A crucial factor in the amount of money in individual health accounts is whether the employer contributes to it—whether a little or a lot, according to new findings by EBRI.
- In 2014, there was $22.1 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 10.6 million accounts, according to data from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey (CEHCS). In 2008, there were only 4.2 million accounts with $5.7 billion in assets.
- The average account balance was $2,077 in 2014, up from $1,356 in 2008.
- An increasing number of individuals have held their account for three or more years. One-quarter (27 percent) had held their account for three to four years, up from 19 percent in 2008. Thirteen percent had held their account five or more years, up from 4 percent in 2008.
- Accounts with an employer contribution had a higher average balance than those without an employer contribution. Accounts with an employer contribution had an average balance of $2,403, whereas those without an employer contribution had an average balance of $2,056.
- Individuals who had held an HRA or HSA for five years or more had $3,092 in their account. Those who had held an account for less than a year had less than $1,500 in their account. In general, average account balances have grown over the longer term regardless of how long the account had been open.
- Average rollover amounts increased from $1,165 in 2013 to $1,244 in 2014.
- $8.9 billion was rolled over in 2014, down from $9.4 billion in 2013.
- Eleven percent of individuals had held an account for more than a year without a rollover in 2014.
- Rollover amounts increased with the length of time an individual had held an account. In 2014, those who had held an account one to two years rolled over an average of $982; those who had held an account three to four years rolled over an average of $1,421; and those who had held an account five or more years rolled over an average of $1,428.
- Accounts with an employer contribution had a higher amount rolled over than those without an employer contribution. Accounts with an employer contribution had an average rollover of $1,280, whereas those without an employer contribution had an average rollover of $1,069.
Accounts (millions) Accounts (millions) Figure References place restrictio Assets statistically significant. This survey 10, Ave warage Ac ns on th s madecount pos How e amo sie ble Balances, ver, the unt that with the low can by L fe be carri ur ndin e201 vel o g s 4 fenrollm An ed over. upport nual e Individua fr n Wh om the t es en timate affects other it com fol l Co low ntributio es to HSAs, any ing organiz n, 20 trend ations: Blu 07– money 20 data 14 ................................... 12 e Cro presented in this left in ss and B an accou luen S pa t at hield per. the Health Savings Accounts and Health Reimbursement ® 6 Figure 9 Association, HealthEquity, Healthways, Lincoln Financial Figure 1 Group, National Rural Electric Cooperative Association, end of t As a result he yea of the lo r automatical wer estimate, it a ly rolls over ppea anrd is ava s that total asse ilable Figure 3 Figure 17 Figure 15 Figure 13 Figure 1 Figure 7 in the ts held in fol 1lowin Hg year SAs and HRAs fel because ther l, an e is d t no hat uthe se-it-or growth -lose-it rat rule. e in Accordin Fronstin, g to P., & Elmlin findings from ger, A. t h"Fi e 201 ndings 4 CEHC From S, ther the 20 e 14 was $ EB Figure 5 RI/Gre 22.1 bienwa llion in ld HSAs and HRA & Associates Consumer s in 2014, spr Engagem ead across 10. ent in Health 6 mil- Arrangements: Assets, Account Balances, and Rollovers, a b Optum, and Prudential. Average Account Balances, by Level of Figure 11, Average Account 4 Balanc Length es, by Rollover of T a ime With HRA Level, 2007–2014 b or HSA ............................................................. , 2006–2014 5 .......... 13 Total Assets and Number of Adults Ages 21–64 Average Average Rollov A A A cco T v v o erage A erage Rollov tal Rollov unt Balances, cco er eA r un m A et r sset oBalances, A u by m nt s o s, by Rollov u and nts, by Lev Number of er Lev bye Length Length l of el, Annual 2007–2014 assets was negative as well, wh Aven, i erage HRA n fact, this is sim or HSA plyA a fu cco nction o unt Balances, f a lower estimat 2006–2014 e for HRA and HSA enrollment lion acco Care S unts (Figure 3). urvey." EBRI Issue Bri In 2008, ef no. there 40 we 7 (E re only mployee 4.2 Be milne lion acco fit Research unts In with stitute, De $5.7 billio cem n in b assets. er 2014). In 2014, growth Annual Employer Contribution, a b 2007–2014 2006–2014 Overall, the 50% percentage of individuals wit With an h a rollover HRA has increase or HSA, d2006–2014 . In 2008, 16 percent of individuals with an HRA or AEmploy cco of T of T unt iime With me With s er Contribution, With a Rollov A Ac cc coun ount, t, er 2007–2014 2007–2014 2007–2014 , 2006–2014 between 2013 and 2014 tha $6,000 t is within the margin of error. $4 $2 ,00 ,50 00 rates were negative for both assets and the number of accounts (Figure 4). As noted earlier, the decline between 2013 $2,000 $10,000 9 Figure 12, Rollover Amounts, Among Individuals Holding Account for More Than One Year, 2006–2014 .................... 13 January 2015 $3• ,50 No. 409 0 2006 2007 2008 2009 2010 2011 2012 2013 2014 Paul Fronstin is director of the Health Education and Research Program at the Employee Benefit Research Institute HSA di d not ro $2,000ll over any money (Figure 12). By 2014, 11 percent did not have a rollover. Taylor, H. (2003). "Does Internet Research ‘Work’? Comparing Online Survey Results With Telephone Surveys." and 2014 was likely $25,000 the result of the lower incidence rate of CDHPs in 2014 that was not statistically signi 16.0ficant. Note By Paul Fronstin, Ph.D., Employee Benefit Research Institute, and Anne Elmlinger, Greenwald 2007 20 20 07 08 20 20 09 08 2020 1009 2011 2010 2012 2011 2013 20 20 12 14 2013 8.1 2014 45% 2007 2008 2009 2010 2011 2012 2013 2014 (EBRI). Anne Elmlinger is vice president, Healthcare Practice lead, with Greenwald & Associates. 