Besides comparison shopping the latest Mercedes, rectangulargrey back splashes, and lip injection doctors (complete with Yelpreviews and Instagram pics from the Samsung Galaxy), there areother trends to keep up with if an employer wants to be "onfleek." (Don’t know what that means? Look it up. I dare you.)

Employers across industry type, geographic location, and sizeoffer consumer driven health plans (CDHPs) these days.

Per the Kaiser Family Foundation 2015 survey of employersranging in size from 2 to 5000+ lives, the percentage of employeesenrolled in a high-deductible health plan(HDHP) packaged with a health reimbursementarrangement (HRA) or health savings account (HSA)qualified HDHP, between 2006 and 2015 has grown from 4 percent to24 percent (15 percent in compatible plan and 9 percent enrolled ina HDHP coupled with an HRA). They did not report informationregarding FSAs, oddly enough.

In that same 2015 survey, 7 percent of employers offering healthbenefits offered a HDHP/HRA combination and 20 percent offered anHSA.

In a different 2015 employer survey, 69 percent offered FSA, 43percent offered HSA, 19 percent offered HRA. And reported that 17percent of small firms and 74 percent of large firms offer FSAs.While a third 2015 employer survey concluded 90 percent of allemployers offered FSAs, 44 percent offered HSAs, 20 percent offeredan HRA. Bottom line: HRAs are increasing, though not as quickly asHSAs. FSAs are stable, HSAs are increasing.

Adoption rates of the three various account based options is duein part time in marketplace.

There is variance among plan design utilizing any of the three:HRA, FSA, or HSA such as rollover options and employercontributions, or various FSA features like grace period, dependentcare, parking, and transit options, all depending on howemployee-centric they intend to be. This is where the guidance ofan employee benefits advisor is critical.

HRAs are making a comeback, most notably among smaller employers(2 to 100), large employers (5,000+), and any size groups withhistorically low utilization. Their appeal may also increase asthey as they appear to have the least impact on the Cadillac Tax(which is now set to take effect in 2020) thresholds since actualclaims versus potential claims paid from the HRA are expected to beused in the calculations, assuming the Cadillac Taxsurvives.

While FSAs are offered more frequently than the HSA or HRA, theywere offered most often in group sizes 100-500. And HSAs weregenerally offered as one of multiple options among larger employers(500 to 5000+) and as a standalone option in employers 2 to100.

HSAs have not hit their saturation point as they are the newestof the three. And HSAs are also the ones with the most appealespecially now that the marketplace (brokers, employers, providers,and employees) has had over 10 years to understand the triple taxadvantages, flexibility of contribution structure, and transparencytools continue to increase in number, ease of use, andaccessibility. It is apparent the greatest surge of adoption willcontinue to be with HSAs. Their impact to effect the change in theway an employer intends, however, really is contingent uponemployee communication and education strategies. It’s worthrepeating: This is where the guidance of an employee benefitsadvisor is critical.

Purpose of these account-based plans? Short and long term costmanagement and reduce fixed cost of insurance through increasedemployee education, engagement, and accountability.

Next time you are taking a Snapchat selfie with Mr. or Mrs.Jones over a Matcha tea and paleo small plate (formerly known as anappetizer) comparing your latest CrossFit WODs, ask which accountbased plan options they partake in and why.