 10% 5% 14% 7% 10% 8% 8% 27% 11% $17,965.7 $9,838.8 13% 10% 5% 8% 7% 9% 6% 11% 3% 9% 9% 9% 7% 7% 6% $23,781.2 $9,228.8 16% 0% 18% 18% 20% 20% 31% 18% 21% 25% 22% 23% 25% 28% 23%