An estimated 5.5 million employees are now enrolled in high-deductible health plans (HDHPs) with a tax savings option, such as a health savings account (HSA) or a health reimbursement arrangement (HRA).
According to the Kaiser Family Foundation’s 2008 Annual Survey of Employer Health Benefits, the growth in HDHPs has increased mainly among companies that employ between 3 and 199 workers, with 13 percent of employees in these small companies now enrolled in a HDHP, up from 8 percent in 2007. For companies with more than 200 employees, the 5 percent inclusion rate is about the same as the previous year.
Premiums are typically lower than for other plans, but the deductibles are high. On average, the annual deductible for single coverage is $2,010 for HSAs and $1,552 for HRAs. HDHPs generally have not caught on among patients who need biologics, who would be likely to meet their deductibles quickly.
Most companies offering HDHPs reported that cost savings were, to them, the most successful outcome of these plans. The greatest challenge in implementing a HDHP was educating employees about the difference between these and traditional managed care plans. More than a quarter of employers offering HSAs contribute nothing to their employees’ health savings accounts.
