Rocket Your Sales With Our Annual HSA Survey

By Leila Morris

Welcome to our annual HSA Survey. We asked the top companies in the state essential questions about coverage and services that affect you, the broker. Read on to find out what plans will work best for you and your clients. Look For Part II of Our Annual HSA Survey in the February 2012 Edition

1. What are the primary services you offer as part of your HSA product?

Aetna: Compatible high deductible medical plan, HSA administration, HSA investment services.

Anthem Blue Cross: We offer Medical HSA Health Plans and an option to in an integrated Banking system through our contracted partners; NY/Mellon.

Blue Shield: Blue Shield offers an integrated eligibility and claims experience for clients that choose an Account Based Health Plan (i.e., Health Plans wrapped with an HSA, HRA or FSA account).  2012 will be a year of choice.  Members can choose a HDHP PPO and couple it with a Health Savings Account or choose a regular PPO or HMO plan and wrap a Health Reimbursement Account around the product.  In either case the member will be empowered to manage their health and wealth.

Cigna: Cigna Choice Fund HSA is an integrated HSA, combining the plan’s entire healthcare and financial management features into one easy-to-use healthcare product. It includes several features, such as health coaching, medical and HSA claim capabilities, a diverse range of mutual fund choices, employee education, and medical and pharmacy cost transparency tools, hospital quality comparison tools, and online health risk assessments.

HealthEquity: HealthEquity provides Member and Employer Web Portals, an integrated online investment platform, and 24/7/365 customer support services.

HSA Bank: Employers benefit from a team of experts focused on designing their company’s HSA program, enrollment meeting participation, and ongoing business support.  Knowledgeable, prompt, and friendly customer service is an integral component of our HSA product for the broker, employer and accountholder.
Accountholders also have access to convenient Internet banking and plenty of self-directed investment choices.  A unique service that we provide for all accountholders is penny funding.  HSA Bank funds each new HSA on the day it’s opened with a penny to meet IRS “establishment”.  This is very important because if the account is not open and someone has a claim it cannot be paid with HSA funds.  With penny funding, accountholders can be reimbursed for eligible medical expenses that occur the day their account is opened. Please refer to hsabank.com for a list of all HSA services offered at no charge to accountholders.

HSA California: The HSA California Exchange is the only small-group, fully integrated HSA program with multiple carriers. Each employee can choose from a menu of HSA-qualified high deductible health plan benefits from Health Net, Kaiser Permanente, and Western Health Advantage with no minimum participation requirements.
HSA banking and savings programs are offered through The Bancorp Bank, with accounts FDIC insured to at least $250,000. Accounts include a free debit card, access to hundreds of investment options, personalized checks, and 24/7 online online banking access. There is no application or fee to open an HSA with The Bancorp Bank.
HSA California also offers Dental, Vision, Hearing, HR Support, Life, and Section 125 POP plans, as well as prescription discounts of up to 75% through the California Rx Card Program, and amusement park, movie ticket, and other discounts through the Cal Perks Employee Discount Program (offered at no cost to enrolling groups).

J.P. Morgan: J.P. Morgan is the right partner to help companies make the transition to HSAs. As one of the first and largest banks in the nation to offer these accounts, we have implemented programs for thousands of employers nationwide and manage over 900,000 accounts and over $1.5 billion in assets.

When companies offer their employees an HSA program through J.P. Morgan, they gain the support and strength of a solid financial institution with experience in the healthcare industry. Yet what truly sets our program apart is the focus on HSA administration.  Our program places a particular emphasis on helping employees track their HSA contributions online or via mobile phones and manage medical expenses, including the ability to store receipts online, which is especially important at tax time.

Kaiser Permanente: Kaiser Permanente offers HSA-Qualified Deductible HMO plans (available to the Individual and Family market, Small, Mid and Large employer groups), PPO plans (available to Small business, and large groups), EPO plans for Individuals and Self–Funded EPO plans. We have selected Wells Fargo as our preferred financial administrator to provide HSAs in connection with our HSA-qualified health plans. Wells Fargo offers to all Kaiser Permanente customers a competitively discounted monthly administrative fee, an FDIC-insured tiered interest rate account, HSA Visa debit cards, investment options, online account management, and dedicated customer service.