8.0 Any views expressed in $1,774 International Journal of Market Resea 42% rch , 42, no. 1 (August 2003). Where the world turns for the facts 2007 2008 2009 2010 on U.S. employee benefits. 2011 2012 2013 2014 $1,800 $9,000 that in 2013, the number of accounts grew 3 percent while assets grew 38 percent. Part of the reason for the Figure & Associate 13, Total Rollov s er Assets and Number 2007 of Accounts 2008 2009 Wit 41% 2010h a20 Rollov 11 20e 12 r, 2006–2014 2013 2014 ............................................ 8 . 14 $1 $3,50 ,800 0 The number of accounts with a rollover increased annually until 2013, and the total level of assets being $2,077 rolled over has $2,065 this report are those of the authors and should not be ascribed to the officers, trustees, or other sponsors of EBRI, $5,000 $3,000 39% $2,889 $4,792 40% $1,634 14.0 difference in the growth of assets compared with the growth of accounts was due to a change in $1, the survey. 627 In prior 7.1 $1,614 $2,000 increased in all years except for 2010, 2013, and 2014. In 2008, 2.5 million accounts rolled over $2.5 $2,768 billion (Figure Employee Benefit ResearchAbout the 2014 EB Institute-Education and Rese RI/Greenwald & Associates arch Fund (EBRI-ERF), or their staffs. Neit her EBRI nor EBRI- $1,600 $8,000 $1,547 $4,472 Figure Retirement 14,$1 Ave ,600rage H and health benefits are at the heart of w RA or HSA Rollover Amounts, 2006 ?2014 ............................................................................... orkers’, employers’, and our nation’s 14 36% 7 years, “$3,000$2 or more 0,000 ” was the highest account balance category that a respondent could choose. Starting with the 12.0 35% 13). By 2014, $3,0007.1 million accounts rolled over $8.9 billion. The average rollover increased from $1,000 in 2008 to 35% 11.7 Endnotes ERF lobbies or takes positions on specific policy proposals. EBRI invites comment on this research. Health Savings Accounts and Health Reimbursement $1,428 economic security. Founded in 1978, EBRI is the most authoritative and objective source of $1,421 Consumer Engagement in He As Asse setts s (m ($m illi ilon lions s) ) alth Care Survey 12.0 Introduction 2013 survey, respondents could report account balances in the “$5,000–$9,999” and “$10,000 or more” ranges. $2,500 $1,378 $7,000 $1,400 $1,244 in 2014 (Figure 14). 31% $1$4 ,40 ,00 0 0 10.6 Figure 15, Average Rollover Amounts, by Length of Time With Account $1,318 , 2007–2014 ................................................ 15 information on these critical, complex issues. 30% 30% $1,314 6 Arrangements: Assets, Account Balances, and Rollovers, 5.6 $1,534 Employers first started offering acco A Ac cc cunt o ou un nts ts-ba (mi (mills lliion on ed h s s) ) ealth plans in 2001, when a handful 29% of employers began to offer health 30% $2,183 $2,140 $1,470 1 28% 28% $2,500 $1,217 $1,500 $1,211 $1,208 The See Employe http://www.mercer. e Benefit Resea com/rc ch Institut ontent/mercer e (EBRI) and /global/al $1,419 l/en/news Greenwalroom/m d & Associates creat odest-health-benefit-cost ed the EBRI/G -gro $1,205 reenwald & Associates wth-continues-as- $1,188 27% 10.0 Copyright Information: This report is copyrighted by the Employee Benefit Research Institute (EBRI). It may be $6,000 reimbursem $1en ,200 t arrangements (HRAs), empl $1,356 oyer-funded h $1,153 ealth $1,355 plans26% that reim 26% burse workers for qualified medical Length $1,200 $15,0 of Tim 00 e With Account—The length of time that an individual has held the account had an impact on 2006–2014 $1,320 Figure 16, Average Rollover Amounts, by Presence of Employer Contribution, 2007–2014 ......................................... 15 $2,000 EBRI focuses solely on employee benefits research — no lobbying or advocacy. consumerism-kicks-into-high-gear.html 24% 8.4 Consumer Engagement in Health Care Survey (CEHCS $1,076 ) to examine issues surrounding consumer-directe 5d health care, used Ewithout BRI Em 25ploye % permission, e Benefit Rebu seat citation rch Institute I of t ssue B he source rief (ISS is re N 0887 quire ?137d X. ) is published monthly by the Employee Benefit Research Institute, Account Balances $1,059 $1,795 expenses. In 2004, employers were able to start offerin 23% g health plans with health savings accounts (HSAs), tax-exempt rollover amounts. The analysis found that $1,020 people holding an account for one to two years had an average rollover of $2,869 $3,000 $1,717 $993 22% $1,697 1100 13th S EBRI t. NW, S stand uite 8s 78, alone in em Washington, Dpl Coyee , 20005ben -4051, efits at $3 rese 00 pear r ych ear or i as $986 san inclinde uded as pend part eof nt, a m nonprofit, and no embership subscription. npa P rtisan eriodi- $982 $976 $2,773 $2,778 $5,000 $974 inclu By Paul Fro ding th $2e c ,000n ost of insura stin, Ph.D n., Em ce, the $962 plo cost of $956 yee care, satisf Benefit Resear action with ch Institute, health care, and Anne Elm satisfa $959 ction with al health c inger, 8. Greenwald 0are plan, $1 $1 ,00 ,00 00 $932 $1,582 In 2014, average account balances reach 20% ed $2,077 (Figure 5). In 2008, average account balances were $1,356, and as trusts or custodial accounts used to pay for healt $1,563 h care expenses. The theory was that these accounts would give Figure 17, 2 $982 i caln s p 201 os Average Rollover ta4 ge (Fi rag te ur pai e 1 d in 5 ). W In ash Amounts, comparison, ington, DC, and by a t Lddi hose hol evel tional m of Annual Employer d ail in