Category:
Health Savings Accounts (HSA)

WEX Health guest blog Bill Stuart HSA Enrollee Checklist

HSA Enrollee Checklist

1/08/2018

by William Stuart

 

If you’ve enrolled in HSA-qualified medical coverage for the first time, your work is only half-done! This checklist can help ensure that you get the most out of your new coverage.

 

  1. Make sure you’re HSA-eligible. Refer to IRS Publication 969 [https://www.irs.gov/pub/irs-pdf/p969.pdf] for more information. The most common situation that makes you ineligible to open and contribute to an HSA, even when you’re enrolled in an HSA-qualified plan, is enrollment in any part of Medicare or your own or your spouse’s participation in a traditional health FSA.

 

  1. Open an HSA. If you have employer-based coverage, then your employer may send enough information directly to its chosen HSA administrator to set up the account. Be sure to check with your benefits office. You may have to complete a paper application or enroll online.

 

  1. See whether your employer offers a limited-purpose health FSA. You can remain eligible when you participate in a health FSA that reimburses dental and vision expenses only. This option may make sense if you need funds early in the year (you can spend your entire annual balance at any time) or if you want to maximize tax savings or preserve HSA balances. These are annual accounts, which means that you may forfeit unused balances. Some employers offer limited-purpose health FSAs to their employees enrolled in HSAs, while others don’t. See whether this is an option, and determine whether it makes sense for you.

 

  1. Set up payroll deductions. The best way to build your HSA balance is through regular deposits. Many people start by contributing the difference in premium between their old coverage and their new plan(s). Some who can no longer contribute to a health FSA divert those elections to their new HSA(s). In both cases, the contributions merely reroute money from one pre-tax deduction to another, so that your net paycheck doesn’t decline.

 

  1. Name a beneficiary who will inherit your balance. You may have completed this step with paper or online enrollment. Be sure you name someone. If you designate your spouse as the beneficiary, then the HSA passes intact as a tax-advantaged account to your spouse. If you name anyone else, then the account is liquidated before being passed to the beneficiary, who may incur a tax liability.

 

  1. Set up online access. Your HSA administrator offers an online portal through which you can manage your account, track deposits and withdrawals, monitor debit card activity, and manage investments (which you may begin to make after your account reaches a certain cash balance).

 

  1. Check for fees. Read your account documents, which are probably posted online. Some administrators automatically send monthly paper statements and may charge a fee for this service. You can provide your email address to receive statements electronically at no charge. You may be able to set up notifications whenever your administrator receives a deposit or you use your debit card.

 

  1. Download your HSA mobile app. You can have instant access to your account activity on your smartphone. It’s a great way to stay connected to your HSA and provides real-time information wherever you are (for example, in line at the pharmacy) and whenever you need it.

 

  1. Manage your pretax payroll contributions. You can change your contributions prospectively during the year. See your employer for details. If you need more money to reimburse an unexpected expense, then you can increase your contribution. If you have accumulated a sufficient balance and want to reduce or stop your contributions to increase your paycheck, you can do so (note this isn’t recommended as it’s tough to start again).

 

  1. Decide how you want to use your HSA. Many people use their HSAs as they did a health FSA, making regular withdrawals to fund all eligible expenses. Some consciously decide to become HSA savers, either by contributing up to the maximum allowed ($3,450 for self-only coverage and $6,900 for family coverage in 2018, plus an additional $1,000 if age 55 or older) or by not reimbursing eligible expenses immediately. It’s possible for many HSA owners, particularly those who begin in their 20s or 30s, to build a six-figure HSA balance to spend in retirement on Medicare premiums and out-of-pocket medical, dental, and vision expenses.

 

  1. Remain engaged as a consumer. You assume additional financial responsibility when you’re covered on an HSA-qualified plan. You’re spending your own money from your HSA to cover many expenses. You can preserve your funds without impacting the quality of your care if you shop for price and quality (most insurers have tools to help), ask more questions of your doctor (“Would every doctor recommend the same course of treatment, or might others suggest an alternative treatment?”) and consider the site of service (retail clinic versus Urgent care center versus emergency room) when making treatment decisions. Your job isn’t to practice medicine, but rather to apply to your medical care the same principles that you consider when you buy other complex consumer products like a mortgage, vehicle, or life-insurance policy.

 

That’s it. The list isn’t onerous. And many of these items are one-and-done activities that you don’t need to think about again. The key to success with an HSA is to understand how to use your account, both mechanically and strategically. In time, most HSA owners accumulate balances, as contributions exceed distributions. This gives them a sense of security, with less fear of a sudden high medical expense – and potentially the ability to enter retirement with additional assets.


