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Consumer-driven health care (CDH) accounts, such as healthsavings accounts (HSAs), health reimbursement arrangements (HRAs) andflexible spending accounts (FSAs), offer huge benefit to consumers,employers, and the U.S. health care system. But, despite beingwidely offered by employers, these accounts are too oftenunder-utilized and under-funded.

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According to Aite Group research, only 23 percent ($86.3 billion) ofthe $371 billion spent on out-of-pocket health care costs in 2018are estimated to flow through tax-advantaged accounts. This meansthat a staggering $285 billion will be spent on out-of-pocketexpenses using post-tax dollars, leaving billions in tax savings onthe table. Broken down, a simple change in the way consumers payfor their eligible out-of-pocket medical expenses would saveemployers $22 billion in FICA taxes and consumers another $85billion in state and federal taxes (assuming an averagefederal/state tax rate of 30 percent).

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With open enrollment just around the corner, there are plenty ofthings that brokers and their clients can do to influence accountadoption to help employers take home their share of a $22 billiontax savings opportunity. With CDH account penetration rates rangingfrom single digits to more than 75 percent, clearly, some employershave found ways to push uptake well beyond the nationalaverage.

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Let's learn some tricks of the trade.

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With employers increasingly using consumer-driven healthcare andfinancial wellness strategies to protect their employees againstincreasing out-of-pocket expenses and long-term healthcare costs, how can they best ensure employees adopt theseaccount-based programs this open enrollment season?

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It's not as simple as offering CDH accounts, the plan design andcommunication strategy employers use must be right.

1) Pair a tax-advantaged account with every health planoffered

Nearly every health plan requires some consumer out-of-pocketspending. And, whether the plan is a traditional PPO or a highdeductible plan, there is value in pairing the plan with atax-advantaged healthcare account that enables both the consumerand the employer to save money. Between FSAs, HSAs and HRAs, everyhealth plan offered should be paired with a complementarytax-advantaged account or accounts. If they aren't, both employersand their employees will leave money on the table in the form ofmissed tax savings.

2) Position the consumer-driven health plan towin

According to the National Business Group on Health, this openenrollment season, 39 percent of large employers will onlyoffer consumer-driven health plans (CDHPs). This means that for themajority of employer groups, CDHPs are still offered in parallelwith traditional plans, and, therefore, are still achoice. So, the question becomes: Are your clients' CDHPprograms positioned to win?

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Because it's human nature to resist change, when CDHPs are achoice, employers can expect employees who are currently enrolledin a traditional health plan to resist the transition to aconsumer-driven plan unless the new plan is designed to deliverreal value, is supported with the right training and communicationplan, and is introduced in a way that purposefully disrupts thestatus quo.

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Employers who offer both a consumer-driven health plan and atraditional plan should construct the CDHP so that it is benefitneutral to the traditional plan and gives employees equivalentvalue for out-of-pocket costs. They should consider making premiumadjustments to legacy plans so that there is a clear savings forthe CDHP offering, always require active enrollment so employeescannot passively default into prior year benefit elections, andsupport the program with a comprehensive training and communicationapproach that includes visible endorsement by key executives andleaders.

3) Provide incentives

As you might expect, employer contributions to CDH accounts makea substantial impact on adoption. In fact, an annual employercontribution of $800 to an HSA nearly doubles the adoption rate.According to the same National Business Group on Health research,86 percent of large employers currently contribute to HSAs, with$650 median contributions for single participants and $1,070 forfamilies.

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Some progressive companies are beginning to structure theiraccount contributions more like a 401(k) match. Mercer reports that6 percent of large employers offer matching contributions and 19percent leverage incentive-based contributions, such as wellnessrewards for completing specific tasks that are delivered with acash value directly into the benefit account.

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Regardless of how an employer structures their accountcontributions, they are essential for CDH adoption and willincrease employee satisfaction. Employees will be able to see thattheir employer offers CDH not to shift costs, but to deliver morevalue for the dollars already spent on health care today.

4) Provide robust education and decisionsupport

You know the drill. Employees perpetually struggle to understandtheir benefit options, particularly when it comes to calculatingthe likely out-of-pocket costs associated with different healthinsurance plans. Another recent Alegeus research report found that more than half (51 percent)of consumers can't forecast their likely out-of-pocket costs forthe current plan year.

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Arm employees with the information and tools they need tocalculate the financial implications of their plan options. Inaddition, be sure to educate key staff to properly position andcommunicate the benefits of consumer-driven health plans andaccounts during open enrollment. Benefit account providers shouldmake these resources available to their broker and employerclients.

5) Communicate year-round, not just during openenrollment

According to Alegeus research, communication is a huge barrier toadoption, with 60 percent of employers relying exclusively on plansummary documents and enrollment forms to influence employeedecision making. At the same time, only 33 percent offer plancomparison tools and multimedia educational content and just 17percent offer interactive decision support tools based on personaldata entered.

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While open enrollment is a hugely important time to educate andcommunicate with employees, it isn't the only time to doso. Unfortunately, 65 percent of employers only communicate abouthealth benefit offerings during open enrollment, and as a result,employees are left in the dark most of the plan year. Communicatingwith employees throughout the year keeps timely topicstop-of-mind.

Shift, support, and enroll

If your clients' plan designs are optimized with appropriateincentives to participate in the account and are supported by aneffective year-round communication and training approach, theseaccount-based CDH programs can be an extremely effective benefitstrategy that leaves employees satisfied, engaged, and receivingbetter value for their health care dollars.

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