ing g a offi n a cesccou . POS nTt for MAS Contribution, Tthree to ER: Send fo ad 2007–2014 ur y dress c ears ha hanges t ................................... d an o: EBRI average rollover of Issue Brief, 1100 16 Recommended C organization. itation:It analyzes a Paul Fronstinnd and A rep 19% o nne 19% rts Elml resea inger. rch data “Health without Savings Acco $2,494 spin or unde unts and Healt rlying agend h Reim a. All fin burseme dingn st , $887 19% See http://www.i-say.com/ 19% 20% 3.7 $1,460 $1,441 $849 4 reasons for & Associate 13th St. Nch W,oosing a S s uite 878, pla Wa $826 shi n, and sources o ngton, DC, 20005-4 f h 05e 1. C alth opy infor right ma 2015 tion. Findin by Employee B gs from enefit R the 2014 esearch In st CEHCS is comparabl itute. All rights reserved. N e wi o. 4th 09. $1,500 $830 $1,403 $1,000 $2,292 recently as 2012 they were $1,534. $1,344 Between 2008 and 2014, the percen $1,348 tage of accounts with a balance o 17%f $3,000 or individuals more control over funds allocated for health care services and would cause them to become more engaged $1,421, and twheth hose wit $10,000e $790 r h a on fi n nan account at cial data, leaoption st 5 years o s, or tre ld had a nds, are reve n average rollover aling and of $1,428. reliable — the re ason EBRI information is Arrangements: Assets, Account Balances, and Rollovers, 2006–2014.” EBRI Issue Brief, no. 409, (Employee Benefit $4,000 $768 $800 $767 16% 16% 5.5 $800 6.0 15% findings from the 2005–2007 EBRI/Commonwealth Fun 3.0 d Consumerism in Health Care Survey, and the 2008 -2013 $1,198 Figure 3 18,$1 Average ,500 Rollover $694 Amounts, by Level of Annual Individual Contribution, 2007–2014 .................................. 16 more increase the d from gold sta 18 per ndard cent to for 27 priva petr e cent. At t analysts a he s nd ame ti decisi me, on the make perce rs, n gove tager w nme ith a nt $1,890 zero policy bala make nce rs, fell the media, and slightly from in their health care, thereby using health care services more effectively, especially once they became more educated In theory, a ra 15 $2 %,00ndom sample of 2,000 yields a 0 statistical precision of plus or minus 2.2 percentage points (with 95 percent $1,102 Research Institute, January 2015). 4.6 13% $696 3 4.2 12% CEHCS. 2.5 AT A GLAN CE Employer a the publi ndc Indivi . dual Contributions— Accounts with an employer contribution had a higher amount rolled $3,000 $1,561 9 percent to $67 perc 00 11% ent (Figure 6). about the a $1c ,00 tu 0al price of health services. Furthermore, these accounts could be used as tax-advantaged vehicles to confidence) of what the results would be if the entire population ages 21–64 with private health insurance coverage was $600 $1,452 10% 3.4 4.0 The Employee Benefit Research Institute (EBRI) was founded in 1978. Its mission is to 9% 9% 9% 10% over than those without an employer co 1.8 ntribution in 2014. Accounts with an employer contribution had an average Report Availability: This r 8%8% e 8% port is available on the Internet at www.ebri.org 8% save for futur $1,00e 0 health care expenses. surveyed with $500 complete accuracy. There are also other possible sources of error in all surveys that may be more serious than $5,000 $1,083 2 7% contribute to, to encourage, and to enhance the development of sound employee benefit The 2014 survey was conducted within th$1,018 e United States between Aug. 7 and Aug. 27, through an 11-minute Internet $991 $959 $400 $2,000 6% $942 Length of Time With Account—Not surprisingly, the length of time that an individual has held an account had a EBRI explores the breadth of emplo $878 yee benefits and related issues. rollover of $1,280 in 2014, whereas those without an employer contribution had an average rollover of $1,069 (Figure $1 $4,00 00 0 5% Who we are theoretical calc ? In 2014, th ulations of sampling erro ere was $22.1 bill programs and so ion in r. These include refusals to be intervie health s und public policy avings accoun through objective ts (HSAs) and wed and other forms of nonresponse, the health research and reimbu educati rsement arra on. EBRIn is the only gements 1.4 4% 5% $500 2.0 survey. The national or base sample was drawn from Ipsos’s online panel of Internet users who have agreed to 3% EBRI studies the world of health and retirement benefits — issues such as 401(k)s, IRAs, retirement major impact on the amount of money in the account. In 2014, the average account balance was $796 among people By 2014, 27 percent of employers with 10–499 workers and 48 percent of employers with 500 or more workers offered 16). Individuals with an employer contri private, nonprof bution of less tha it, nonpartisan n $1 , ,0 Washington, DC-b 00 had an averased organi age rollove zat r of $1 ion com ,2m 11 itted exclusivel in 2014, whyil e to 2 effects of ques (HRAs), s tion wording a pread across 1 nd question 0.6 million order, and scree accounts, accordin ning. While attempts are g to data from the mad 201 e to minimize these factors, it is 4 EBRI/Greenwald & Associates 1 $500 $200 $1,000 0.5 participate in research surveys. Nearly, 1 2,000 adults ages 21 -64 who had health insurance through an employer, income adequacy, consumer-driven benefits, Social Security, tax treatment of both retirement and health $200 public policy research and education on economic security and employee benefit issues. who held an account for less than six months, while those with an account six months to less than a year had an either an HRA- or HSA-eligible plan. As a result, these plans, collectively known as consumer-driven health plans those with an employer contribution of at least $1,000 had an average rollover of $1,314 (Figure 17). In contrast, 0% $960.8 impossible to q Consumer En uantify the