Not Every HSA is Alike, Part 2

In my last blog entry, I reminded you of the advantages of an HSA-high deductible health care plan that does not include preventive care in the deductible. If preventive care is not included in the deductible, then the employee does not have to pay anything additional (other than a co-pay) for annual exams, pap smears and other preventive care.

Here are some other variations in HSA plans that can make all the difference to the people in the plan:

• The plan should allow the employer to make contributions to the HSA. Employers can facilitate employees opening HSAs by either giving them a one-time or regular contribution. The regulations governing HSAs enable anyone to contribute, but when employers make a contribution, a greater percent of employees are likely to open an account.
• The plan should have those features employers want now. While some employers are interested in bare bones plans that may only pay for long-term hospitalization, we have found that among employers of all sizes, the current widespread attitude towards health care benefits is to provide certain core components of basic health care:
  - Emergency care
  - Preventive care
  - Prescription drugs
  - Long-term hospitalization
• There should be online capabilities to manage HSA expenses. Many people are reluctant to try an HSA because of the increase in paperwork that’s required to figure out when the deductible limit has been reached. Being able to access all these records on-line 24/7 makes it much easier for employees to manage their health care costs.
• The plan should include some access to wellness programs. Because HSA plans tend to make consumers more aware of costs, they also tend to influence consumers to take actions to maintain or improve their health. For example, a 2008 survey of its members by the Blue Cross and Blue Shield Association found that people with HSA plans are one-third to one-half more likely to use health screening, exercise and health coaching services, compared to traditional health plans that also offer these preventive and wellness services for free.
• The insurance should include extensive training and support.

Employers and individuals cannot assume that all plans are alike. For the near future at least, carriers will continue to introduce innovative features to the HSA plans they offer.