SeeChange Health: SeeChange Health Insurance offers high-deductible health plans compatible with HSAs that financially reward members for taking actions to manage their health.

Sterling HSA: Sterling offers education, implementation and account management services through personal sales and service teams, as well as online for brokers, employers and accountholders. Among our primary services are HSA education, enrollment assistance, a review of the EOB, bill paying, record keeping, scanning and archiving of bills, receipts, and other critical information in case of an IRS audit. We also offer options for self-directing investments and flagging expenses submitted as qualified and non-qualified for HSA distribution. Our online services include online enrollment, banking, account transaction information, and the ability to make changes to the HSA account. Our most recent satisfaction survey found that among the Sterling services valued most by our HSA accountholders, online services are at the top of the list with 91% of Sterling accountholders responding favorably.

We offer educational materials and services in English and Spanish. Our trans-created Spanish website includes HSA online enrollment for individuals and employer groups. Our forms and collateral have also been trans-created for clients who prefer Spanish and we have many Spanish bi-lingual customer service representatives to help them.

UnitedHealth Group: UnitedHealthcare is the largest provider of consumer-driven health plans in the country with nearly 3 million members enrolled in consumer-driven health plans that incorporate a health savings account or health reimbursement. Additionally, UnitedHealth Group uses its own financial corporation, OptumHealthBank, for its HSA program administration. OptumHealthBank, an FDIC-insured financial institution focused solely on health care banking, is the nation’s largest HSA administrator. Account holders receive market competitive interest rates on their deposits, online bill payment options, and direct debit card access to their accounts. Additionally, once they get a qualifying account balance, they also can invest in a range of highly regarded no-fee, non-proprietary investment options.

2.  Do you offer an HSA-qualifying high deductible health insurance plan?

Aetna: Yes.

Anthem Blue Cross: Yes

Blue Shield: Yes, Blue Shield offers predictable qualified High Deductible Health Plans that can be wrapped with a Health Savings Account.

Cigna: Yes, Cigna offers a full suite of account-based medical plan designs that meet the definition of a qualified high deductible plan.

HealthEquity: No, HealthEquity offers administration of the HSA benenefit in conjunction with a health plan’s qualifying HDHP.

HSA California: Yes, HSA California only offers HSA-qualified health plans; our portfolio includes seven different HSA-compatible plan designs.

J.P. Morgan: No

Kaiser Permanente: Yes, Kaiser Permanente offers an array of HSA-Qualified Deductible HMO plans for the Individual, Family and Employer group markets, PPO plans for Small and large business groups, EPO plans for Individuals and Self Funded EPO plans.

SeeChange Health: Yes. To the best of our knowledge we offered the nation’s first value-based benefit HSA-compatible plans in the country.

Sterling HSA: As an independent HSA administrator, Sterling can work with all HSA compatible plans — fully insured and self-insured. In mid-2011, we launched Sterling level funding and traditional self-insurance products that do include HSA-qualifying high deductible health plans as an employer option.

3. Are you providing a health spending arrangement or a savings vehicle?

Aetna: Yes.

Anthem Blue Cross: We have partnered with BNY/Mellon and their support staff – ASC/Mellon to provide banking and investment options for the financial piece of our HSAs.  Our integration allows members to login to www.Anthem.com/.ca and be linked to their BNY/Mellon account.

Blue Shield:   Blue Shield offers choice.  Our clients and members can choose to have an integrated HSA model or a stand-alone HSA bank account.  Both options promote pre-tax deposits and after-tax deposits; when the member reaches a certain dollar amount, he/she can choose to invest the savings in mutual funds.

Cigna: Cigna has an extensive offering of consumer products that include an HSA, HRA, healthcare flexible spending account, dependent care flexible spending account, and incentive health reimbursement accounts (Healthy Awards).

HealthEquity: Both. Whether account holders use their HSA as a spending arrangement or a savings vehicle really depends on the consumer.

HSA California: HSA California and The Bancorp Bank have partnered to create a seamless, online approach for employers and employees to fund an HSA with a wide array of savings and investment options.

