How to help your employer clients implement a High Deductible Health Plan with HSA

How to help your employer clients implement a High Deductible Health Plan with Health Savings Account and engage employees so they embrace (may even be excited about) the new plan design:

There is nothing “easy” about initially understanding a Qualified High Deductible Health Plan (plan with no copays) and the accompanying Health Savings Account.

More than 12 years of experience moving employers to these plans has taught us a great deal.

The first recommendation I make to employers is that they need to understand and embrace these plans themselves…for themselves first.

Many employers will say….”We like offering the traditional copays and don’t think our workforce is suited for a plan that doesn’t offer copays”. My next comment is….”Can I show you a way that you can create the same robust benefit plan by spending the same dollars you would on the traditional PPO plan through employer funding into the Health Savings Account and if employees don’t use the dollars…they are the employee’s to keep in the account for future health expenses…even in retirement?”

1)      Provide an easy to read, colorful engaging education summary about how these plan works that uses pictures and arrows and graphics to explain the basic concepts about High Deductible Health Plans and Health Savings Accounts to the C Suite involved in the decision making.  The employer will be astounded with all the favorable elements of these types of plans.  Don’t forget to remind your LLC and S Corp owners and Partners that they can fund these accounts as well and deduct them off their taxes.
2)      Let the employer know that if they are moving from a traditional PPO with copays they should be initially committed to spend at least the same dollars for health benefits per employee that they did the prior year.  The difference is that they will be paying lower premiums and applying the saved premiums to fund the employee’s Health Savings Accounts.  I often encourage the employer to offer a dollar for dollar match to what the employee puts into the account since these plans only work if the account is funded and the premium contributions the employee pays for the group plan monthly typically will be less (sometimes significantly less).  I ask for the employer’s permission to encourage the employees to fund the accounts with 100% of their premium savings which is where the employer match incentive helps.
A funded account up to the maximum out of pocket exposure is the goal for the employees to begin really liking the program.  Sometimes an extra funding bump/incentive by the employer in the beginning can make all the difference in how the plan is perceived and embraced.
3)      Sell the heck out of the benefits of the Health Savings Account.  The benefits are too numerous to list here but know these plans inside and out and sell the tax advantages and the benefit of entering retirement with some money allocated to future healthcare expenses.
Health Savings Accounts continue to be a gift provided to us all in year 2004 by the US Department of the Treasury.
4)      I recommend group education meetings with an education PowerPoint or video as well as catchy enrollment materials and one on one counseling for the initial enrollment. Preferably the enrollment would be done with an online tool; however, the employee will still need some explanation and hand holding or they will be very skeptical.
5)      A dual option offering with a High Deductible Health Plan (HDHP) and Health Savings Account(HSA) with a “buy up” to a higher cost PPO with no HSA funding is a great way to reinforce to employees the premium advantages of the lower cost HSA plan.  Many will sign up for the lower cost plan especially if they will be receiving employer funds to their HSA.
6)      If the employer sees these types of plans as a way to reduce cost but is unwilling to consider any funding into the HSA the only way the employees will embrace the  concept is if their premium contributions are much less than in the past.  They need to understand this and be shown the need to fund the Health Savings Accounts with the savings. Much more communication and hand holding is needed if the employer is not going to fund the HSA. However, if the monthly premium savings to the employee is significant, you can still have a successful enrollment with individual counseling.  The employee needs to understand they need to elect automatic contributions to systematically fund their HSA (with the premium savings they are receiving) or they are entering a danger zone!
7)      Provide Telehealth services with a very low copay and sell the heck out of this as well.  Pair the telehealth benefit with one of the newer technology advocacy/ concierge assistance services for members to be able to call and find the lowest price/highest quality providers and facilities and save on RX prior to entering the healthcare system.  Educate employees and family members on the value of this service which allows them to spend their HSA money more wisely. Reinforce to them they will not be on their own in their quest for defined cost/quality information if they use the advocacy/concierge assistance.  Most of these advocacy/concierge services include telemedicine in the package and they can create immense savings not only for the employee but for the plan as well since the claim dollars paid out will be reduced.
8)      The proposed healthcare plan replacement options at the federal level include an expansion of Health Savings Accounts so the demand for these plans will continue to grow as the benefits are enhanced.  
9)      These federal proposals also exclude the funds in the HSA from any employer cap on deductibility of premiums unlike the current Cadillac tax which includes the HSA value.
10)   Now is the time for every employee in America who receives a plan from their employer to be presented with an option to have an HSA . I see the responsibility to drive this education and promotion as that of the Employee Benefit Advisor/broker.  It is our responsibility to educate, communicate and be advocates for these types of consumer driven plans. Not until we eliminate copays that detach employees from the real costs of receiving healthcare will we ever have any chance of combatting the continually increasing costs of healthcare which now equates to 24% of the average American workers paycheck (including employer and employee contributions).  Enough is enough.  The solutions exist and continue to improve.  We must be the advocates of education and change.

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