gageme erront in rs that may re Health Csult from them. are Survey (CEHCS). In 2008, there were only 4.2 million accounts with $0 0.0 benefits, $0 cost management, worker and employer attitudes, policy reform proposals, and pension assets purchased directly from a carrier, or EBRI’s member purchased tship includes a hrough a government cross-section of exchange pension funds; businesses; trade associations were drawn randomly from the Ipsos ; Less Than 6 Months 6 Months to Less Than 1 1–2 Years 3–4 Years 5 or More Years average of $1, $0$0 423 (Figure 7). In comparison, individuals who had held an account for one to two years had an average (CDHPs Table ), cove of Contents red about20 2 $303.8 06 6 million 2007 people20 in 2 08 014, re 2009presen 20 ting 10 abou 20t 15 perc 11 20ent 12 of the privately 2013 2014 insured market individuals wh $0o contributed less than $1,000 had an average rollover of $961, while those who contributed at least $0 2006 2007 2008 2009 2010 2011 2012 2013 20 014 $5.7 billion in assets. Year and funding. There is wi labor un despread ions; health recog care prov nition iders and insur that if employee be ers; government org nefits data exist, EBRI kno anizations; and service firms. ws it. Les Les s T sh T an han $1 $1 ,000 ,000 $1, $0 1, 00 000 or o Mo r Mo rere $0 $0 sample for this base sample. This sam Less Thp an le $1was stratifi ,000 ed by gender, age, region, inco $1,000 m o e, an r Mored race. The response rate 2006 2007 2008 2009 2010 2011 2012 2013 2014 4 of $2,499. Those who had held an account for three to four Rollover years h Levelad an average of $3,225. And those who had held (Fronstin & Elmlinger, 2014). As the number of people with a CDHP grows, total assets associated with these plans can $1,0 The CEHCS undercounts the 00 had an averag< e rol 6 Month los vnumber of HSA er of $1, 6 Mon 44t4 hs to (Fi sLes and total HSA gur s Te 1 han 1 8).Annual Em asse ploy ts becaus er Contributon e the survey only examines H 5 or More 5 Ye or Mo arsS reAs among pe Years ople 1–2 Years 1–2 Y 3–4 Y ear ear ss 3–4 Years Introduction .......................................................................................................................................................... 4 Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2006–2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Sources: EBR Sources: EBR I/Commonw I/Commonw ealth Fund C ealth Fund C onsumerism onsumerism in Health in Health Care C Su are 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 was 36.3 percent (26 percent for the base sample or Year national sample, and 48 percent for the oversample). Because a Survey, 2008–2014. an account for at least five years had an average account balance of $3,092. be expected to grow Health C Health C as are Surv awell re Surv ey, 2008–2014. . ey, 2008–2014. with an HSA-eligible health pla ? The average account n balanc . Individu e was als $2, who have an HSA but not a 077 in 2014, up from $1, n HSA-eligib 356 in 2008. le he alth plan are not examined in the EBRI’s work advances knowledge and understanding of employee benefits and their EBRI delive Sources: EBR Sources: EBR a Sources: EBR r I/C s a stead I/C I/C ommonw ommonw ommonw ealth Fund C ealth Fund C ealth Fund C y stream of invaluable research and anal onsumerism onsumerism onsumerism in in in H H ealth H ealth ealth C C are C are are Surv Su Su rv ey rv ey ey , , 2007; 2006–2007; EBR , 2007; EBR EBR I/G I/G reenw reenw I/Greenw ald ald & Associates & Associates ald & Associates C C C onsumer onsumer ysis. onsumer Engagement Engagement Engagement i in in HH ea e n H lth C alth C ealth C are are are Sources: EBR Sources: EBR Sources: EBR a a I/C I/C I/C ommonw ommonw ommonw ealth Fund C ealth Fund C ealth Fund C onsumerism onsumerism onsumerism in in in H H H ealth ealth ealth C C C are are are Su Su Surv rv rv ey ey ey , 2007; , 2007; , 2007; EBR EBR EBR I/G I/G I/G reenw reenw reenw ald ald ald & Associates & Associates & Associates C C C onsumer onsumer onsumer Engagement Engagement Engagement in in in H H H ee ea aa lth C lth C lth C aa a re re re Health reimbursement arrangement. Health reimbursemen Health reimbursement t arrangement. arrangement. Enrollment in CDHPs .............................................................................................................................................. 4 non-probability sample was used, traditional survey margin of error estimates did not apply. However, had the survey Surv Surv ey ey , 2008–2014. , 2008–2014. Surv b ey Surv , 2008–2014. ey, 2008–2014. Surv Surv b ey ey , 2008–2014.. , 2008–2014. b Health savings account. Health sav Health sav ings account. ings account. importance to the nation’s economy among policymakers, the news media, and the public. It survey. EBRI publications include in-depth coverage of key issues and trends; summaries of research used a pro Employer a bability sampl nd Indivi e, thdual e margin o Contributions f error for t —Anh nual co e national sample ntribution amounts, would hav wheth e been ± er they 2.2came from percent. the employer CDHPs are no longer a new type odoes this b f health plan. H y conducting SAs have been and publishing policy re around now for a sear decade ch, analysis, and HR and As since 2 special reports on 001. ? An increasing number of individuals have held their account for three or more years. One-quarter (27 percent) About th Conclusio e 201n 4 EBRI /Greenwald & Associates Consumer Engagement in Health Care Survey ...................................... 