Median of Dollar Change in Participant 401(k) Contributions in First Year of HSA Percentage of 401(k) Participants Who Reduced Contributions in the First Year They Percentage of 401(k) Participants Who Reduced Contributions in the First Year They Distribution of Dollar Change in Participant 401(k) Contributions in First Year of HSA The Research You Want, in the Format You Need Speakers Study Evidenc Summary of Finding Credit C Deb Asset All Spen Low Share Resea Cop Review of Comb Withdrawals Upd Low Profile Share Con Loo Cop Resea Modking ts ayments ates ayments tri - - el Overvi Value Health Value Health ding ined bution rch rch Overview of 4 With / Cha Assets e ard to th to EBRI’s HSA ocation of Leakag Rou Overview 01(k) vs Profiles Mod Balance racteri Deb Deb sew vs C vs C e Futu nd el Results tt-Up: stics oinsu oinsu . Care Services (cont.) Care Services s IRA re es Sho Mike’s rance rance Holding Datab w Highe Take (cont.) ase s r Growth Upcoming Events Contributions, by HSA Contributions Health Retireme Care Researc nt and Financia h l Wellbeing Research Made HSA Contributions, by Participant 401(k) Contribution Rate in Year Before Study Made HSA Overview Contributions, by Participant Annual Income Contributions Q&A Q&A Socio-Economic Characteristics of Four Spending Profiles Retirement and Financial Wellbeing Share of Each Spending Profile Retirement and Financial Wellbeing 80% • • • • • • • • • • Famili 401(k) plans IRA equity allo Conve Discr While When indi The percentage The proportio Although househol etionar es bala rsely, with head nces vidua y the percentage represe Spender cations n grow of hou ls of Tradi s own both ds 65 nt steadil peaked s sehol with the or olde had t tional y of ds he r $2,000 80% Median Among P P Credit R IRA R IRA erce erce atio of atio of Own Asset nta nta Card Individuals T A the A er g g otal Debt e of e of v Alloc s erage Debt in Taking v F IRAs ation, erage amilies Combine -to Older Househ With Both a a Withdraw T 401 hat R -b Asset R With y Age in 201 (k) ecei d* Ac Plan, Debt atio ved a cou 401 l, olds a IRA, b nt 7 (k) y Con Age in 20 Balance Plan and an and tribution, Both Balances s to A 17 b v y Age in 201 IRA erage , the Majori to T 401(k) heir Initial Y 7 Plan ty of Balance Assets ear Were Average Percentage 75% Household Expenditure Distribution by Category in 2016 Dollars Issue Briefs Fast Facts Infographics/Interactives • Overall, 56 percent of • • • • • • • • • • This study uses data This paper examined Advocates EBRI’s simula Rai In 2019, EBRI’s HSA EBRI conducted We find that Interviewee EBRI built a simula sing heal of HD s th coinsu view tion plan intervi HPs ed model tion rance from the EBRI/ICI Participan deductib their firm’s hea Database the differential eff argue ews with model suggested t reduce that higher levels les to analyze t is an increa grew over two dozen benefits s the usage lth hat the by more benefits ects of copaymen he impa singl of cost than 700,000 t as an important ty -Dir ct of popul ected -shari a Medicare buy ar executives representing ts way to control Retirem ng (a set f o total 10.5 millio encour recrui ee for a speci ent age ting Plan Da -in policy heal patients and ret th n ta care cost HSAs, and tot ali on Col ention t a wide to seek out st empl lection visit, for oyers ool range Project al • 401(k) AUM Projected Through Year-End 2030 by Plan Size and Employee Demographics as a Function of By Age Group Tuesday, February 16 — Workplace Wellness: Firm Size Matters webinar Two’s a C • Patients who rowd: Do HSA Cont had ribution met t s Crowd heir out 401(k) HSA contributions led to lower 401(k) contributions, particularly among those greatest portion of high experi Tradition by ages for t 401(k) plans heads ages with head IRAs receivin hose wi est enced total income across all 45 al s – IRA ow th only 54. ages 75 or a signi 55 and IRAs, g Equitie – a contributio 64 the ners 401(k) plan ficantly are the s, taking a older n • Employee Attitudes Toward the Fut F F By Held or am Ag ure of Workplace T ili ho e in es With se Gr 401 ou Ha p ving (k) Head Plans Eithe s Ag r es 55 Account and - o Increased Sponsore r Older Each Yea r Ov an d er Tim d Heal Both e Account th Benefits Types at Some Point $1,143 Reducing Recently Released • The median dollar change in Alternative Financial Market Assumptions • Higher HSA 401(k) contribution participants s were Contributio and EB exampl high of inpatient of f inflatio assets contained worker ns?irm er RI’s HSA Database t -n s sizes and industries. value e) and encourage who wo and coinsurance and speciali heal uld th withi benefit from a Medicare care n st these accounts patients