Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006-2011

32 Pages Posted: 14 Jan 2012

See all articles by Paul Fronstin

Paul Fronstin

Employee Benefit Research Institute (EBRI)

Date Written: January 2012

Abstract

This paper examines HSA and HRA assets, account balances, and rollover amounts, using data from the 2011 EBRI/MGA Consumer Engagement in Health Care Survey (CEHCS), sponsored by the Employee Benefit Research Institute and Mathew Greenwald & Associates. It then examines differences and trends in account balances by demographics, income, contribution levels, and engagement in an individual’s own health care using a regression equation. Rollover amounts are then examined. In 2011, there was $12.4 billion in health savings accounts (HSAs) and health reimbursement arrangements (HRAs), spread across 8.4 million accounts, according to data from the 2011 CEHCS. This is up from 2006, when there were 1.3 million accounts with $873.4 million in assets, and 2010, when 5.4 million accounts held $7.3 billion in assets. After average account balances leveled off in 2008 and 2009, and fell slightly in 2010, they increased in 2011. In 2006, account balances averaged $696. They increased to $1,320 in 2007, a 90 percent increase. Account balances averaged $1,356 in 2008 and $1,419 in 2009, 3 percent and 5 percent increases, respectively. In 2010, average account balances fell to $1,355, down 4.5 percent from the previous year. In 2011, average account balances increased to $1,470, a 9 percent increase from 2010. After declining to $1,029 in 2010, average rollover amounts increased to $1,208 in 2011. Total assets being rolled over increased as well: $6.7 billion was rolled over in 2011, up from $3.7 billion in 2010. The percentage of individuals without a rollover remained at 13 percent in 2011. Individuals who smoke have more money in their accounts than those who do not smoke. In contrast, obese individuals have less money in their account than the nonobese. There is very little difference in account balances by level of exercise. Very small differences were found in account balances and rollover amounts between individuals who used cost or quality information, compared with those who did not use such information. However, next to no relationship was found between either account balance or rollover amounts and various cost-conscious behaviors. When a difference was found, those exhibiting the cost-conscious behavior were found to have lower account balances and rollover amounts. Men have higher account balances than women, older individuals have higher account balances than younger ones, account balances increase with household income, and education has a significant impact on account balances independent of income and other variables.

Keywords: Account-based health plans, Consumer-driven health care, Employment-based benefits, Health insurance coverage, Health reimbursement arrangements (HRAs), Health savings accounts (HSAs), Health status

JEL Classification: I1, I11, J3, J32

Suggested Citation

Fronstin, Paul, Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006-2011 (January 2012). EBRI Issue Brief, No. 367, January 2012, Available at SSRN: https://ssrn.com/abstract=1984743

Paul Fronstin (Contact Author)

Employee Benefit Research Institute (EBRI) ( email )

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