Special Report - Health Savings Accounts - Convincing Employees to Accept An HSA Or HDHP Combination

When it comes to dollar amounts having anything toDon't call it a High Deductible plan! Perhaps something
do with spending, Americans firmly believe that lowerlike "Maximum Benefit Tax Advantaged Health Plan".
is better, higher is worse. In the year and a half sinceMBTAHP doesn't exactly roll off the tongue though. If
the new IRS acronym HSA emerged on the scene,you have a creative writer around, you may be able to
many American businesses are finding difficulty dealingwork on some new words that communicate value
with employees that have that common belief.and savings rather than high deductible payments.
To refresh your memory, Health Savings AccountsElect, as many companies have, to take the middle of
(and the tax deductions and tax free reimbursementsthe road option that insurance companies, if pressed,
that go with them) require as a prerequisite a "Highwill provide-a dual coverage plan. The employee has
Deductible Health Plan". Notice that a HDHP starts withthe option of picking the HDHP or the traditional lower
"High" and you might have an insight into the problemdeductible plan all within one overall plan with the
businesses are facing.insurance company. Plans with as few as 4 or so
Not surprisingly, a HDHP is one that includes a highemployees can adopt this option. Naturally, the
deductible which means that you have to spend aemployees taking the higher cost plan have to pay all
higher amount before you get any reimbursement oror a portion of the higher cost or no one will choose
insurance benefits. The IRS provides individualsthe HDHP. You may want to give the employee a
covered by a HDHP the opportunity to make taxcash incentive to join the plan and an opportunity to
deductible contributions to their HSA and take fundselect the lower cost plan.
out of their HSA to reimburse health care expensesGive the employee an incentive to contribute to the
tax free. Unlike most tax deferred plans such as IRAsHSA by making company contributions to the
and retirement plans, the HSA provides both aemployee's individual plan. Any employer contribution
deduction going in and tax free distributions when youshould be accompanied by an education program to
take it out.help them take the best advantage of the HSA.
Many individuals, a significant number of whom wereAnother less financially attractive option is to offer
previously uninsured, have purchased the HDHP typeemployees the option of electing the HDHP but include
of insurance coverage. They have found that having aa side plan, called a Health Reimbursement
higher deductible means the insurance company is lessArrangement, or HRA, which will provide company
likely to have to make payments on the policy andreimbursement of a portion of the deductible. The HSA
thus the cost is often lower. In many cases, the cost ismust come into effect after the HDHP plan deductible
significantly lower. As we know, lower is good. Whenis met or it might modify or eliminate the ability to
rolled in with the tax advantages of the HSA, thecontribute to the HSA. It could ease some employee
individual often finds that the plan pays for itself over aworries regarding the potential cost of the new plan,
few short years. The amount in the HSA can beparticularly during the first years of the plan.
invested for long term growth providing a medical costNone of these options are guaranteed to win over the
nest egg for retirement years when income is limited.employees to the long term advantages of the HSA.
The HDHP may be great for a person who has toGiven recent rises in health insurance costs, employers
write a check monthly for health insurance; howeverare finding it ever more difficult to provide the
the story is a little different when a company proposescoverage they have in the past. The HSA/HDHP
a new HDHP. The individual employee hears the highercombination gives the employee an incentive to be
but doesn't see or particularly care about the lowercareful about health care spending plus a powerful
premium cost. The majority of that premium savingslong term tax free growth investment account that
does not directly benefit the employee's pocket.can help them pay expenses now and in retirement.
The employer's reading along right now will be thinkingWisely invested, the HSA can grow significantly to
that the employee should realize that the savings doprovide retired individuals valuable help with medical
impact the employer's ability to pay the employeeexpenses on a tax free basis in the future.
anything and even stay in business. Even though theyHSA investments are governed by the same rules as
should and probably do, realize it is hard to expectIRAs, including the ability to be self directed into
them to give up something for what appears, in thenontraditional investments such as real estate. Your
short term at least, as nothing much.Entrust office will be able to help you understand the
What approach should an employer take wheninvestment options with a self directed HSA.
offering a HDHP/HSA plan to reluctant employees?