5 What we do findings and policy developments; timely factsheets on hot topics; regular updates on legislative and employee benefits issues; holding educational briefings for EBRI members, congressional and 5 (in the case of both HRAs and HSAs), or from individuals (as they apply to HSAs only) had a strong impact on overall Hence, a growing percentage of the population has had either an HRA or HSA for a number of years. In 2008, 19 per- The term “ass had helets” is used loosely as it relates to HRAs. An HR d th regul eir account atory defor th velopment ree tos; four comp years, up rehensi from ve A is typically refere 19 pe nce rcent set up as a no resou in 2008. rces Th on tion irtee benefit pro al arrange n percen grams m t ha ent and exist d h an eld d their workforce s only Employers first started offering health reimbursement arrangements (HRAs) in 2001, and they were able to start Assets ................................................................................................................................................................... 7 federal agency staff, and the news media; and sponsoring public opinion surveys on employee The sample was divided into three groups: those with a consumer-driven health plan (CDHP), those with a high- account balances. Not surprisingly, the more money that was contributed to an account, the higher the average cent of the population issue w s; ith and an HRA or major survey HSA had he s of puld an blic at acco titudes. unt for three to four years, and 4 percent for five years or on paper. Employees may vie account five or more wy the HRA as if money was a ears, up from 4 percent inc tually 2008. being d eposited into an account, and they may carry a debit offering health plans with health savin benefit issues. gs accounts (HSAs EBRI’s Ed)uc ination and Re 2004. In 2014, searc 2 h F 7 und perce (EBRI-ERF) performs nt of employers with the char 10–4it99 able , deductible health plan (HDHP), and those with traditional health coverage. Individuals were assigned to the CDHP or Account Balances .............................................................................................................. EBRI meetings present and explore issues with thought leaders from all se .................................... 7 ctors. account balance. In 2014, for instance, accounts with an employer contribution had a higher average balance than more (Figure 1). By 2014, 27 percent educa ha tiona d held l, and an scientif accouic func nt forti three to ons of the Instit four years, an ute. EBRId 13 -ERFperc is a tax-ex ent for five years o empt organizatio r n card that can be used to pay for health care services at the point of service, but employers do not incur expenses associated workers and 48 percent of employers with 500 or more Figure 2 workers offered either an HRA- or HSA-eligible plan. As a result, Figure 14 Figure 12 Figure 16 Figure 18 Figure 6 Figure 4 Figure 8 Figure 10 HDHP group if they had a deductible of at least $1,250 for individual coverage or $2,500 for family coverage. To be EBRI regularly provides congressional testimony, and briefs policymakers, member organizations, ? Accounts with an employersupported b contributio y co n ha ntributions d a higher and g ave rants. rage balance than those without an employer those without an employer contribution. Accounts wit a h b an employer contribution had an average balance of $2,403, more. As the length of time individuals have these a plans inc b reases,a average accou b nt balances should increase as well. with the arrangement until an employee incurs a claim. Percentage of Adults Ages 21–64 With Private Rollovers ............................................................................................................................... Average HRA or HSA Rollover Amounts, 2006 ?2014 ................................ 7 Distribution of Rollov A A n vA n erage Rollov v uerage Rollov al Grow er HRA Amouth or HSA nts, Rate er er A Am m A in on o m Au HRA ccou o g Indiv nu tn s, by tn s, by or HSA t Balances, i duals Holding Presence Level Assets of 2007–2014 of these plans covered about 26 million peo AA verage A v perage A le in 2014, cco cco re un un pt rt es Balance, Balances, enting ab by ou by Presence t 1 5 Lev perce el nt of the privately insured market. and the media on employer benefits. assigned to the CDHP group, they must also have been eligible to contribute to an HSA, or had a health reimbursement a contribution. Accounts with an employer contribution had an average balance of $2,403, whereas those without whereas those without an employer co Health Insurance Cov ntribution had ane average red by ba a CDHP lance of , 2005–2014 $2,056 (Figure 8). AA cco and the Number nof Employ nEmploy u unt al Indiv for More Than One er Contribution, ier dual Contribution, Contribution, of Account Y 2007–2014 s, ear 2007–2014 2007–2014 , 2007–2014 2006–2014 of Annual Individual Contribution, 2007–2014 According to findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey EBRI issues press releases on newsworthy developments, and is among the most widely quoted Conclusion .................................................................................................................... 30 $2 % ,000 ...................................... 