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Many employers tell us they want to increase enrollment in high-deductible health plans (HDHPs) as well as participation in health savings accounts (HSAs). But without specific goals, it is difficult to define a strategy that will succeed.
So what choices are your people making? How do your decisions as an organization and in communications affect those choices? And what can you do, as an HR leader, to meet your organization’s goals?
Read on for insights and recommendations based on a study of enrollment data from 145 employers representing 2.8 million employees and their families. (See the last page for more information on the study.)
of organizations offer HDHPs.
15% do not offer HDHPs.
of eligible employees enroll in an HDHP.
60% do not enroll in an HDHP.
Let’s start with the basics. Overall, about 85% of organizations offer high-deductible health plans and 62% of employees are eligible to enroll in an HDHP. For organizations that offer an HDHP, 74% of employees are eligible to enroll in an HDHP. And of those employees who are eligible, 40% enroll in an HDHP.
This percentage has increased slightly over the past two years.
The 40% who enroll represent a strict average – the real numbers show that enrollment can range from 1% all the way to 100%. What this means is that an organization’s benefit plan design and pricing strategy significantly affect the results.
So what factors influence enrollment in high-deductible health plans?
Income. This is a significant predictor of enrollment. As income increases, so does HDHP enrollment – up to a point. Employees who earn less than $20,000 annually have the lowest enrollment rate. Enrollment peaks for employees earning $100,000 to $174,000 at 53%, but then begins to decline.
Age. Younger employees are the most likely to enroll. 45% of employees ages 26 to 29 enroll, while only 35% of employees ages 60 to 64 make that choice. Our research also shows that when it comes to HDHP enrollment, income and age have an inverse relationship. For employees ages 26 to 64 and with incomes up to $100,000, the likelihood of enrolling in an HDHP increases as salary goes up and age goes down.
Younger employees at higher income levels are the most likely to enroll in an HDHP, while older employees at lower income levels are the most likely to enroll in a different medical plan.
Marital status. Single employees enroll at higher rates (46%) than married employees (41%).