Table of Contents
Scope and Themes
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- What you need to know
- Overview
- Abbreviations and terms
- Abbreviations
- Terms
Executive Summary
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- Industry snapshot
- HSAs and the healthcare system
- Employers and HSAs
- The current marketplace
- HSAs as “healthcare IRAs”
- HSAs and insurance providers
- HSAs and other distribution channels
- HSAs and the future
Background
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- How the HSA works
- Consumer-driven health plans
- Retiree Medical Accounts
- Medicare Medical Savings Accounts
- Voluntary Employee Benefit Associations (VEBAs)
- Health Reimbursement Arrangements (HRAs)
- Flexible Spending Accounts (FSAs)
Market Drivers
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- Rising cost of health care
- Employer health care coverage declining
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- Figure 1: Growth rate of private companies vs. healthcare spending by private companies, 1998–2003
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- Figure 2: Share of firms offering health benefits, by number of employees, 1999-2006
- Consumer views and concerns over healthcare
- Overall healthcare
- Health care management
- Views on HSAs
- Application and use of health care questionnaires
- Concerns over paying for healthcare
- Planning for long-term healthcare
- Consumer-directed health care requires a cultural shift
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- Figure 3: Preferred health plan options, employees vs. employers, 2002
- HSAs still struggling to catch on
- HSAs more cost effective for employers
- Legislative issues—HSA support divided along party lines
- Highlights of the Tax Relief and Health Care Act of 2006
- Retirees facing challenge of paying for health care costs
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- Figure 4: Health care costs for retiree baby boomers—projected consumption in 2014
- Planning for and selling health care expenses in retirement
- Need for health care solutions for small businesses
- Consumers uninformed about HSA investments
- HSAs are a savings opportunity for consumers who aren’t likely to save
- Lack of information for consumers
- The impact of the Internet
Market Size and Segmentation
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- Figure 5: Projected growth of CDHPs, 2005-10
- Employers offering HSAs
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- Figure 6: Firms offering health benefits—percentage offering HDHP/HRA or HSA, 2005 and 2006
- Enrollment by age
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- Figure 7: Age of HSA eligible enrollees, by market segment, 2006
- HSA balances
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- Figure 8: Deposit data for HSA accounts, 2006
- Figure 9: Total HSA deposits, transactions and new accounts per month, by provider, 2006
- Individual, small and large group HSAs
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- Figure 10: Market characteristics of HSA-qualified HDHPs, by number of covered lives, September 2004 – January 2006
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- Figure 11: Health plans available to small groups (50 or fewer workers), 2006
- Figure 12: Health care options offered by small groups, by number of employees, 2006
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- Figure 13: Percentage of firms that offer employees a high-deductible health plan, by firm size, 2003-05
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Competitive Landscape
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- The bank channel
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- Figure 14: Primary source of financial information among individuals, 2006
- Top HSA providers
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- Figure 15: Percentage of HSA accounts by type of company, 2006
- Figure 16: Top 10 HSA providers by number of HSA accounts, 4th quarter 2005
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- Figure 17: Top 10 HSAs by total HSA deposits, as of 4th quarter 2005
- HSA administrators and fees
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- Figure 18: Fees charged by HSAs, 2006
- Figure 19: HSA Administrators and Fees, August 2005
- HSA administrator snapshots
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- Figure 20: Snapshot of 33 large and small HSA administrators, July 2006
- Figure 21: Major California HSA providers: services, products, and employee group size, 2006
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- Figure 22: Information from california hsa providers: enrollment, integration and investments (continued)
- Figure 23: California HSA providers (continued): distribution channels,
- HSA providers—the Blues
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- Figure 24: CDH product and HSA enrollment update from selected blue plans, February 2006
- Selling HSA eligible health insurance
- Providing brokerage services for HSA owners—HSA Trustee Services
- Other developments among HSA providers
- HSA providers offering payment cards
- HSA providers offering decision making tools
- Debit cards and lines of credit
Advertising and Promotion
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- Marketing strategies
- Company specific strategies
- Sample advertising
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- Figure 25: National City print advertisement, 2006
- Figure 26: LaSalle Bank print advertisement, 2006
- Figure 27: First National Bank of Northern California, B2B print advertisement, 2006
- Figure 28: BancCorpSouth print advertisement, 2006
- Figure 29: Somerset Valley Bank print advertisement, 2007
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- Figure 30: Aetna print advertisement, 2007
- Figure 31: $2,250 Deductible/30% Plan with HSA Option from Kaiser Permanente,
- Figure 32: Anthem Blue Cross Blue Shield direct mail advertisement, 2006
The Consumer
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- HSA ownership
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- Figure 33: HSA ownership and interest in ownership, by age, March 2007
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- Figure 34: HSA ownership and interest in ownership, by gender, March 2007
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- Figure 35: HSA ownership and interest in ownership, by household income, March 2007
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- Figure 36: HSA ownership and interest in ownership, by marital status, March 2007
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- Figure 37: HSA ownership and interest in ownership, by number of children in the household, March 2007
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- Figure 38: HSA ownership and interest in ownership, by employment status, March 2007
- Disadvantages of HSAs
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- Figure 39: Disadvantages of HSAs, by age, March 2007
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- Figure 40: Disadvantages of HSAs, by gender, March 2007
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- Figure 41: Disadvantages of HSAs, by household income, March 2007
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- Figure 42: Disadvantages of HSAs, by race/ethnicity, March 2007
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- Figure 43: Disadvantages of HSAs, by marital status, March 2007
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- Figure 44: Disadvantages of HSAs, by number of children in household, March 2007
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- Figure 45: Disadvantages of HSAs, by employment status, March 2007
- Advantages of HSAs
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- Figure 46: Advantages of HSAs, by gender, March 2007
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- Figure 47: Advantages of HSAs, by age, March 2007
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- Figure 48: Advantages of HSAs, by household income, March 2007
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- Figure 49: Advantages of HSAs, by marital status, March 2007
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- Figure 50: Advantages of HSAs, by number of children in household, March 2007
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- Figure 51: Advantages of HSAs, by employment status, March 2007
- How HSA funds would be invested
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- Figure 52: Preferred type of investment for HSA account, by gender, March 2007
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- Figure 53: Preferred type of investment for HSA account, by age, March 2007
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- Figure 54: Preferred type of investment for HSA account, by household income, March 2007
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- Figure 55: Preferred type of investment for HSA account, by race/ethnicity, March 2007
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- Figure 56: Preferred type of investment for HSA account, by marital status, March 2007
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- Figure 57: Preferred type of investment for HSA account, by number of children in household, March 2007
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- Figure 58: Preferred type of investment for HSA account, by employment status, March 2007
- Type of institution preferred for HSA account
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- Figure 59: Type of institution preferred for HSA account, by gender, March 2007
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- Figure 60: Type of institution preferred for HSA account, by gender, by age, March 2007
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- Figure 61: Type of institution preferred for HSA account, by household income, March 2007
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- Figure 62: Type of institution preferred for HSA account, by race/ethnicity, March 2007
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- Figure 63: Type of institution preferred for HSA account, by marital status, March 2007
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- Figure 64: Type of institution preferred for HSA account, by number of children in household, March 2007
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- Figure 65: Type of institution preferred for HSA account, by employment status, March 2007
Future and Forecast
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- Future trends
- Universal Health proposals
- Other future developments
- HSA enrollment projections
- Market forecast
- HSA enrollment
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- Figure 66: Forecast of total U.S. HSA enrollment, 2006-09
Appendix: Trade Associations
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- The Henry J. Kaiser Family Foundation
- HSA Council
- Investment Company Institute
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