The triple tax benefit is very attractive.
Health savings accounts are hot.
Financial advisors, plan
consultants and the news media are recommending the HSAs as a potentially
important element in planning for retirement healthcare costs. Plan sponsors
also appear to be getting on the bandwagon. Consider this eye-opening stat: The
Plan Sponsor Council of America’s 2017 report, “Health
Savings Accounts and Retirement Plans,” found that 75 percent of
companies “regard the HSA as part of their retirement benefits.”
Growth Estimates Vary
HSAs’ popularity makes
sense. Workers worry about retirement healthcare expenses. Employers want to
control healthcare costs, and high-deductible health plans that are
HSA-eligible can provide immediate savings. The convergence of these factors
has led to the idea that HSAs can serve as longer-term savings vehicles, notes
Patrick Delaney, vice president, DCIO Marketing with T. Rowe Price Investment
Services Inc. in Baltimore. “It’s the triple tax benefit that everyone grabs on
to that makes them a viable long-term savings vehicle.”
Estimates of HSAs’ usage
vary. A recent survey from Devenir Research reported
continued strong growth in the number and size of accounts with 22 million
accounts (up 11 percent from 2016) holding about $45.2 billion in assets (up 22
percent from 2016) as of year-end 2017. But a February 2018 Employee Benefit Research Institute study
finds reduced recent growth rates: “In 2017, enrollment estimates in
HSA-eligible health plans vary considerably from 21.4 million to 33.7 million
policyholders and their dependents. But there is one consistency between the
enrollment estimates—most sources show that growth appears to have slowed in
2017, especially when looking at the market share of HSA-eligible health plan
enrollment.”
Challenges
If growth has slowed,
structural obstacles could be one reason. Gregg Levinson, senior director,
retirement with Willis Towers Watson in Philadelphia, points out that HSAs were
never intended to be longer-term investment accounts. Instead, they were
designed as short-term savings vehicles that worked in tandem with
high-deductible health plans.
That’s how account owners
appear to be using the plans. Delany notes that the vast majority of HSA owners
don’t use the accounts as longer-term savings vehicles either because of
awareness, education or financial wherewithal. They instead are using them for
contributions in and distributions out for qualified expenses in the same
year. Another EBRI report for years through 2016
supports that assertion: “On average, account holders appear to be using HSAs
as specialized checking accounts rather than investment accounts … most account
holders appear to be using the accounts to cover current expenses, such as
deductibles, coinsurance and copayments, rather than fully taking advantage of
the tax preference by contributing the maximum. … Very few account owners
invested their HSA balance in investments other than cash despite the tax
saving possibilities. In 2016, 4 percent had investments other than cash.” That
pattern might be changing as account longevity increases, however, Devenir
Research found higher investment account usage of almost 15 percent at year-end
2016 and 18.4 percent by year-end 2017.
HSAs must evolve to gain
wider acceptance like that enjoyed by 401(k)s and other defined contribution
plans, Levinson maintains. In contrast to 401(k) plans, HSAs are not subject to
ERISA fiduciary standard and the market has only recently started to get a
degree of due diligence scrutiny on account fees and investment plan
lineups. Morningstar’s 2017 survey of 10 of the largest
HSA plan providers concluded that only one plan looked “compelling for use as a
spending vehicle and an investment vehicle, suggesting there is much room for
improvement across the industry.”
Starting the Conversation
HSAs aren’t yet a
compelling business story from an assets perspective and it’s not immediately
obvious how advisors can monetize them, says Delaney. But he maintains that
plan sponsors’ growing awareness of and interest in the accounts likely will
generate inquiries whether or not the advisor wants them. Delaney suggests that
advisors become “at least conversant” with the plans’ features and benefits,
otherwise sponsors will have those conversations with other vendors.
Advisors
and consultants can also bring balance to the discussion. T. Rowe Price has
examined HSAs’ pros and cons and Delaney cautions that HSAs
are not the optimal solution for everyone. Employees’ financial circumstances
and medical expenses differ, which means that their ability to use HSAs as
longer-term investments will vary. Instead he maintains that “the best path
forward for Americans to save for health care is probably not just an HSA, but
it’s probably a combination of employer-sponsored savings like pretax or Roth
contributions in conjunction with an HSA if it’s available.”
Article written by Ed McCarthy | Jun 12, 2018
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