Account for Health Care

Rx for today and tomorrow.

Workplace Thought Leadership & Public Policy - 07/30/2015

A prescription for rising costs

A High-Deductible Health Plan (HDHP) paired with a Health Savings Account (HSA)—also known as an HSA-eligible health plan—can be a key part of a strategy to help control costs. Here’s a look at how employers are embracing these plans:

The pressure on employees

Your employees are feeling similar pressures as their costs rise and they are asked to take on more responsibility for their own health care. You can increase their comfort level by educating them on the benefits of an HSA, both today and far into the future.

An HSA can help employees across the spectrum — from those who use it to pay today’s medical expenses to those who see it as a way to save for health care costs during retirement.

Learning to shop around

Your employees are probably not accustomed to "shopping around" for health care, but as they shoulder more of the cost of care, they are becoming more careful of how they spend their money. Employees with HSA-eligible health plans have proven to be more cost-conscious, which can help both employees and employers save.

How HSAs help spenders save

TRIPLE TAX ADVANTAGE

Employees who fund an HSA can save money on taxes now and later:

1. When they contribute
They don't pay federal income tax on their contribution. So, a $6,750 HSA contribution in 2016 could cut a family's tax bill by $1,687 (assuming a 25% federal income tax rate).
2. As the money grows
If they invest what they don't spend, they aren't taxed on any potential earnings as their balance grows.
3. When they pay their medical bills
Withdrawals made to pay qualified medical expenses are never taxed.

HSAs may help employees spend less on their out-of-pocket health care expenses today — both because of their tax advantages and the notion that they are spending their own money on health care. They also help employees save for tomorrow. More than 90% of HSA account holders carried a balance into 20143. Even a small balance carried over from year to year can accumulate savings over time.

Satisfaction grows over time

Learning how to become a smart health care consumer is challenging and requires an extra level of employee communication support. But employees who participate in these plans are broadly satisfied with their health coverage — and that comfort level rises over time.12

How HSAs help savers

Employees who are healthy or can afford to cover their current expenses out-of-pocket can save their HSA balances well into the future — even into retirement. For savers, an HSA is another powerful tax-advantaged way to save for retirement.

3 uses for an HSA during retirement

Health care often is the second-biggest expense for retirees, after housing. Fidelity estimates an average 65-year-old couple retiring today will spend about $245,000 on health care during retirement.4 Money saved in an HSA can help in three important ways during retirement:14

How you can help

Across the spectrum, you as an employer can help your employees make the most of an HSA, no matter where they are on the spending-to-saving spectrum.

NEXT STEPS

1 Towers Watson, 2014 Health Care Changes Ahead Report, September 2014

2 National Business Group on Health Annual Health Care Benefits Survey, August, 2015

3 Fidelity recordkept data of 227,000 HSA accounts as of 12/31/2014

4 2015 Fidelity analysis performed by its Benefits Consulting group. Estimate based on a hypothetical couple retiring in 2015, 65 years or older, with average life expectancies of 85 for a male and 87 for a female. Estimates are calculated for “average” retirees, but may be more or less depending on actual health status, area of residence, and longevity. The Fidelity Retiree Health Care Costs Estimate assumes individuals do not have employer-provided retiree health care coverage, but do qualify for the federal government’s insurance program, Original Medicare. The calculation takes into account cost-sharing provisions (such as deductibles and coinsurance) associated with Medicare Part A and Part B (inpatient and outpatient medical insurance). It also considers Medicare Part D (prescription drug coverage) premiums and out-of-pocket costs, as well as certain services excluded by Original Medicare. The estimate does not include other health-related expenses, such as over-the-counter medications, most dental services and long-term care. Life expectancies based on research and analysis by Fidelity Investments Benefits Consulting group and data from the Society of Actuaries, 2014.

5 Fidelity Retiree Health Survey conducted by GfK Public Affairs of 1007 pre-retirees and recent retirees, March 2014.

6 Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2015 Employer Health Benefits Survey

7 Congressional Budget Office, “An Update to the Budget and Economic Outlook: 2015 to 2025”

8 2014 EBRI/Greenwald & Associates Consumer Engagement Health Care Survey

9 Castlight Health The primary source of data used for this analysis is medical claims data. Castlight augments this data with other data including: publicly available data, provider information, and actual provider rate sheets that list the negotiated price between a provider and an insurer. Castlight then applies proprietary algorithms to obtain the provider prices used for this analysis. Prices are defined as the employee cost-sharing plus the amount paid by the employer. Displayed prices are representative of in-network providers.

10 Fidelity recordkept data of HSA Accounts Jan. 1, 2009 through Dec. 31, 2013. Contributions averaged about $2,700 a year and money not spent remained in cash. Participants spent at least the percentage noted (90% or 50%) on qualified health care expenses during a five-year period.

11 With respect to federal taxation only. Contributions, investment earnings, and distributions may or may not be subject to state taxation. The triple tax advantages are only applicable if the money is used to pay for qualified medical expenses.

12 The Fidelity-sponsored 2014 HSA survey was conducted by GfK Public Affairs & Corporate Communications from April 30 to May 9, 2014, using GfK’s KnowledgePanel, a nationally representative online panel composed of 1,247 U.S. adults who are age 25-65, have household income of $25,000 or more, have primary or shared responsibility for household financial decisions, and receive health care benefits through their own or their spouse/partner’s employer. Of these respondents, 332 self-identified as being enrolled in an HSA-eligible health plan.

13 Fidelity recordkept data of HSA Accounts Jan. 1, 2009 through Dec. 31, 2013. Contributions averaged about $2,700 a year and money not spent remained in cash. Participants saved at least 90% of their contributions during the five-year period.

14 IRS Publication 969: Health Savings Accounts and Other Tax-Favored Health Plans (https://www.irs.gov/publications/p969/ar02.html#en_US_2014_publink1000204081)

15 Gallup’s annual Economy and Personal Finance survey, conducted April 3-6, 2014

16 2015 Kaiser Family Foundation and the Health Research & Educational Trust Employer Health Benefits Survey, September, 2015

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Fidelity does not provide legal or tax advice. The information herein is general in nature and should not be considered legal or tax advice. Consult an attorney or tax professional regarding your specific situation.

For Plan Sponsor and investment professional use only.

Approved for use in the advisor and 401(k) markets. Firm review may apply.

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