Employer and Worker Contributions to Account-Based Health Plans, 2006-2010

This paper presents findings from the 2010 EBRI/MGA Consumer Engagement in Health Care Survey, as well as earlier surveys, examining the availability of health reimbursement arrangement (HRA) and health savings account (HSA)-eligible plans (consumer-driven health plans, or CDHPs). It also looks at employer and individual contribution behavior. According to the 2010 EBRI/MGA Consumer Engagement in Health Care Survey, about 5.7 million adults ages 21-64 with private health insurance, or 5 percent of the adult population with private health insurance, were enrolled in an HRA or had a high-deductible plan with an HSA in 2010, up from 4 percent in 2009. An additional 6.3 million adults ages 21-64 with private health insurance, or 4.5 percent, reported that they were eligible for an HSA but did not have such an account. Thus, overall, 12.1 million adults ages 21-64 with private insurance, representing 9.5 percent of that market, were either in a CDHP or a high-deductible plan that was eligible for an HSA, but had not opened an account. Among workers with an employer contribution, those with employee-only coverage saw their annual employer contributions increase between 2006 and 2008, but fall in 2009 and 2010. Between 2006 and 2008, the percentage reporting that their employer contributed $1,000 or more to the account increased from 26 percent to 37 percent. It fell to 32 percent in 2009 and to 28 percent in 2010. The percentage of workers with an employer contribution of $200-$499 increased from 14 percent to 17 percent between 2009 and 2010, although the increase was not statistically significant. Among workers with family coverage, employer contribution levels decreased as well in 2010. The percentage reporting a contribution of $500-$749 increased from 6 percent to 12 percent between 2009 and 2010, while the percentage reporting a contribution of $1,000 or more decreased from 73 percent to 61 percent. However, a majority of workers with family coverage continued to receive a contribution of $1,000 or more. Individuals’ contributions to HSA plans have increased. Between 2006 and 2009, the percentage of individuals with employee-only coverage contributing nothing to an HSA decreased from 28 percent to 12 percent. It increased to 15 percent in 2010 but the change was not statistically significant. In contrast, the percentage contributing between $1,000 and $1,499 increased from 12 percent in 2009 to 18 percent in 2010, while the percentage contributing $1,500 or more remained at 37 percent. Among persons with family coverage, the percentage not making any contributions was unchanged at 12 percent in 2010. The percentage contributing less than $500 was 8 percent, while the percentage contributing $1,500 or more was 50 percent. Individuals with family coverage are expected to contribute more than individuals with employee-only coverage because deductibles are higher for family coverage. The PDF for the above title, published in the March 2011 issue of EBRI Notes, also contains the fulltext of another March 2011 EBRI Notes article abstracted on SSRN: “The Impact of Modifying the Exclusion of Employee Contributions for Retirement Savings Plans From Taxable Income: Results from the 2011 Retirement Confidence Survey.”