10 6 arrangement (HRA) with a rollover EBRI Issue Briefs provision that they c is a monthly ould ha periodi ve used to cal with pay in-depth for mevalu edical at expenses, or ha ion of employee benefi d tht is e abil suesity This Issue Brief presents findings from the 2014 EBRI/Greenwald & Associates Consumer Engagement in Health Care Individuals are an em 35 20 %%ployer also able to roll over funds fr contribution had an avera om one HSA into ge balance of another HSA without subjecting $2,056. the distribution to income and $2 $3 ,00 ,50 00 $2,000 400% $3,500 sources on employee benefits by all media. (CEHCS), there was $22.1 billion in HSAs and HRAs in 2014, spread across 10.6 million accounts. Overall account and trends, as well as critical analyses of employee benefit policies and proposals. EBRI Our 369% to take th When it came eir account to the level of with them shoul the employer d the y contributio have chan nge , in d jobs. In dividuals divi witduals wit h an employer h only contribution a flexible spen of less th ding accou an $1, nt 000 (FSA) Survey (CEHCS). This study is based on an online survey of 3,887 privately insured adults ages 21 -64. The survey was Refer penalty taxes a ences ............................................................................................................................... s long as the rollover does not exceed 60 days. Rollover contributions from Archer Medical Savings Acc ........................... 17 ounts 2007 2008 2009 2010 2011 2012 2013 2014 2007 2008 2009 2010 2011 2012 2013 2014 $1,800 EBRI CHECK OUT EBRI’S WEBSITE! directs members and other constituencies to the information they need an $3,196 d undertakes new Notes is a monthly periodical providing current information on a variety of employee benefit balances averaged $2,077 in 2014. $3,151 18% ? Individuals who had held an HRA or HSA for five years or more had $3,092 in their account. Those who had were not inclu $1,800ded in the CDHP group. 2007 2008 2009 2010 2011 2012 2013 2014 had an average accou $1,800 nt balance of $2 20 ,1 06 83 in 2 20070120 4, 08whil 20e 09 those 2010with 2011 an employ 2012 2013 er con 2014 tribution of at least $1,000 had an designed to provide nationally representati 2007 ve data 2008 re 20gard 09 ing t 2010 he 20 gro 11 w 20 th 12 of CDHPs 2013 20 14 and high-deductible health plans (MSAs) are also permitted. 350% research on an ongoi topics. ng EBRIef basis. is a weekly roundup of EBRI research and insights, as well as updates on 30% 2007 2008 2009 2010 2011 2012 2013 2014 16.6% 25% Endnotes publications ............................................................................................................................................................ 17 $3,000 $3,000 held an account for less than a year had less than $1,500 in their account. In general, average account average of $2, $1,60768 0 in their account surve (Figur ys, studi e 9). es, Similar litigation ly, in , leg diviiduals slation and r who contributed l egulation affect ess than ing emplo $1,000 yee benef had an it plans, while average (HDHPs) and the impact of these plans and consum Growth er e in Ac ngagement counts m Growth ore genera in Assets lly on the behavior and attitudes of EBRI maintains and analyzes the most comprehensive database of 401(k)-type programs in the 16% Over 7 million accounts rolled over money between 2013 and 2014, with $8.9 billion rolled over. The average amount $1,600 $1,600 Because the base sample (national sample) included only 294 individuals with a CDHP and 237 individuals w 14.7% ith an EBRI’s website is easy to use and packe EBRI’s Blog supplements our regular publications d with useful information! Look for , off 14.6% ering commentary on questions balances have grown over the longer term regardless of how long the account had been open. 300% world. Its computer simulation analyses on Social Security reform and retirement income adequacy account balance of $1,548, while those who contributed at least $1,000 had an average balance of $3,151 (Figure 10). adults with private health insurance coverage. rolled over was $1,244 in 2014. 25% $1,440 $1,444 $1,400 received from news reporters, policymakers, and others. The EBRI Databook on Employee HDHP, an oversample o 14% f individuals with a CDHP or HDHP was added. The oversample included 1,165 individuals with 13.3% are unique. $2,500 these special features: $2,500 $1,295 $2,403 20% Figures $1,400 $1,350 $1,400 Benefits is a statistical reference work on employee benefit programs and work force-related $1,244 $2,307 $1,308 ? Average rollover amounts increased from $1,165 in 2013 to $1,244 $1,206 in 2014. $1,206 a CDHP. It wil l be In impo 25addition 0%rtant to track to being stratified, th this trend over e base sample time. Currentlwa y, account s also wei bal ghted by ances are ge lo nde w rand a , age,r e e t ducati herefoore investe n, region, inc d in ome, The remainder of this report examines the findings from t $1,280 he 2014 CEHCS as they relate to $1,284 the level of assets held in $2,175 $2,165 $1,165 issues.$2,154 $1,200 12% Figure 1, Length of Time With HRA or $1,203 HSA, 2006–2014 ........................................................................................... 6 • EBRI’s entire library of research publications starts at $1,198 the main W $1,203 eb page. Click on $2,075 EBRI $2,056 20% $1,174 and r EBRI make ace/ethnicity to reflect s information freel the actual proportions in t y available to al he popul l. ation ages 21–64 with private health $1,170 insurance relatively safe vehicles such as money market funds (currently, investments are usually restricted to a money market HSAs and HRA $1,200s, account balances, and rollover amounts. Findings from this survey are compar $1,951 ed with findings from $1,200 $1,144 $1,915 $1,968 $2,000 $1,029 $1,890 $1,115 $1,915 $2,000 $1,000 ? $8.9 3 billion was rolled over in 2014, down from $9.4 billion in 2013. $1,075 Issue Briefs 200% EBRI assume and s EBRI Notes a public service re for our in-depth and sponsibility to make nonpartisan pe its findings co riodicals. mpletely accessi $1,069 ble at www.ebri.org $1,845 $1,775 coverage. fund until t 15 Th 10 h % e %e savings accou CDHP oversa nmple t reac $948 was hes a wei minimum t ghted by gen hreshold, der, age, such in as com $2, e, an 000 or d rac $3, e/et $1,754 000 hnicity. Mor ). As accoe unt information balances grow, th can be e the 2005 ?20 $1,00 07 0 EBRI/Comm $1,788 onwealth Fund Consumerism in Health Care Survey, and the 2008 ?2013 CEHCS. Contact EBRI Publications, (202) 659-0670; fax publication orders to (202) 775-6312. $1,015 $1,022 $1,741 Figure 2, Percentage of Adults Ages 21–64 With Private Health Insurance Covered by a CDHP, 2005–2014 ................. 