J.P. Morgan:  We focus on HSA administration.

Kaiser Permanente: Members who enroll in one of our HSA-Qualified Deductible HMO plans can open a health savings account through our preferred financial administrator, Wells Fargo. However, members are also free to open a health savings account with a financial institution of their choice. Our HSA-Qualified Deductible HMO plans are designed to work with HSA administration from any financial institution. In terms of other spending arrangements, Kaiser Permanente also offers different deductible HMO plans paired with Health Reimbursement Arrangements (HRA).

SeeChange Health: No. Members have the flexibility to use the HSA administrator which delivers the most value.  We have preferred relationships with leading HSA providers for the benefit of our clients.

Sterling HSA: Yes. In addition to HSAs, Sterling also provides administration services for HRAs, FSAs, POPs and COBRA.

UnitedHealth Group: Yes. UnitedHealthcare offers several HSA-qualified HDHPs. In addition to administering the medical plan, UnitedHealthcare offers a wide variety of health care services, tools, and tips for its HSA customers.

4. What size employee group is the HSA available for?

Aetna: All sizes of groups.

Anthem Blue Cross: All employee groups are eligible.

Blue Shield: We offer qualified HDHP to be used with an HSA for all markets, including individual and family, small groups (from 2 to 50 employees), midsize groups (51 to 299 employees), and large groups (300+ employees).

Cigna: Our HSA product is available for employers with 50 or more eligible employees.

HealthEquity: Any size. There is no minimum participation requirement for employer groups to offer HSA services with HealthEquity.

HSA Bank: An HSA program is a great choice for any size group. From a small start-up business to a Fortune 500 company, we have the solution for your client.

HSA California: HSA California is available for employers with 2-50 employees.

J.P. Morgan:  J.P. Morgan sells HSAs any size group, from individuals, to large corporations. We offer a streamlined, easy-to-implement HSA program for small and mid-size companies, and a more customizable plan for large companies.

Kaiser Permanente:  Kaiser Permanente offers HSA-Qualified Deductible HMO plans to any group size. PPO plans are available to any group size, and Self Funded EPO plans are available to groups with 500 subscribers.

SeeChange Health: Our fully-insured plans are available to groups of 2-to-200 or more employees. Our sister company, SeeChange Health Solutions offers value-based benefit ASO services that support HSAs.

Sterling HSA: We work with groups of all sizes, including large, medium and small companies. We also work with individuals, many of whom sign up for our HSA online.

5. Is your management team experienced in health insurance, financial services, or both?

Aetna: Health insurance.

Anthem Blue Cross: Anthem has subject matter experts in health Insurance and the financial services for our HSAs plans. These associates can work with the client and agent/broker to explain all processes.

Blue Shield: Blue Shield’s management team is experienced in health-care services, but works closely with our preferred vendors—Health Equity, which provides the integrated model; and Wells Fargo, for stand-alone accounts.

HealthEquity: HealthEquity’s management team has both health insurance and financial services experience, and our founder and CEO is a board-certified general surgeon.

HSA Bank: Our entire team of HSA experts, especially our regional vice presidents located nationwide, is highly experienced in both the health insurance and financial services.

HSA California: Both.

J.P. Morgan:  Our HSA team has over 50 years experience working with national health plans and HSA administrators.  We are also heavily involved in industry organizations such as AHIP, ABA HSA Council and ECFC.

Kaiser Permanente: Kaiser Permanente’s management team is experienced in health insurance and HMO plans. Our preferred HSA administrator, Wells Fargo, brings the appropriate financial services expertise.

SeeChange Health: Our leadership has extensive experience in health insurance and financial services as well as with value-based benefit plan designs.  Our team works closely with brokers and clients to ensure a smooth and successful enrollment and long-term relationship with SeeChange Health.

Sterling HSA: Sterling HSA’s executive team has extensive experience in healthcare, insurance, and consumer directed account management. We have complemented those skills with staff and advisory board members who have experience in financial services to optimize support of our clients during enrollment and to manage their accounts with us long-term.

UnitedHealth Group: Both.

6. Do you provide training for brokers about HSAs?

Anthem Blue Cross: We provide ongoing broker communications, newsletters, and product demonstrations as new products are introduced.

