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Health Savings Accounts - US - April 2007
Finance: USA Price: £2696 / $3500 / €3012
Contents
Scope and Themes
Executive Summary
Background
Market Drivers
Market Size and Segmentation
Competitive Landscape
Advertising and Promotion
The Consumer
Future and Forecast
Appendix: Trade Associations
 
  Research Methodology
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About this report

Health Savings Accounts (HSAs) are the latest addition to the field of consumer directed health plans. This report provides an overview of the HSA, its penetration in the marketplace (including who is enrolling in the product) and where future opportunities may lie.

Consumer-driven health plans are designed to counter the growth in medical costs by giving consumers financial incentives along with the control to decide where and how to make their healthcare expenditures. The shift toward consumer-driven health care will likely create significant opportunities for insurance companies, banks, financial services firms and financial advisors. This report addresses these opportunities, including:

  • Likely candidates to enroll in HSAs

  • Educational programs that will enhance HSA enrollment

  • Recent product developments in the competitive space

  • Growth potential in the future

HSAs essentially operate as an IRA for healthcare. They are a hybrid product—a combination of insurance along with a tax-deferred investment account that allows for tax-free withdrawals to pay for medical expenses. In some ways, the product is also similar to whole life insurance—it includes both a protection component as well as the opportunity to build savings through a separate savings account.

Currently, HSAs are distributed by insurers, custodians/trustees, and record keepers, but more financial firms are becoming involved through alliances with insurance companies and administrators. The savings account component of the HSA is particularly up for grabs, with unexplored opportunities to help consumers make sound investments to build their accounts for future needs.

HSAs have several objectives:

  • To encourage people to set money aside for healthcare expenses
  • To provide financial incentives for people to make prudent healthcare expenditures
  • To provide a vehicle for people to choose and pay for healthcare services on their own initiative, without limitations imposed by insurers or employers
  • To create competition among providers and bring down the cost of health care, as informed consumers negotiate for more affordable services

HSAs are creating interest among larger employers already offering other types of consumer directed health plans or other high deductible insurance. HSAs also appeal to smaller employers who cannot afford to make health care benefits available to their employees with traditional plans. The U.S. Treasury Department estimates that 25 million to 30 million Americans will use HSAs as part of their insurance plans by 2010. For employers, HSAs offer a way to dramatically reduce health insurance premiums for their employees; as a result, it is likely that the number and types of companies offering HSAs and qualifying high deductible insurance plans will continue growing.

If you want more details about this particular report, please contact the Mintel information team on  +1 312-932-0400 in the U.S.,  +44 028-90-241-849 in Northern Ireland,  +353 048-90-241-849 in the Republic of Ireland or  +44 (0)20-7606-6000 in the UK and the rest of the world, or email info@mintel.com.
Contents

Scope and Themes

What you need to know

Overview

Abbreviations and terms

Abbreviations
Terms

Executive Summary

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

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

Rising cost of health care

Employer health care coverage declining

Figure 1: Growth rate of private companies vs. healthcare spending by private companies, 1998–2003
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

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

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

Figure 5: Projected growth of CDHPs, 2005-10

Employers offering HSAs

Figure 6: Firms offering health benefits—percentage offering HDHP/HRA or HSA, 2005 and 2006

Enrollment by age

Figure 7: Age of HSA eligible enrollees, by market segment, 2006

HSA balances

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

Figure 10: Market characteristics of HSA-qualified HDHPs, by number of covered lives, September 2004 – January 2006
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
Figure 13: Percentage of firms that offer employees a high-deductible health plan, by firm size, 2003-05

Competitive Landscape

The bank channel

Figure 14: Primary source of financial information among individuals, 2006

Top HSA providers

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
Figure 17: Top 10 HSAs by total HSA deposits, as of 4th quarter 2005

HSA administrators and fees

Figure 18: Fees charged by HSAs, 2006
Figure 19: HSA Administrators and Fees, August 2005

HSA administrator snapshots

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
Figure 22: Information from california hsa providers: enrollment, integration and investments (continued)
Figure 23: California HSA providers (continued): distribution channels,

HSA providers—the Blues

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

Marketing strategies

Company specific strategies

Sample advertising

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
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

HSA ownership

Figure 33: HSA ownership and interest in ownership, by age, March 2007
Figure 34: HSA ownership and interest in ownership, by gender, March 2007
Figure 35: HSA ownership and interest in ownership, by household income, March 2007
Figure 36: HSA ownership and interest in ownership, by marital status, March 2007
Figure 37: HSA ownership and interest in ownership, by number of children in the household, March 2007
Figure 38: HSA ownership and interest in ownership, by employment status, March 2007

Disadvantages of HSAs

Figure 39: Disadvantages of HSAs, by age, March 2007
Figure 40: Disadvantages of HSAs, by gender, March 2007
Figure 41: Disadvantages of HSAs, by household income, March 2007
Figure 42: Disadvantages of HSAs, by race/ethnicity, March 2007
Figure 43: Disadvantages of HSAs, by marital status, March 2007
Figure 44: Disadvantages of HSAs, by number of children in household, March 2007
Figure 45: Disadvantages of HSAs, by employment status, March 2007

Advantages of HSAs

Figure 46: Advantages of HSAs, by gender, March 2007
Figure 47: Advantages of HSAs, by age, March 2007
Figure 48: Advantages of HSAs, by household income, March 2007
Figure 49: Advantages of HSAs, by marital status, March 2007
Figure 50: Advantages of HSAs, by number of children in household, March 2007
Figure 51: Advantages of HSAs, by employment status, March 2007

How HSA funds would be invested

Figure 52: Preferred type of investment for HSA account, by gender, March 2007
Figure 53: Preferred type of investment for HSA account, by age, March 2007
Figure 54: Preferred type of investment for HSA account, by household income, March 2007
Figure 55: Preferred type of investment for HSA account, by race/ethnicity, March 2007
Figure 56: Preferred type of investment for HSA account, by marital status, March 2007
Figure 57: Preferred type of investment for HSA account, by number of children in household, March 2007
Figure 58: Preferred type of investment for HSA account, by employment status, March 2007

Type of institution preferred for HSA account

Figure 59: Type of institution preferred for HSA account, by gender, March 2007
Figure 60: Type of institution preferred for HSA account, by gender, by age, March 2007
Figure 61: Type of institution preferred for HSA account, by household income, March 2007
Figure 62: Type of institution preferred for HSA account, by race/ethnicity, March 2007
Figure 63: Type of institution preferred for HSA account, by marital status, March 2007
Figure 64: Type of institution preferred for HSA account, by number of children in household, March 2007
Figure 65: Type of institution preferred for HSA account, by employment status, March 2007

Future and Forecast

Future trends

Universal Health proposals

Other future developments

HSA enrollment projections

Market forecast

HSA enrollment

Figure 66: Forecast of total U.S. HSA enrollment, 2006-09

Appendix: Trade Associations

The Henry J. Kaiser Family Foundation
HSA Council
Investment Company Institute