William Stuart

William Stuart

Director of Strategy and Compliance at Benefit Strategies

William G. (Bill) Stuart is director of strategy and compliance at benefit Strategies, LLC, an independent third-party administrator located in New Hampshire. An expert on Health Savings Accounts, he is a member of the American Bankers Association HSA Council. You can check his biweekly blog at www.benstrat.com/hsagps.



What Employees Need to Know About Open Enrollment and Their HSA and FSA Dollars at Year’s End

What Employees Need to Know About Open Enrollment and Their HSA and FSA Dollars at Year’s End

12/4/2017

 

If you’re an employer or benefits administrator, it’s likely that you’ve received your fair share of questions from employees this fall about coverage adjustments during open enrollment. Some of those employees who already have tax-advantaged health savings and flexible spending accounts are also probably asking for clarification on what to do with the sums in these accounts at the end of 2017 and whether or not to continue with their plans.

 

Now is the ideal time to help employees understand how these universally underutilized accounts work and what makes them so valuable. It’s particularly important to educate employees about their flexible spending and health savings accounts in their first year (or during the first year that a company has made an HSA or FSA available) and during the first two open enrollment seasons. Here are the key messages that every employee needs to hear about HSAs, FSAs and open enrollment at the end of the year:

 

All HSA dollars roll over at the end of the year; most FSA dollars won’t

 

While there are many similarities between HSAs and FSAs, some of their most important distinctions arise at the end of the year. Most important, HSA balances can—and ideally will—stay and continue to grow, rolling over into the next year. On the other hand, FSA balances are largely “use it or lose it” by year’s end. Since 2013, however, the IRS has permitted FSA accountholders to carry over $500 annually for expenses in the next year. (Prior to 2013, any unspent funds reverted to the employer’s coffers at year’s end.) Employers can now either allow employees to carry over the $500 to the next year or to spend the remaining funds during a grace period that lasts until March 15 of the following year.

 

Further, employees can change how much they contribute to their HSA at any point during the year, but can only adjust their contribution amounts to FSAs during open enrollment or with a change in employment or family status. The bottom line: HSAs are for saving money for healthcare expenses, and FSAs are for spending it. HSAs are only for employees with high-deductible healthcare plans, while employers can make FSAs available to any employee.

 

Opt for an HSA during open enrollment to save for long-term healthcare expenses

 

HSAs are widely misunderstood. Many people think that these accounts are designed primarily to pay for out-of-pocket medical expenses in the near future (as is the case with FSAs). But the long-term savings value of HSAs is what makes them the most valuable, and during open enrollment, they should be presented to eligible employees as an important part of saving for future medical expenses and retirement.

 

According to a new report from the Employee Benefit Research Institute (EBRI), two-thirds of account holders ended 2016 with positive net contributions, and over 90 percent of HSAs with individual or employer contributions in 2016 ended the year with funds to roll over for future expenses. EBRI’s report also found that the average HSA balance among account holders with individual or employer contributions at the end of 2016 was $2,532, up from $1,604 at the beginning of the year.

 

In 2018, contributions to HSAs will be capped at $3,450 for individuals or $6,900 for families, up from $6,750 in 2017.

 

Opt for an FSA during open enrollment to cover short-term health expenses

 

A flexible spending arrangement, which employers offer to employees at their discretion, can help cover expenses not covered by an employee’s health plan, including deductibles, copayments and prescription costs.

 

In 2018, contributions to FSAs will be capped at $2,650, $50 more than the limit for 2017.

 

More important end-of-year HSA tax information

 

Not all HSA contributions have to be made by Dec. 31 for an employee to claim a tax deduction. Employees and employers can make contributions to an HSA up until April 16, 2018, for 2017.

 

Further, as long as an employee was eligible to contribute to an HSA as of Dec. 1, they are considered to be eligible for the whole year and can still make a maximum contribution for the full year. However, they must remain eligible for an HSA through Dec. 31, 2018. If they don’t, they will have to include the amount over-contributed in income and pay taxes and a 10 percent penalty on it.

 

How should employers communicate the value of FSAs and HSAs to employees? Find tips and ideas in our two part series here and here.

