What Do We Know About Enrollment in Consumer-Driven Health Plans?

This paper summarizes the literature on CDHP offer rates and enrollment. Since consumer-driven health plans (CDHPs) were first offered in 2001, estimates of how many workers would be enrolled in these plans have varied widely. The U.S. Treasury Department has predicted that 25-30 million people would be covered by a health savings account (HSA)-eligible plan and would have an account by 2010. The percentage of employers offering CDHPs has gone from virtually none in 2000 to 12 percent in 2009. When examining the entire employment-based market, what had been steady growth in offer rates appears to have slowed. Between 2008 and 2009, the percentage of small firms (3-199 workers) that offered a CDHP declined from 13 percent to 11 percent (although the change was not statistically significant). However, larger firms continued to add a CDHP as an option. The percentage of employers with 500-999 workers reporting that they were likely to offer a CDHP in 2009 was 20 percent, or 6 percentage points higher than the actual offer rate in 2008. The percentage of firms with 1,000 or more workers that offered a CDHP increased from 22 percent in 2008 to 28 percent in 2009. The overall trend rate did not change because employers with 1,000 or more employees account for about 15 percent of all employers. Based on the various sources of data on enrollment in health reimbursement arrangements (HRAs) and HSA-eligible plans, it appears that 15-19 million people were enrolled in these plans in 2009, representing 9-11 percent of the privately insured market. The PDF for the above title, published in the December 2009 issue of EBRI Notes, also contains the fulltext of another December 2009 EBRI Notes article abstracted on SSRN: “Investment Behavior of Target-Date Fund Users Having Other Funds in 401(k) Plan Accounts.”