Over the last few installments of our series on "Top HSA questions," topics have ranged from account rules for spouses to employer contributions and Medicare to plan design. In this final part of the series, I'll address wellness and health savings accounts, more on employer contributions and year-round benefits communication.
Question: I've heard a lot of talk about pairing wellness steps with an HSA-compatible plan. How are employers incorporating wellness into their HSA offering and why?
Answer: Well, this is a natural pairing, because a high-deductible health plan empowers employees to better manage and educate themselves on the impact of day-to-day habits and expenses. I recommend a two-pronged approach to tackling this issue, in which employers arm employees with strategies to improve wellness and provide meaningful incentives to reward positive health decisions. In turn, employees should be more prepared to actively manage the costs associated with their care.
I believe employees are more likely to be actively engaged in their health care choices when it has a direct connection to their pocketbook. For example, simple changes that will positively impact their health and better manage costs for themselves and their employer, include:
- Checking to see if a generic formulary is available for a prescription
- Not using the emergency room as a primary care provider
- Better managing dietary decisions to prevent or better control chronic disease
- Getting an annual physical rather than waiting until there is a progressed health issue
The second part of the equation suggests that employers make this transition easier by considering meaningful incentives that promote positive changes in healthy behavior, reward accordingly and ultimately make the HDHP (high deductible health plan) and HSA an attractive option. For example, for employees that participate in all health screening requirements, which include assessment of height, weight, cholesterol levels, etc., a meaningful contribution can be made right into their HSA. This directly ties back to the employees' financial motivation and positively contributes to their wellness.
Finally, there also needs to be a commitment to educate and engage employees year-round through benefits communication. While many barrage employees with information around open enrollment, the rest of the year provides a great opportunity to discuss health and wellness topics. I'll dig deeper into year-round communication in the final question below.
Question: Is it possible for an employer to recover contributions made into an HSA?
Answer: The short answer is that generally contributions cannot be recovered, and let me explain. Once the employer contribution is made to an account, the employer has no rights to the funds because it has legally become the property of the HSA account holder. That is because HSAs are individually owned trusts. This means that even if the employer made a mistake, such as a typo in a contribution, there is nothing the employer can do to get it back other than asking the recipient to return it (and them agreeing to it).
The only two exceptions where employers can recover contributions are if the person was never eligible for an account, since the HSA never legally existed, or if the contribution was made in excess of the maximum contribution limit the person was eligible to contribute, then the excess amount can be removed.
Question: I understand it's recommended to communicate with employees throughout the year about benefits, not just during enrollment periods. What type of information can be communicated regardless of the time of year to keep communication steady?
Answer: There was a time when talking to employees once a year about benefits, such as when it was time to enroll, was sufficient. But now we're asking people to take a more active role in their health and finances. We're asking them to understand their plans and participate all year long. Unfortunately, reminding them once a year to do all the things we want them to do isn't a great way to get results.
So to answer your question, a better way to influence employees is to give them tips, reminders and updates throughout the year. When tax laws change, useful studies on health and wellness are released, and addressing popular benefits-related topics, are all ways to consistently communicate.
It may also be helpful to develop and follow a schedule, including seasonal health issues, such as pre-enrollment and post-enrollment reminders on benefits, ways to stay in shape in the winter, safety for outdoor summer activities and protecting oneself in the cold and flu season.
I'd also recommend the employer consider using a variety of channels to communicate as each employee has personal preferences about how to receive information whether that be printed materials, intranet feature stories, emails, social media content, etc.
It seems fitting that our "Top HSA questions" series has ended with questions about pairing health and wellness, just as the summer months are upon us and healthy lifestyle choices and opportunities are front and center. By providing information year-round and answering the top questions, employees can be prepared to make the best choices for their personal and financial health.
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