office visits more o examine (a percentage to shop the impact of initial health grew with aroun of the total bill alr by $5.3 eady d for bett high bil 401 er value and lio that insurance (k) n con to total $28.1 tribu saving tionforgo unnece rat s es. picks up) account billion (HSA) contribu ssary care tions 70% • We identified four deductible increased their • • A Near Med lyic al are l rebu plie yd -in tha cot ul the d be y di ap d no pet aling see the to tho ir fir se ms who ha severing ve lo the w ex linpe k bet nditures, ween emp sinclo e yment Medicare and do he es al th nobe t fea nefits ture an out-of- 68% $1,000 64% Contributions: 56% greater increase in t withdra bala combi age groups. incl most likel bala havin did not udin nces nces ned g wal g credi differ dramatical the equity or both account account bala y are larg incre to have t card debt ased er portion heir debt, t than when with age. nces debt ly 70 types hose by % of of - More than $4,350 ($315) • The Current State of Public Defined Cont 63% ribution Plans: Findings from the Public Retirement Research $525 Lab partici • EBRI’s most in pant 401(k) -depth expert • Provides high-level • Conveys EBRI research and • Who Those Is Mos with the t Vulnerable to the Ticking Debt Time Bomb in Debt in retirement has been increasing steadily over the last 30 years in both Zahra Ebrahimi, Jake Spiegel, associa on employee buy than ted -with lower 401(k) in do policy copayment 401(k) tended contributions. s. to be healthier, lower- reduced their mutuall poy ck exclusi et limit like ve employer-sponsored plans do • consumptio The Impact n of Med of low-icare value Buy heal -in on E th mployers • Two’s a Crowd: Do HSA Contributions Crowd out 401(k) Contributions? • In total, our interviewees employed over 500,000 workers and accounted for more than $3 billion in health benefits $187 • • • • Patients may better understand How But what happens EBRI conducts yearly ever, after meeting once patien long their dedu itudin ts al their li have already hit ctible, and cross abil patients wil ities -sectional with copayme their dedu l be anal theoretical yses ctible? nts rela of the HSA Database ly In theory, this should tive less sensitive to coinsuran to pri ce, and so ces, make throughou to The percentage indi bala with head they just have reached age. Younger -asset ratios than vidua nced ls, funds, peaked its highest t s the period, t and 75 Roth IRA or olde a 401(k) pla incre of Ro famili level s ase th r hose IRA for es as a ince n. Retirement percent of population with wealth, amount, and as a ratio to personal wealth. • Disparit • Howev ies er in , when Retire as me kent d if the Incom ir co e mpe Ade tito qu rs acy took by tha Race t stepan , mos d Et t in hn ter icity: C viewees urren respt Statu onded tha s an t the d the y woul Pote d co nti ns al ider Imp it act 60% $20 analyses of employee benefit Research Asso takeaways of ciate, EBRI research -$34 Rese analysis archin visually intuitive, Associate, contributions in the first year highest 401(k contributio spendi ns. ng ) workers contributions in the first • Home Spenders t spendi sp ng ending profiles ended by to have 55% -$199 care services relative to patients • Copayments reduce the usage of primary care $0 • However, a Medicare bu60 y-% in could be appealing to those who have high expenditures, since Medicare features lower • Data from 45,132 them less sensitive since t patients hey are no lon with copayme empl to prices ger oyees, nts payin may use heal 19 g and old full freight er, th care with both services di a 401(k) and an HSA are fferently examined. Having owne accounts switchi portion with head Both 1992 in 2019. experi The youngest owne of a 401 rs Vario rs ng enced of t with a withdr were (k) owne s between us he whol ages 55 Plan Le the steepest material d gisla The median and oldest have an by those ages d e account tive, an –over time. awal 64 IRA: ly Regu since more How Muc latory, and Plan h Does Design Utilizatio Mo n of dif bo icatio th 40ns 1(k) and IRA accounts indicate higher balances, however EBRI • What Happens after the Deductibl EBRI e? issues and trends, including in a condensed -$558 format. graphical formats. that t • hey made HSA Who Is Most Vulnerab le to the Ticking Debt Time Bomb in Retirement: Families With the Oldest, Wednesday, February 24 — COVID-19, Telemedicine, and More: Findings 50% 55% 49% contributi • This year, key f on rate in indings included: the lowest anal year yzing that they made office averag the estimated visits. e weal th. • who Interviewee had not s met t wereheir optimi deductibl stic about the role t e elemedicine could play in the future reimbursement rates for health care relative to employer-sponsored plans This Change the Retirement Asset Picture? constant switching between the two lessens overall outcomes. 