Employers, This Is the Comparative Data You Should Use to Evaluate Your Benefit Plans 

Employers, This Is The Comparative Data You Should Use to Evaluate Your Benefit Plans 

 10/23/2017

 

Just as more patients are taking control of their health information by bringing personal data from their cell phones or activity trackers into their doctor’s appointments, more employers are using mobile, data analytics and personalized consumer portals to engage with employees and evaluate the effectiveness of the benefits plans they offer. Continue reading

5 New Findings That Show More Workers and Employers Are Utilizing HSAs

5 New Findings That Show More Workers and Employers Are Utilizing HSAs

10/16/2017

 

A trio of surveys released by separate organizations in the past month indicate that American employers and workers are utilizing HSAs more often and warming to their benefits, especially as deductibles rise, the excise tax looms and healthcare reform now seems unlikely. Here are five of the latest findings from the Kaiser Family Foundation, the Health Research & Educational Trust, the Employee Benefit Research Institute and Mercer:
Continue reading

Tax Reform Is the Next Hot Ticket for Healthcare Regulation

Why Tax Reform Is the Next Hot Ticket for Healthcare Regulation

10/03/2017

In spite of the many headlines and healthcare bills that have centered on repealing or replacing the Affordable Care Act (ACA), the healthcare landscape in the United States today looks remarkably similar to the way it did when the ACA was passed seven years ago: The majority of Americans still receive insurance through their employers. Continue reading

Is It Time for a Quick HSA/FSA Checkup?

Is It Time for a Quick HSA/FSA Checkup?

This is a good time for organizations and employees to do a little fall cleaning and run through a healthcare checklist to make sure they are aware of the most current HSA/FSA benefit information. Continue reading

Communicate the Value of FSAs and HSAs – Part II: Health Savings Accounts

Communicate the Value of FSAs and HSAs – Part II: Health Savings Accounts

In our most recent post, Communicating the Benefits of FSAs and HSAs Part I, we explored the benefits of flexible spending arrangements and how to help your employees to understand the value. Today, however, we would like to turn our attention to a topic that has been recently politicized, but misunderstood, Health Savings Accounts.

According to the 2016 SHRM Employee Benefits Survey, the percentage of organizations offering HSAs increased from 43 percent to 50 percent in the past year. Continue reading

Communicate the Value of FSAs and HSAs – Part I: Flexible Spending Accounts

Communicate the Value of FSAs and HSAs – Part I: Flexible Spending Accounts

Help employees navigate flexible spending accounts (FSAs) and health savings accounts (HSAs) to their advantage. Employees may just need a little reeducation about the cost-savings and value that these types of plans can provide them. Prior to open enrollment, is a great time to remind your workforce of the many reasons why to enroll and use a FSA or HSA. Continue reading

IRS Announces Health Savings Account Contribution Limits for 2018

Health Savings Accounts have received a lot of attention over the past few months as the accounts manifest themselves as a leading option for certain employees enrolled in a high-deductible health plan, allowing these employees to contribute money pre-tax for healthcare expenses in the short- and long-term.

Background

A health savings account a tax-favored account that allows eligible individuals covered by a qualified High-Deductible Health Plan (HDHP) to pay for current and future qualifying medical expenses tax-free. Defined contribution healthcare dollars are commonly used to fund health savings accounts. Signed into law in 2003, these accounts have grown in importance over the years and are expected to be a lynchpin of future healthcare reforms.

May 4, 2017: IRS Announces Contribution Limits for HSAs in 2018

On May 4, 2017, the Internal Revenue Service released Revenue Procedure 2017-37, providing the 2018 inflation adjusted amounts for Health Savings Accounts (HSAs) as determined under § 223 of the Internal Revenue Code. The contribution limits for 2018 are as follows, alongside contribution limits for 2017, graphed by the Society for Human Resources Management:

Contribution and Out-of-Pocket Limits
for Health Savings Accounts and High-Deductible Health Plans
For 2017 For 2018 Change
HSA contribution limit (employer + employee) Self-only: $3,400

Family: $6,750

Self-only: $3,450

Family: $6,900

Self-only: +$50

Family: +$150

HSA catch-up contributions (age 55 or older)* $1,000 $1,000 No change**
HDHP minimum deductibles Self-only: $1,300

Family: $2,600

Self-only: $1,350

Family: $2,700

Self-only: +$50

Family: +$100

HDHP maximum out-of-pocket amounts (deductibles, co-payments and other amounts, but not premiums) Self-only: $6,550

Family: $13,100

Self-only: $6,650

Family: $13,300

Self-only: +$100

Family: +$200

* Catch-up contributions can be made any time during the year in which the HSA participant turns 55.

** Unlike other limits, the HSA catch-up contribution amount is not indexed; any increase would require statutory change.

