Account-Based Health Plans Grow in 2011

January 12, 2012 ( – Account-based health plans grew in 2011, increasing to 12.4 billion in assets among $8.4 million accounts. 

According to the latest survey by the Employee Benefit Research Institute (EBRI) and Mathew Greenwald & Associates (MGA), the number of accounts is up more than 55% and the amount of assets almost 70% since 2010.

This growth comes after a leveling-off of account balances during the recession years of 2008 and 2009, and a slight decline in 2010. The average health account balance was $1,490 in 2011, up 9% from 2010.

The EBRI report notes that by 2010, 16% of employers with 10–499 workers and 23% of those with 500 or more workers offered either a health reimbursement account (HRA)- or health savings account (HSA)-eligible plan. As a result, these plans covered about 21 million people in 2011, representing about 12% of the privately insured market.

“As the number of people with account-based plans grows, total assets in these plans can be expected to grow as well,” said Paul Fronstin, director of EBRI’s Health Research and Education Program and author of the report.

Other findings in the EBRI/MGA survey on health accounts include:

•  After declining to $1,029 in 2010, the average amount being rolled over from one year to the next 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.

•  Men rolled over more money than women, and older individuals had higher rollover amounts than younger individuals. Rollover amounts increased with household income and education, and individuals with single coverage rolled over a slightly higher amount than those with family coverage.

•  Individuals who smoke have more money in their accounts than those who do not smoke. In contrast, obese individuals have less money in their accounts than the non-obese. 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.


These and other findings are based on the results of the 2011 EBRI/MGA Consumer Engagement in Health Care Survey, published in the January 2012 EBRI Issue Brief, “Health Savings Accounts and Health Reimbursement Arrangements: Assets, Account Balances, and Rollovers, 2006–2011,” at