6 $1,646 8.7% $1,689 $1,701 $979 — so that all deci $960 sions that relate to employee benefits, wheth $1,666 $958 er made in Congress or board rooms or $1,000 $948 $961 $1,569 $935 $1,000 Subscriptions to EBRI Issue Bri $1,548 8.2% efs are included as part of EBRI membership, or as part of a found in Fro 15%nstin & Elmlinger (2014). $920 potential to invest in more risky investment vehicles (such as mutual funds and stocks) will grow. The opportunities for $900 Orders/ ? Eleven percent of individuals had held an account for more than a year without a rollover in 2014. 15 8% 0% families’ homes, are based $873 on the highe $871 st quality, most dependable information. EBRI’s Web site posts • Visit EBRI’s blog. $1,500 7.3% $800 $199 annual subscription to EBRI Notes and EBRI Issue Briefs. Change of Address: EBRI, $1,500 capital appreciation will increase but so will the 6.7% opportunities for capita $1,370 l losses, even among individuals with high levels Figure 3, Total Assets and Number of Adults Ages 21–64 With an HRA or HSA, 2006–2014 ........................................ 8 147% $8all 00 research findings, publications, $1,209 and news alerts. EBRI also extends its education and public service 1100 13th St. NW, Suite 878, Washington, DC, 20005-4051, (202) 659-0670; fax number, $800 $750 $751 $1,178 10% While panel Internet surveys are nonran $1,125 dom, studies have demonstrated that such surveys, when carefully designed, Subscriptions $592 Enrollment in CDHPs $1,100 $675 of employer6% and individual contributions. ? Rollover amo 10% unts increase $675 d with the length of time an individual had held an account. In 2014, those who had role to improving Ameri (202) 775-6312 cans’ financial ; e-mail: knowle subs dge criptions@ebr through its a i.org w ardMe -win mbe ning rship Information: public service cam Inquiries paign 10$6 0% 00 • EBRI’s reliable health and retirement surveys are just a click away through the topic boxes at $924 obtain results comparable$903 wi® th random-digit-dial telephone surveys. Taylor (2003), for example, provided the results $1,000 $597 67% Figure 4, Annual Growth Rate in HRA or HSA Assets and the Number of Accounts, 2007–2014 ................................... 8 regarding EBRI membership and/or contributions to EBRI-ERF should be directed to EBRI Individuals $6 wit 00h a deductible of at least $1,250 for individual coverage or $2,500 for family coverage who also have an ChoosetoSave and the companion site www.choosetosave.org held an account one to two years rolled over an average of $982; those who had held an account three to four $1 $6 ,00 000 the top of the page. 4% 3.4% 45% from a num Rollovers ber of surv —Like contri eys th 3.1% at wer butio President Dallas e n co levels, an nducted at nual Salisbur the rollover amou sa yme time at the above usin nts had a address, ( g the same large impact on 202) 659-0670; questionnaires e-mail: average bo salisbur th via t accoun y@ebri.org et bala lephonces. n e an d $400 38% 50 % HRA, or were enrolled in an HSA-eligible health plan (regardless of whether the HSA was opened) were assigned to the years rolled over an average of $1,421; and those who had held an account five or more years rolled over an 26% 5% 5% 19% 54% Figure 5, Aver $400age HRA or HSA Account Balances, 2006–2014 14% ................................................................................... 9 online. He found that the use of demographic weighting alone was sufficient to bring almost all of the results from the Individuals with less than a $1,000 rollover had an average account balance of $1,452 (Figure 11). In comparison, $400 EBRI is sup $500 ported by organizations from all industries and sectors that appreciate the value of CDHP group in the CEHCS. 2% Everyone else with a deductible of at least $1,250 for individual coverage or $2,500 for • Need a number? Check out the EBRI Databook on Employee Benefits. 39% average of $1,428. Editorial Board: Dallas L. Salisbury, publisher; Stephen Blakely, editor. Any views expressed in this publication and those of the authors should 14% 3% $200 23% $500 -11% indivi online d survey uals wit 0%close to th h a rollover o e re f at l plies east $ from th 1,00 e 9% 0 paralle had al te n ave leph rage one survey. account balance He also of foun $4, d t 7h 92. at in some cases, propensity unbiased, reliable information on employee benefits. Visit www.ebri.org/about/join/ for more. not be ascribed to the officers, trustees, members, or other sponsors of the Employee Benefit Research Institute, the EBRI Education and family coverage was assigned to the HDHP group. Individuals with no deductible or a deductible below $1,250 for $200 Figure 6, Distribution of HRA 2007 or HSA 2008 Account Bala 2009 nces, 20 2007–2014 10 20 .............................................................. 11 2012 2013 2014 ............ 