Blue Shield: Yes, Blue Shield provides a continuing education seminar on HSAs to our IFP brokers periodically.  Brokers also have access to educational programs and tutorials through Health Equity and Wells Fargo websites: http://www.healthequity.com/BSCemployeeEd
https://www.wellsfargo.com/com/retirement-employee-benefits/hsa/broker-sales-support

Cigna: Cigna provides consumerism education on products including the HSA to brokers via forums and through highly skilled sales managers.

HealthEquity: Yes. HealthEquity offers a number of HSA continuing education courses on a nationwide basis. We also provide broker education through online tools, webinars, and other live training events.

HSA Bank:  Yes! And, we love to. Your regional vice president, David Drzymkowski, is happy to visit your office and host a Lunch and Learn on the basics of an HSA or how to increase adoption at enrollment meetings. Or, if you have brokers spread out in various cities – ask us for a Webinar.

HSA California: Yes. HSA California has dedicated HSA experts ready to provide personalized training and HSA education to brokers. We can be reached between 8 a.m. and 5 p.m., Pacific Time, Monday-Friday at sales@hsacalifornia.com or toll-free at (866) 251-4625. HSA California also provides ongoing seminars to provide brokers with the necessary information and tools to explain High Deductible Health Plans and HSAs to clients.

J.P. Morgan: Yes, we conduct monthly webinars and can also set up meetings at our clients’ offices to answer any questions brokers or their clients may have regarding managing HSA programs.

Kaiser Permanente: Yes. We provide training to our brokers. In addition, our preferred financial administrator for HSAs, Wells Fargo, has a dedicated support line to assist our brokers with questions.  Wells Fargo also has an online flash educational presentation for our customers about HSAs online at:wellsfargo.com/investing/hsa/demo

SeeChange Health: Yes. We provide extensive training on all of our value-based benefit products, including HSA-compatible plans. We also work with the state’s major general agencies to help educate brokers.  Our training options include individual sessions, group “lunch and learns,” webinars and CE courses.

Sterling HSA: Yes. Sterling offers a variety of training options, including CE courses, webinars, “lunch and learn” meetings for large regional brokerage groups, and individual sessions pairing Sterling account representatives with brokers and consultants.

7. What commissions are paid to brokers and when?

Aetna: Standard commission levels, monthly.

Anthem Blue Cross: Brokers are paid the standard medical commission for the HSA compatible medical plan.

Blue Shield: Blue Shield does not pay commissions for HSAs because we administer the HDHP.

Cigna: Cigna pays its standard commissions for HSA sales.

HSA Bank: We recognize the important role you play in our success. To show our appreciation, we created a producer recognition program that rewards brokers on three levels beginning at ten HSAs. For more info, visit hsabank.com.

HSA California: HSA California pays standard commissions monthly.

J.P. Morgan:  When brokers recommend J.P. Morgan to their clients, they deserve our special thanks. We are now in the process of evaluating ways to acknowledge their continued trust in our products and services. For more details as they become available, contact us at 866-566-6653.

Kaiser Permanente: Brokers are paid the standard medical commissions for all of our HSA-qualified health plans.

SeeChange Health: We pay 7% level commissions for groups of 2-to-50 employees and 5% level for groups of 51 or more employees.

Sterling HSA: Commissions for our HSA business are 10% of the fees for all new and renewing groups and are paid quarterly. We also pay commissions on HRA, FSA, and POP business.

UnitedHealth Group: UnitedHealthcare’s standard commission schedules and payment processes apply to the CDH products.

8. Are electronic enrollment forms accessible through your Website?

Aetna: Yes.

Anthem Blue Cross: Yes.

Blue Shield: Enrolling online eliminates the need to complete and mail in paper enrollment forms, provides an efficient enrollment process that is accurate and secure, and delivers immediate enrollment confirmation to employees.
During the Blue Shield group installation for our integrated program, the client will be seamlessly set up with HealthEquity.  Blue Shield will pass employee eligibility information to HealthEquity, which will automatically set up bank accounts.  The client will be able to fund its employees’ HSA through payroll deduction.