50% 52% • 2021 Retirement Confidence Survey • Since at least some workers move to the This is presuma 1992. types (orange line) begin incre 25 like the highest incre amoun –44. ly ased ase to contribute Those allo t of this debt negl in debt ratios of combined igi bly bly preval cations drive to their as account also ence n to see then by • We asked each interviewee about their outlook on health benefits, such as severing the link data updates; emerging contributions Black/African A was a reduction merican, and Hispanic Family Heads • At the median, 401(k) • • • 401(k) participan EBRI examined The Center for R ts six different esearch who: on Heal “low-th value Benefits Innovation ” health care service (CRs, such HBI) produced as conducting two papers imaging for total spending and Year 1 HSA OLDER AMERICANS wercontributi e most ons. ' SPENDING PROFILES: EBRI from IRA Data the 202 base: IRA 0 Bala Consum nces, Contriber ut-$1,000 ions Engag , ement Younger in Health populations used Care Roth IRAs Survey webina more heavily while oldr er populations take • HSA Database (Cross-Sectional, Longitudinal) • Who is Building up Assets 50in % Individu • al Become quickly Account Retireme informed nt Plans an on d The •ir Impo PowerPoi rtance nt in Fam presen ilies’ tations Net of 47% • • Othe Averag r ty e pe ba s la of nc ca es rein , su creased ch as ph buys t re icmained al therapy rela an tiv d ely modest at $3,055 $2,001 to $4,350 buy-in, this has the effect of lowering ($161) decli owne reduced the higher likel to 401(k) Roth IRA than were since 2007. reached ned rs aged. balances. through ages its peak -only balances. The sharp ihooin 2019. d This is of olde 65– r IRAs likel 70. y between employment and health benefits, the future of telemedicine, and the role of government • Discretionary Spenders were • Interviewees were split on the role of government in health care, but were curious about the designs, practices, and of $34. -$1,645 contributions fell $315 among Rollovers, Withdrawals, and Asset Allocation, 2017 Update greater IRA withdrawals. exami lower-ning back this issue pain and uncomplicated headaches (within 6 weeks of their diagnosis) spending allocations for 40% • Strategies Worth? Is Thi that nudg s Different e patients to for Families With Minority Heads? An Analysis of the 2019 Survey of Consumer emergency room visits, were not sensitive to the likely WHO IS MOST VULNERABLE TO to reduce THE TICKING benefits topics. these visuals are also • Having Both a 401(k) Plan and an IRA: How Much Does This Change the Retirement Asset o Could be followed over a two-year study period. employers’ spending on health care incre due t contributio of older Roth IRA owners. ase o cein t ssations in indi ns, he 71 vidua high-er ls orlike -olde ly r age in healthcare most likely to report being in a possibility of a Medicare buy-in program produ • cts; Few ac and employee countholders (7%) invest some portion of their balances in assets other than cash Olde HSA r Americ participa ans' Spen nts di contributin ng Profiles: One g Size Does Not Fit Spending patterns in retirement evolve over time and are influenced by factors type of cost sharing indi Fin vidua ances l categories. We -$2,000 seek out higher-value health care ONE SIZE 40% DOES NOT FIT ALL HAVING B EBRI IRA DATABAS OTH A 401(K) E: IRA BALANCES PLAN AND AN IRA , : EMPLOYEE ATTITUDES TOWARD THE Picture? available to make it easier for 401(k) contributions • One that examines the extent to which patients use more low-value health care services after meeting their deductible contributio contributio group represent is consistent ns n 401(k) lim and/or its to plan with the 401(k) coupled household rather than All such as education, marriage status and wealth. benefit o Made poli thecies and ir first HSA contribution 30in % the second year of the two-year study period (see appendix). more than $4,350. • Spending Profiles; Findings from EBRI Survey • However, this could have the effect of raising also observed how • Accountholders who had the benefit of receiving an employer contribution tended to have higher balances and more post-deductible may be necessary TWO’S A CROWD: DO HSA CONTRIBUTIONS DEBT TIME BOMB IN RETIREMENT: FAMILIES THE IMPACT OF MEDICARE BUY you to share -IN ON with colleagues • Lower- and higher- in Year 2. • Since coinsurance reduces the usage of withdra plan RMD rollovers. s * than to I rule wals. s that indicate RAs, and Health Care a single