Account-Based Health Plans See Continued Growth in 2011

February 15, 2012 ( – Contribution patterns to account-based health plans are changing, according to a report from the Employee Benefit Research Institute (EBRI). 

Collectively, health savings accounts (HSAs) and health reimbursement arrangements (HRAs) are known as “consumer-driven” health plans. According to the latest EBRI/MGA Consumer Engagement in Health Care Survey, there were $12.4 billion in HSAs and HRAs, spread across 8.4 million accounts in 2011. 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. This growth reflects the increasing number of employers that offer these account-based health plans.

The EBRI survey found that about two-thirds of workers with an HRA or HSA reported their employer contributed to their account in 2011, a level that has remained steady since 2006. However, employer contribution levels have declined for some enrollees.

Specifically, for those with employee-only coverage in these plans, annual contributions from their employer have fallen since 2008; the percentage reporting that their employer contributed $1,000 or more to the account dropped from 37% in 2008 to 24% in 2011. Employer contributions of $1,000 or more to those with family coverage remained steady at 64%, EBRI found.

By contrast, individuals’ contributions to HSA plans have increased. The percentage contributing $1,500 or more increased from 21% in 2006 to 44% in 2011.

“This may be due to the continued weak economy. Workers with employee-only coverage continued to respond by increasing their own contributions,” said Paul Fronstin, director of EBRI’s Health Research and Education Program, and author of the report. “Generally, lower-income individuals did not increase their contributions, whereas higher-income individuals did.”

The full report is published in the February 2011 EBRI Notes, “Employer and Worker Contributions to Health Savings Accounts and Health Reimbursement Arrangements, 2006‒2011,” available at

Tara Cantore

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