 

Difference Between IRS and HHS Limits

Additionally, the IRS limits differ from those set by the Affordable Care Act and announced by the Department of Health and Human Services on December 22, 2016:

2017 2018
Out-of-pocket limits for ACA-compliant plans (set by HHS) Self-only: $7,150

Family: $14,300

Self-only: $7,350

Family: $14,700

Out-of-pocket limits for HSA-qualified HDHPs (set by IRS) Self-only: $6,550

Family: $13,100

Self-only: $6,650

Family: $13,300

 

Related Resources: Health Savings Accounts

We’ve been talking about the evolution of HSAs alongside the Affordable Care Act, offering key insights into the best practices for employers, employees, and servicers like banks and other financial institutions. Learn more by reading our resources below:

Webcast Recap: Healthcare Benefits Trends to Watch in 2017

The only constant in the healthcare benefits environment is change. As 2017 marks a “changing of the guard” in the political world, a year in which technology is improving, and a year in which you will need to compete aggressively for the best talent; your organization must be able to adapt, evolve, and provide benefits that meet your employees’ unique needs.

In Wednesday’s article, we took a deeper look at the challenges and opportunities that other employer groups are facing in offering healthcare benefits as we looked into the results of our 2017 Healthcare Benefits Trends Benchmark Study, which was given to all attendees of our webcast and provided many insights from nearly 300 benefits professionals at organizations of all sizes.

Trends and Talking Points: 2017 Healthcare Benefits to Watch Webcast

The Healthcare Benefits Trends to Watch in 2017 Webcast brought together three of the leading voices in the community to present their insights on our survey, as well as offering strategies and predictions for the year ahead.

Featuring Tiffany Wirth, Executive Director of the Healthcare Trends Institute and Vice President of Marketing at WEX Health, Sander Domaszewicz, Principal and Senior Consultant at Mercer, and Chris Byrd, Healthcare Operations Officer at WEX Health, these leaders brought decades of combined experience in healthcare benefits, legal policy, and business strategies, condensing a lot of highly valuable information into a brief, one-hour webcast.

Engagement Driving Changes in 2017

With many employer groups already making changes to their strategies over the past few years—implementing a wellness or preventive health program, adjusting cost sharing, or focusing on defined contribution—the top concern for employers in 2017 is employee engagement.

Engaging these employees, however, does pose a challenge as nearly 40% of employees had concerns about benefit communication and education and only 36% felt that benefit cost information was clearly presented, according to our consumer survey completed in Fall 2016.

Five Top Benefits Communication Methods

With engagement being its own issue, employers need to look at the way they communicate. While email may be right for some, other employees have other preferences, with a notable discrepancy between employer methods and employee needs:

Employer Communication Methods Employee Communication Preferences
Email: 77.1% Website: 54.4%
Meetings with HR/Benefits: 51.4% Printed Factsheets: 47.4%
Print: 49.1% Live Presentations: 38.6%
Intranet: 48.6 Email: 38.6%
Meetings with Advisors: 41.1% Videos: 23.7

 

Employers feel confident in their ability to educate employees, rating themselves at a 7.2 out of 10, roughly in line with employees rating their employers at 69% in the consumer survey.

Cadillac Tax Not Changing Many Minds

Even as this survey was completed during the election season, many employers are still in a holding pattern with respect to the Cadillac Tax. As it had already been delayed once from 2018 to 2020, respondents may have expected the threat of the tax to be delayed again, as fewer than 6% of employers have made aggressive changes to prepare, and a vast majority were waiting for definitive guidance:

  • 6% of Employers haven’t taken any actions
  • 7% are unsure what they need to do
  • 7% were not affected

Some Things Change, Others Stay the Same

As much as there have been changes in the way employers look at benefits, many things have remained steady:

  • Dental, Family Coverage, and Vision were the most commonly offered benefits.
  • Three Quarters of Employers in the last two years believe that benefits offerings are critical to their recruitment and retention.
  • In this and last year’s report, nearly 90% are still yet to make changes for the Cadillac Tax

Much, Much More: Healthcare Benefits Trends to Watch in 2017

If all of the information above came from the first ten minutes of the webcast, imagine what you can learn from the remaining 50 minutes.

The entire Healthcare Benefits Trends to Watch in 2017 features proprietary research into health plans, costs, adoption rates, and more from Mercer, presented by Sander Domaszewicz, Principal and Senior Consultant, and an in-depth look at the legal and regulatory outlook under Trump, the importance of the CURES Act passed last year, and the repeal and replace/revise and repair future for the Accordable Care Act, presented by Chris Byrd of WEX Health.

Learn more about what you can expect and how you can prepare in 2017 by watching the entire Healthcare Benefits Trends to Watch Webcast.