Anmerkungen:
In: EBRI Issue Brief, Number 435 (July 12, 2017)
Nach Informationen von SSRN wurde die ursprüngliche Fassung des Dokuments July 12, 2017 erstellt
Beschreibung:
This paper examines whether offering a health savings account (HSA)-eligible health plan for free, alongside other health plan options with a premium, alters employee enrollment choices; and if responders differ by health status. The data for this study come from two large employers and cover the years 2011 to 2014, spanning the 2013 intervention when one of the two employers eliminated employee premiums for the HSA-eligible health plan. As a result of eliminating premiums for the HSA-eligible health plan, enrollment increased by 21 percentage points among individuals with employee-only coverage and 25 percentage points among individuals with family coverage. After eliminating employee premiums for all coverage tiers, HSA-eligible health plan enrollment increased from 4 percent to 25 percent among individuals with employee-only coverage and from 3 percent to 28 percent among individuals with family coverage. Clearly, workers and their families are highly sensitive to health insurance premiums, a major driver of plan choice. Healthier-than-average employees are enticed by $0 premiums for HSA-eligible health plans. Offering coverage with no payroll deduction attracted individual enrollees who were marginally healthier than those who would have enrolled without this financial incentive in place; therefore, adverse selection was not mitigated as anticipated. The analysis did not find strong evidence that suggests the positive risk selection routinely reported in HSA-eligible health plan enrollment was moderated by eliminating the premium. While there is weak evidence that prior users of health care services were more likely to enroll in the HSA-eligible health plan as a result of the elimination of premiums, for the most part, the findings are to the contrary. In summary, the financial incentive drew new individuals and families into the HSA-eligible health plan who were on average healthier than those who would have enrolled without the incentive in place. For employers looking to drive more workers to sign up for HSA-eligible health plans, one of the biggest financial incentives they can offer is to reduce or even eliminate the annual premiums