Part One: 10 Employer Hacks to Help Employees Build Their HSA Balances

By William G. Stuart | Originally posted for MaxHSA on LinkedIn

Employers can create many levers to help HSA-eligible workers contribute to and retain greater balances in their Health Savings Accounts.

Surveys show that workers expect their employer to help them improve their financial situation. Not just with a paycheck, but with benefits, education, and support that help them keep more of what they earn, pay less in taxes, and prepare for the future.

Health Savings Accounts are the perfect opportunity to achieve each of these aims. Too often, though, workers need help. Employers can deliver by designing better benefits offerings related to HSA-qualified plans and Health Savings Accounts. We review five this week and follow up with a discussion of five more next Wednesday.

Note that an employer cannot adopt all 10 hacks. Some represent different approaches to the same goal. Some others are conflicting. However, incorporating a handful into the benefits offering may enhance the value proposition for employees covered on the HSA-qualified plan.

ONE. Design the Right Medical Plan

When we think of the variables in a medical plan, we usually focus on patient financial responsibility, also known as cost sharing. Premiums and cost sharing are usually inversely proportional. Plans with high patient responsibility bear lower premiums than plans that leave patients with lower out-of-pocket financial responsibility.

There is another important consideration in plan design: the financial coverage of specific benefits. All services except select preventive care and a handful of others must be applied to the deductible on an HSA-qualified plan. The higher the deductible, the higher the perceived financial barrier to care.

In 2019, the Trump Administration issued an executive order that creates a safe harbor that permits insurers and employers to cover diagnostic services or treatments for 14 specific chronic conditions. The list includes beta blockers, ACE inhibitors and statins for specific cardiac conditions; SSRIs for depression; inhaled corticosteroids for asthma; and a glucometer for diabetes. (You can read the full list here.