9 0% $2 0% 00 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, weig hting (meaning the propensity for a certain type of person to be online) reduced the remaining gaps, but in other • ? Accounts wit Instantly get e-m h an emaployer il noti c? ocations of the latest EB ntribution had a higher amRI data, ount rolled ov surveys, publications, and m er than those without an -11% emeetings ployer 0% individual cove $0rage an $0 d $2, Le 500 for ss Than $ fami 100 ly $100–$299 coverage were assign $300–$499 ed to $500–$999 the “tradit $1,000–$1,499 ional” covera $1,500–$1,999 ge cat$2 egory. More detail ,000 or More 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 $0 or interpretative rule, or as legal, accounting, actuarial, or other such professional advice. www.ebri.org -50% Nothing Less Than $200 $200–$499 $500–$999 $1,000–$1,499 $1,500–$1,999 $2,000–$2,999 $3,000 or More 2006 2007 2008 2009 2010 2011 2012 2013 2014 Less Than $1,000 $1,000 or More cases it did not reduce the remaining gaps. Perhaps the most striking difference in demographics between telephone $0 contributio and sem $0 in nars by clicking on the “Notify Me” or . Accounts with an employer contribution had an “RSS” buttons at the t average rollover of $op of our hom 1,280, whereas t eh page. ose without about the methodology is provided in Fronstin & Elmlinger (2014). Figure 7, Average Account Balances, by Length of Time With Rollover Am Account, ounts 2007–2014 .................................................. 11 $0 E Empl mploy oyer er Co Contr ntriib bu ute tes t s to o A Ac cc co ou un ntt E Empl mplo oy ye err Do Does es Not Not Cont Contrriibu bute to te to Ac Acc coun ountt Rollovers Annual Individual Contributon and online surveys was the under-representation of minorities in online samples. Less Than $1,000 $1,000 or More an emEBR ployer I Issu c e o Brief ntributio is register n ha ed in the U. d an avera S. Patent and T ge rollover of $1,069. rademark Office. I SSN: 0887 ?137X/90 0887 ?137X/90 $ .50+.50 Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Source: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2005–2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2006 ?2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Sources: EBRI/Commonwealth Fund Consumerism in Health Care Survey, 2006–2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care Survey, 2008–2014. Survey, 2008–2014. Employers have a tremendous amount of flexibility in designing health plans that incorporate an HRA. Leftover funds at As reported Surv iney Fronstin , 2008–2014. & Elmlinger (2014), this survey finds that 14.7 percent of the population was enrolled in a CDHP Figure 8, Aver Survage ey, 2008 Acco ?2014. unt Balance, by Presence of Employer Contribution, 2007–2014 ............................................ 11 Surv Sources: EBR ey a , 2008–2014. I/Commonwealth Fund Consumerism in Health Care Survey, 2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care a There’s lots more! a Sources: EBR Sources: EBR Health reimbursement I/C I/Commonw ommonwealth Fund C ealth Fund C arrangement. onsumerism onsumerism in in H Health ealth C Care are Su Surv rvey ey, 2007; , 2007; th EBR EBRI/G I/Greenw reenwald ald & Associates & Associates C Consumer onsumer Engagement Engagement in in H He ea alth C lth Ca are re aSources: EBR Health reimbusement I/Commonw arrangement. ealth Fund Consumerism in Health Care Survey, 2007; EBRI/Greenwald & Associates Consumer Engagement in Health Care CDHP = Consumer-driven health plan w/ deductible $1,250+ (individual), $2,500+ (family), with HRA, HSA, or HSA-eligible health plan in 2014. Health reimbursement arrangement. b 1100 13 Street NW · Suite 878 N Surv b ote: 2006 data w ey, 2008–2014. as capped at $1,500 or more. Health savings account. Surv Surv Health sav ey ey, 2008–2014. , 2008–2014. ings account. bSurvey, 2008–2014. the end of each year can be carried over to the following year (at the employer’s discretion). Employers can, however, in 2014, comH p ealth sav ared to ings account. 16.6 percent in 2013 (Figure 2). The difference between the 2013 and 2014 estimates is not © 2015, Employee Benefit Research Institute Washington, DC ?Education and Re 20005 search Fund. All rights reserved. Visit EBRI online today: www.ebri.org Figure 9, Average Account Balances, by Level of Annual Employer Contribution, 2007–2014 ..................................... 12 (202) 659-0670 www.ebri.org www.choosetosave.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org A monthl ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org ebri.org Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri Issue Bri y resea Issue Issue Issue Issue Issue Issue Issue Issue Issue rch report f e e e e e e efffffff • Januar • Januar • Januar • Januar • Januar • Januar • Januar Brief Brief Brief Brief Brief Brief Brief Brief Brief • • • • • • • • • r January January January January January January January January January om th y y y y y y y 20 20 20 20 20 20 2015 • No. 409 15 • No. 409 15 • No. 409 15 • No. 409 15 • No. 409 15 • No. 409 15 • No. 409 e EBRI Education and Re 2015 2015 2015 2015 2015 2015 2015 2015 2015 • • • • • • • • • No. No. No. No. No. No. No. No. No. 409 409 409 409 409 409 409 409 409 search Fund © 2 014 Em ployee Benefit Research Institute 16 12 14 13 11 15 9 6 8 10 17 3 2 5 7 4 Assets ($millions) Assets (millions) 23% 10% 15% 9% 16% 6% 10% 7% 13% $701 7% 13% $581 5% 11% 5% 10% $842 11% 7% $694 $740 7% 9% 10% $849 12% 9% 14% $1,965 10% 16% 11% $796 13% 8% 8% 10% $4,504.6 7% 10% $1,726.0 7% 10% $898 10% 12% 8% $886 11% 8% 12% $875 7% $5,697.2 12% 9% $962 $2,480.5 10% 8% $1,081 6% 12% 7% 11% $967 7% 11% $1,607 $1,423 9% 15% $6,522.4 6% 15% $3,919.5 8% 12% 8% 12% 5% 13% 6% $1,358 12% 6% 7% 12% $1,332 6% 11% $7,408.8 $1,356 $1,213 $3,787.5 $1,324 9% 12% 14% $1,527 10% 9% 28% 10% $1,528 14% 9% 11% $2,090 $1,214 8% 8% 10% 10% $12,376.8 $2,499 8% 15% $6,722.8 $1,198 8% 11% 10% 6% $1,631 11% 7% 11% 8% $1,727 10% $17,947.0 5% 14% $2,028 $9,828.5 7% 10% 8% $1,822 13% 27% 8% 11% $2,010 6% 10% $1,896 24% $2,703 13% 10% $24,834.1 5% 8% $3,225 $9,379.1 7% 9% 6% 11% 3% 9% 9% 9% 7% 6% 7% $1,667 $1,357 7% 9% $2,109 $22,102.6 $8,862.3 $2,563 0% 16% 18% $2,231 18% 20% 20% $1,968 31% 18% 21% $2,320 22% 25% 23% $3,491 25% 28% 23% $3,092 28% 27%