HSA Education
Post-Enrollment HSA Education
Keeping Client Relationships Strong

by Kristin Komen

A mid-sized manufacturer decided to replace its medical coverage with a consumer-directed health plan with health savings accounts (HSAs). The company educated its workforce extensively during open enrollment, contributed generously to employees’ HSAs, and followed up with employees early in the plan year.

Every division reported high satisfaction with the new plan and the HSA – but for one. What was different about that outlier? It had rolled out the plan without following the communication strategy from headquarters, giving workers just one opportunity -- at the open enrollment meeting -- to learn how to get the most for their health care dollars. Absent any follow-up, employee buy-in at that division fell well behind the rest of the workforce and continued to lag for several years.

The clear lesson is that ongoing engagement of employees is key to the success of health plans accompanied by HSAs. Brokers can play a key role in this, from helping employers address early-year questions to reinforcing basic education with some simple yet effective techniques that help ease the transition for employees new to HSAs.

In the HSA market, brokers who provide strong service seldom lose clients and often gain referrals, says Tom Lindberg, BenefitMall’s market director for Northern California.

Be Prepared for a Satisfaction Dip

In my experience (and backed up by customer interviews conducted by our company), HSA owners sometimes suffer a dip in satisfaction with their accounts three to six months after account opening. The downturn may be because it usually takes a few months before employees start incurring medical expenses and building up their HSA balances. Some, no doubt, get frustrated because it’s a new routine and a new way of paying for health care.

That’s the time when brokers should be prepared to act and many do. Brokers can provide well-timed educational opportunities to move employees over the bumps by using tools and information provided by HSA custodians combined with their own personal service and strong client relationships. And action yields results: most HSA owners are satisfied or very satisfied with their accounts by the one-year anniversary, according to OptumHealth customer data.

Lindberg notes that the top brokers he works with typically meet with their clients during the first month of the plan year and then hold quarterly meetings thereafter, particularly with groups over 50 lives.

“Brokers with the happiest clients regularly check in with their clients to ask, ‘How can I help?’ send emails to employees to see if they have questions, and post simple explanations of HSAs on their Web sites,” says Lindberg. “HR departments particularly love online chat rooms provided by some large agencies in which employees can submit questions and get a swift reply.”

“You absolutely have to come back at least by mid-year,” agrees Paula Wilson, an employee benefits agent at Paula Wilson Inc. in Temecula, Calif. She recalls the high degree of confusion among employees at a client of 50 lives during a follow-up meeting halfway into the plan year.

“Even though I had spoken to the workers and flooded them with materials and Web links back at open enrollment, they clearly needed a refresher course,” she says. She ran the meeting – mandatory for all employees for an hour and then spent nearly another two hours answering questions. “By the time I was done, the HSA naysayers had largely been converted to enthusiasts,” says Wilson.

Jeff Fallick, principal of Fallick Insurance Services Inc. of Mountain View, Calif., holds brown-bag lunches two months into the plan year at his small and mid-sized clients’ offices and hosts webinars to address employees’ health savings account (HSA) questions.

The lunches often provide eureka moments. “Sometimes an employee who took the HMO instead of HSA hears that a co-worker has $600 in his HSA and says, ‘That’s kind of cool, I didn’t really think about that’ when he made his plan choice,” says Fallick.

Remind Employees to Open Accounts

To start saving in an HSA, of course, employees must open the account at a qualified financial institution. Yet, when the employees elect a consumer-directed health plan many mistakenly believe their employer automatically opens accounts for them. Months later, they still haven’t opened a bank account.

“This is a huge problem,” notes Lindberg, who estimates that well over one-half of eligible employees neglect to open HSAs. Brokers can encourage employers to continually educate employees that it is employees’ responsibility to open an account and that the account can be opened at any time during the plan year.

They can and should also tap the HSA custodian to help. An HSA custodian can work with brokers and employers to make account-opening as simple as possible so employees who want accounts are set up to begin saving as soon as their HSA-qualified health plan takes effect. HSA custodians can also help brokers compare the number of opened accounts with the number of employees with HSA-eligible health plans to identify any gap in the numbers that may prompt the broker to follow up.

Clarify FSA and HSA Differences

Another common source of confusion, early in the plan year, concerns HSA withdrawals. Many employees are accustomed to flexible spending accounts (FSAs), which entitle them to spend whatever amounts they have elected (even if all payroll deductions haven’t occurred) over the period outlined in their benefit plan.

HSAs, on the other hand, are bank accounts. Employees may have to be reminded that they can only use funds actually deposited into the HSA to pay for eligible expenses. Providing a side-by-side comparison chart of FSAs and HSAs can help clarify the differences for employees.

Some brokers, like Paula Wilson, go the extra mile. Employees at a small group client were disgruntled about being ineligible to sign up for the company’s newly installed HSA since they were enrolled in their spouses’ FSAs. So Wilson took matters into her own hands by setting up a schedule to track the expiration date of those FSA plans. A month before the FSA plans expired, she called the employees to remind them not to re-enroll in the FSA so that they could open HSAs.

Anticipate and Answer Commonly Asked Questions

It’s not surprising that employees may be initially confused about how HSAs, paired with a qualified high-deductible health plan, can help them plan, save, and pay for healthcare. Many have spent years making co-payments at the doctor’s office or pharmacy without exposure to their total medical costs.
In many cases, human resources experts are also learning about the new plans and HSAs right along with the employees they serve. Even after open-enrollment meetings are over, I am frequently asked questions like:
• What medical expenses are covered by the deductible?
• How do I pay for doctor visits and medications with HSA funds?
• How do I use my HSA debit card?
• How can I find out how much money is in my account?
• What should I do with the tax forms I get from the bank where I have my HSA?
Working with the right partners and with effective educational materials can make these questions easier to handle, such as an HSA user guide and hand-outs explaining how an employee, who has yet to meet the plan deductible, can pay for medical expenses.

Follow These Steps to Boost Engagement

Research shows that employees become more active, satisfied healthcare consumers when they have access to tools and educational resources. To help their clients achieve high satisfaction levels, brokers can also do the following:
• Ask your HSA custodian for a checklist to make sure that employees have taken all necessary steps to open and fund their HSAs.•
Emphasize time-tested savings principles: start early, make regular deposits and set yearly savings goals.
• Remind employees to keep their receipts for all HSA-eligible medical expenses. They’ll need them if they want to reimburse themselves later from their HSA or if they are audited by the IRS.
As with any new concept, the best approach it to take small steps when rolling out a consumer directed health plan with an HSA. Delivering materials gradually, starting with the big picture, moving to smaller details, and then reinforcing the fundamentals through on-going education is a winning formula.
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Kristin Komen is the regional sales director in California for OptumHealth Financial Services. She can be reached by email at kristin.komen@optumhealthfinancial.com or by phone at 949-251-9540.
OptumHealth Financial Services helps individuals and employers plan, save and pay for health care with tax-advantaged health accounts, benefits and COBRA administration and retiree solutions. It is a division of Optum-Health, one of the nation’s leading health and wellness companies.