On the 10th anniversary of their creation, a unique new database from the nonpartisan Employee Benefit Research Institute (EBRI) offers insights into how Americans are using increasingly common health savings accounts (HSAs).
- The EBRI HSA Database contains data collected from various HSA providers on 1.5 million accounts with total assets of $2.7 billion as of December 31, 2013. This Issue Brief is the first annual report drawing on cross-sectional data from the EBRI HSA Database. It examines account balances, individual and employer contributions, annual distributions, deductibles and type of coverage when the HSA was opened, and account- owner demographics for 2013.
- This year marks the 10th anniversary of the creation of health savings accounts (HSAs) under the Medicare Prescription Drug, Improvement, and Modernization Act of 2003.
- Starting from scratch a decade ago, enrollment in HSA-eligible health plans is estimated to range from 15.5 mil-lion to 20.4 million policyholders and their dependents, and it has also been estimated that there are 10.7 mil-lion accounts holding $19.3 billion in assets as of Dec. 31, 2013. Seventy percent of HSAs were opened since 2011.
- The average HSA balance at the end of 2013 was $1,766, up from $1,280 at the beginning of the year. Average account balances increased with the age of the owner of the account. Account balances averaged $697 for owners under age 25 and $4,460 for owners ages 65 and older.
- HSAs with either individual or employer contributions accounted for 69 percent of all accounts and 87 percent of the assets. Six percent of these accounts ended the year with a zero balance.
- On average, individuals who made contributions deposited $2,032 to their account. HSAs receiving employer contributions received $1,184, on average.
- Four-fifths of HSAs with a contribution also had a distribution for a health care claim during 2013.
- Among HSAs with claims, the average amount distributed for health care claims was $1,953.
- Distributions for health care claims increased with age, with the exception of those ages 65 and older. Average annual distributions were $667 for account owners under age 25; $2,335 for account owners ages 55–64; and $2,017 for account owners ages 65 and older. Average annual distributions were higher for accounts that were older. However, the likelihood of taking a distribution for health care claims was higher among accounts opened more recently.
- HSAs are likely to keep growing: It is expected that 30 percent of larger employers will offer an HSA-eligible health plan or HRA as the only plan option by 2015.