SECTION8. HIGH-DEDUCTIBLEHEALTHPLANSWITHSAVINGSOPTION COST-SHARINGFOROFFICE-VISITS • Thecost-sharingpatternforprimarycareofficevisitsdiffersforworkersenrolledinHDHP/SOs. Thirty-ninepercentof coveredworkersinHDHP/HRAshaveacopaymentforprimarycarephysicianofficevisitscomparedto7%enrolled in an HSA-qualifiedHDHP[Figure8.22]. Workersinotherplantypesaremuchmorelikelytofacecopaymentsthan coinsuranceforphysicianofficevisits(seeSection7formoreinformation). HealthReimbursementArrangements(HRAs) aremedicalcarereimbursementplansestablishedbyemployersthatcan beusedbyemployeestopayforhealthcare. HRAsarefundedsolelybyemployers. Employersmaycommittomakea specifiedamountofmoneyavailableintheHRAforpremiumsandmedicalexpensesincurredbyemployeesortheir dependents. HRAsareaccountingdevices,andemployersarenotrequiredtoexpendfundsuntilanemployeeincurs expensesthatwouldbecoveredbytheHRA.UnspentfundsintheHRAusuallycanbecarriedovertothenextyear (sometimeswithalimit). EmployeescannottaketheirHRAbalanceswiththemiftheyleavetheirjob,althoughan employercanchoosetomaketheremainingbalanceavailabletoformeremployeestopayforhealthcare. HRAsoften areofferedalongwithahigh-deductiblehealthplan(HDHP).Insuchcases,theemployeepaysforhealthcarefirstfrom his or her HRA andthenout-of-pocketuntilthehealthplandeductibleismet. Sometimescertainpreventiveservicesor otherservicessuchasprescriptiondrugsarepaidforbytheplanbeforetheemployeemeetsthedeductible. HealthSavingsAccounts(HSAs) aresavingsaccountscreatedbyindividualstopayforhealthcare. Anindividualmay establish an HSAifheorsheiscoveredbya“qualifiedhealthplan”–aplanwithahighdeductible(i.e.,adeductibleofat least $1,300 for single coverage and $2,600 for family coverage in 2017) that also meets other requirements. Employers canencouragetheiremployeestocreateHSAsbyofferinganHDHPthatmeetsthefederalrequirements. Employersin somecasesalsomayassisttheiremployeesbyidentifyingHSAoptions,facilitatingapplications,ornegotiatingfavorable fees fromHSAvendors. BothemployersandemployeescancontributetoanHSA,uptothestatutorycapof$3,400for single coverageand$6,750forfamilycoveragein2017. EmployeecontributionstotheHSAaremadeonapre-income taxbasis, andsomeemployersarrangefortheiremployeestofundtheirHSAsthroughpayrolldeductions. Employers arenotrequiredtocontributetoHSAsestablishedbytheiremployeesbutiftheyelecttodoso,theircontributionsare nottaxabletotheemployee. InterestandotherearningsonamountsinanHSAarenottaxable. Withdrawalsfromthe HSAbytheaccountownertopayforqualifiedhealthcareexpensesarenottaxed. Thesavingsaccountisownedbythe 4 individual whocreatestheaccount,soemployeesretaintheirHSAbalancesiftheyleavetheirjob. 4 SeeU.S.DepartmentoftheTreasury,HealthSavingsAccounts,availableathttp://www.irs.gov/pub/irs-drop/rp-14-30.pdf The Kaiser Family Foundation and Health Research & Educational Trust / Page 146