household. • EBRI was able to fund the development of this research thanks to a generous grant from the RRF Foundation proposals. • One that examines the extent to which copayments affect the use of health care relative to coinsurance • But ranged from a large • The Im frequent pact ly of in the vest Pan ed, su de gg mic o esting n Old that er American employers can s play a key role in fostering employer engagement with HSAs • EBRI IRA Database: IRA Balances, Contributions, Rollovers, Withdrawals, and Asset Allocation, Thursday, March 11 — Stud -$3,000ent Loan Debt: Who Has It, What Is Its Impact, premiums for workers who 30% remain on the spending profiles CONTRIBUTIONS, ROLLOVERS, WITHDRAWALS, $1,001 to $2,000 • ChanFUTURE OF ge HOW MUCH DOES THIS CHANGE THE in employee 401(k) contri HSA DATABASE WORKP butions: LACE ($39) -SPONSORED WHAT HAPPENS AFTER THE DEDUC and clients. TIBLE? income workers are 20% Employee specia Attitudes list Towar office visits, employers seeking d the Future of Workplace- Employ to ers are thinking strategically about the future of healthcare benefits given leaka company matching ge from the system. for Aging. reduction of $5,127 to a large • Among HSA 2017 Update participants employer-sponsored plan changed as individuals • Home Spenders were • Accountholders withalso the longer tenure – people who have Mo ha de d rato their r: HSA Mics hae for l a Sowa, while – tended to have higher balances, CROWD OUT 401(K) CONTRIBUTIONS? WITH THE OLDEST, BLACK/AFRICAN Spon •and sored Summari What Are Health Bene es are incl fits Employe uded for rs Doing EMPLOYERS to the Help? focus among employees and recruits. most likely rein in high to reduce users of high-cost health care contributions. Health Care o Defined as Year 2 employee 401(k) contribution minus Year 1 employee 401(k) contribution adjusted for salary growth. • Thanks to the RSRC members whose comments/suggestions helped improve and clarify the findings of this increases of $1,143. -$4,000 contributing $1,000 or less, 20% higher contributio Retir ns, and inement a vested more frequ nd Financial Wellbeing ently, suggesting that there is a familiarity effect aged. Solutions Strategist - 10% Medicare buy-in’s benefits healthier low-spend participants. Overall employer least likely to hold a college AND ASSET ALLOCATION, RETIREMENT ASSET PICTURE? HEALTH BENEFITS 2017 UPDATE those needing a quick • Older Americans' Spending Profiles: One Size Does Not Fit All services may want to consider moving from • 401(k) Trends in contributi health insuran ons in ce plan design The Impact of Medicare Buy-in on Employers research: American Funds/Capital Group, Ameriprise Financial, BlackRock, Empower Retirement, J.P. median 401(k) contributions fell costs Defi declne ine, d Co howev ntrib er av utio erag n, e spends increase due to the resulting population. • Rate of crowding out between employee 401(k) contributions and employee HSA contributions: degree. AMERICAN, AND HISPANIC FAMILY HEADS overview. -$5,127 • Cost differentials by site of treatment copayments to coinsurance the first year that they Health Car Resear e Resea Wrap ch Round -Up rch Round -Up -Up Morgan, Mercer, Principal Financial Group, Prudential, Retirement Clearinghouse, SS&C Technologies, -$5,000 10% 0% LGIMA, Moderator Participants spend more on low-value items but don’t increase high-value only $8. ($8) $1,000 or Less What Happens after the Deductible? • Consumer Engagement in Health Care Survey and Workplace Wellness Survey Research Round-Up $25,000 or less $25,001 to $50,001 to $75,000 to $100,001 to $150,001 or more o Defined as the change in employee 401(k) contributions between Year 1 and Year 2 divided by the amount of employee HSA made HSA spends while coinsurance users utilize less specialty medical services. Transamerica Retirement Services, and Wells Fargo. Zah Jake Spi ra Ebrah egel, imi , EBRI EBRI Research Research Ass Ass ociat ociat ee Save the Date: Spring Virtual Policy Forum May 10, 11, and 13 $50,000 $75,000 $100,000 $150,000 • Telemedicine study contributions in Year 2. Despite the growing use of HSAs, a fraction of the population leverages the long -$6,000 contributions. 0% HSA Database • Introducing the FSA Database 10th 20th 30th 40th Median 60th 70th 80th 90th Note: All dollar amounts are in 2016 dollars. Based on data from the Health and Retirement Study and the Consumption and Activities 4% or less EBRI term be Web nef4.01% to its ina of the r 6 % platform. 6.01% to 10% 10.01% or more Mail Survey. * * R 410 MD = (k) r pl equ an ire and d minimum IRA balance distr s ib hel ution d each . year. 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