Survey examines what drives health plan choice, satisfaction

By Ayo Mseka

During a recent EBRI webinar, attendees gained valuable insights into the findings of the EBRI/Greenwald Research Consumer Engagement in Health Care Survey (CEHCS), as well as useful ideas on how to better communicate their health savings account (HSA) programs to plan participants.

The CEHCS survey was conducted to provide data on the growth of consumer-driven health plans and high-deductible health plans and examine the behavior and attitudes of health care consumers.

Overall satisfaction with plan selection is relatively high, according to speaker Sara Rubinstein, director, healthcare, Greenwald Research. But most enrollees do not spend a lot of time on health plan choice. High deductible health plan (HDHP) enrollees spend more time than traditional plan enrollees on choosing health plans and most reported that they understand these plan offerings somewhat or very well.

When asked how important some aspects of a health insurance plan would be in their current choice of plan, 78 % of respondents chose a good network of physicians and hospitals, 73 chose low out-of-pocket costs when they are seeing a doctor, and 72% opted for lower cost of premiums.

Overall satisfaction with health plans is also relatively high, added Rubinstein, although there is a lower level of satisfaction among HDHP employees, which appears to be driven by cost sharing. Most enrollees reported that their plans have not changed during the past two years.

Rubinstein added that enrollment in consumer driven health plans (CDHPs) decreased last year and HDHP enrollment also fell slightly. Three in five traditional plan owners with a choice of plans have the option for an HDHP or a CDHP, but one-third do not know if an HDHP is being offered. A quarter of employees with a CDHP who were offered an account said that they did not open it because they did not like the use-it-or-lose-it rule, indicating a knowledge gap.

Use of HSAs

Consumers decided to open HSAs mostly to take advantage of employer contributions and to save for future expenses, Rubinstein added. Most currently use an HSA to pay for recent or upcoming out-of-pocket expenses. And two-thirds value HSAs as savings accounts, although few use them as investment accounts. When asked what would make more of them more likely to accumulate and invest unused funds in their HSAs, the following were some of their responses:

Annual review of their HSA balance
Information about account benefits and how they work sent to them via email
Access to an online HSA-contribution calculator
Ability to add wellness dollars to their account

Additional insights

Webinar attendees also heard from Kerry Settee, vice president, consumer insights and research, Voya Financial. Settee said that as she listened to Rubinstein’s presentation, some of the things that stood out to her are that satisfaction with plans is down and plans have changed in an adverse way. This is consistent with Voya research. “All are feeling the pinch, stress appears to be up, and it seems to be impacting employees’ physical and mental health,” she said.

According to Voya research, 46% of women said that their workplace-retirement plan was their only source of emergency savings, Settee said. Seventy percent of women are spending less on non-essentials, compared to 52 % of men, and 22% of women are putting off health care or medical care, compared to only 14% last year.

In addition, Settee said, just 50% of women are enrolled in HSAs, and only 20% are using them to save for health-care costs in retirement, compared to 42% of men. Also, 42% of men have their HSA savings invested, compared to just 13% of women. Employees do not understand how HSAs work, Settee pointed out. “And women are less likely to choose HSAs,” she said. “This is an opportunity for HSA education among all employees, as well as to build women’s confidence around investing,” she added.

Communicating HSA programs effectively

To communicate HSA programs effectively, Settee offered the following suggestions:

Get the timing right and include action steps.
Focus on tax benefits.
Use personalized messaging.
Position HSA as a savings vehicle for unplanned medical expenses.
Offer integrated support and planning tools.
Show how an HSA and a retirement plan complement each other.

HSA takeaways

Attendees also received several HSA takeaways from Settee, including the following:

Employees will likely face a widening retirement health-care savings gap.
HSAs are uniquely positioned to help close the retirement health-care-savings gap.
Employees may not understand how HSAs work and need their employers to help educate them and help them make benefits decisions.
To design an effective HSA program, employers should offer HSAs through providers offering investment options, consider offering employer contributions, and use proven default options.
Financial professionals and benefits brokers can play valuable roles in helping employers elevate their benefits.
Employers can use digital technology to provide employees with decision-making support without increasing administrative costs.

Ayo Mseka has more than 30 years of experience reporting on the financial services industry. She formerly served as editor-in-chief of NAIFA’s Advisor Today magazine. Contact her at [email protected].

Ayo Mseka has more than 30 years of experience reporting on the financial services industry. She formerly served as editor-in-chief of NAIFA’s Advisor Today magazine. Contact her at [email protected].