Health Savings Accounts and Health Reimbursement Arrangements : Assets, Account Balances, and Rollovers, 2006-2009

This paper examines HSA and HRA assets, account balances, and rollover amounts. It examines the types of individuals likely to have a consumer-driven health plan (CDHP). It then examines differences in account balances by demographics, income, contribution levels, and engagement in an individual’s own health care, using a regression equation. Rollover amounts are then examined. In 2009, there was $7.1 billion in consumer-driven health plans (CDHPs), which include health savings accounts (or HSAs) and health reimbursement arrangements (or HRAs), spread across 5 million accounts. This is up from 2006, when there were 1.2 million accounts with $835.4 million in assets, and 2008, when 4.2 million accounts held $5.7 billion in assets. Increases in average account balances appear to have leveled off. In 2006, account balances averaged $696. They increased to $1,320 in 2007, a 90 percent increase. Account balances averaged $1,356 in 2008 and $1,419 in 2009, 3 percent and 5 percent increases, respectively. The typical CDHP enrollee was more likely than traditional plan enrollees to be young, unmarried, higher-income, educated, and exhibit healthy behavior. No differences were found between CDHP enrollees and traditional plan enrollees with respect to gender, race, and presence of children. Overall, the number of people with a rollover, as well as the total level of assets being rolled over, have been increasing. The average rollover increased from $592 in 2006 to $1,295 in 2009