Employees enrolling in a Wells Fargo Health Savings Account (HSA) through their employer are able to conveniently enroll online directly with Wells Fargo.

Cigna: Cigna provides an online and paper version of the HSA bank enrollment application. Employers can provide online or paper enrollment options for their employees.

HealthEquity: Yes. Once the member has enrolled in a qualified plan, they can sign up for their HSA directly from the HealthEquity website (www.healthequity.com). Members can enroll through the online enrollment process or by downloading the enrollment form and submitting it to HealthEquity.

HSA Bank: We do.  Auto enrollment provides an efficient, quick way to open the accounts automatically—no paperwork, no separate process required, no signature.

HSA California: PDF enrollment forms are available on our Website at www.hsacalifornia.com.  Employers and employees can open and fund an HSA on our Website through a simple process driven by our partner, The Bancorp Bank. Employers can even maintain employees’ membership information online.

J.P. Morgan:  Yes, most of our clients and account holders enroll in the HSA via the online portal.  Employers can customize their program including the ability to pay for HSA fees and provide employees access to any of the customized communications materials we offer.

Kaiser Permanente:  Individuals and Families can apply for Kaiser Permanente health plans online by logging on to: kaiser.healthinsurance-asp.com/expressweb/user/Welcome.action Wells Fargo: HSA Employer and Individual applications can be downloaded at wellsfargo.com/hsa.
Kaiser Permanente health plan enrollees from companies whose employer is not sponsoring an HSA, and individuals enrolled in Kaiser Permanente’s Individual and Families health plans, can open and fund an HSA account online at: wellsfargo.com/investing/hsa/enroll.

SeeChange Health: We will add this functionality in 2012.

Sterling HSA: Yes. We provide online enrollment for individuals who are part of employer groups, individuals seeking an HSA administrator on their own, and for employer groups to manage the HSA enrollment of employees. Sterling account enrollment and management forms are also available on our website at www.sterlinghsa.com in a fill-able PDF format to download, complete, and email or mail to Sterling. Our online enrollment and paper forms are available in English and Spanish.

9. How do you assist account holders with paying medical bills?

Aetna: We provide cost estimator and quality assessment tools.

Anthem Blue Cross: High Deductible Health Plans engage the members to be knowledgeable about their healthcare treatment and management of funds.
Members manage their own bank accounts, pay for their medical and Rx needs with their HSA account.  Members can view online their banking balances and their claim activity.
Account status and explanation of benefits documents are available through our Website.
Members can use their debit card or Mellon checks to pay for their out-of-pocket responsibility.  The customer service advocates are available to help members understand their financial responsibility.

Blue Shield: With our new Account Based platform with Health Equity, there are just five simple steps from visit to reimbursement:

• Member visit to healthcare provider
• Claims sent to HealthEquity by Blue Shield
• Automatic notification of responsibility
• Claim and account information on the same screen
• Provider paid directly or reimbursement from CDH account

When employees are notified of a claim with member responsibility, they just access the website to process payment and reimbursement.  After viewing the claim detail, members can choose the action to be taken:  pay provider, reimburse themselves, or close expense.  The medical expense payment process is easy and flexible.  Members can directly pay a provider from their HSA pre-tax account or add an additional external bank account; both pre- and post-tax distributions are tracked and housed on the member portal for tax reporting purposes.

Cigna: Cigna helps account holders manage their healthcare expenses with information decision support tools and ready access to HSA funds. Cigna provides cost and quality information according to the individual’s plan for more than 200 procedures performed by specialists, in hospitals and in outpatient facilities. The pharmacy price quote tool compares actual real time out-of-pocket costs for brand name, generic and over the counter medications at 57,000 pharmacies nationwide.

HealthEquity: HealthEquity provides a debit card to account holders so they can pay for eligible expenses directly at the point of service. Alternatively, members may choose to wait for the insurance claim to process before paying for the expense. Once the claim is processed, it appears on the HealthEquity Member Portal where the account holder can login and determine how to pay the claim. If the account holder wishes to pay the provider with their HSA funds, HealthEquity will mail a check directly to the provider.

HSA California: Our carrier partners – Kaiser Permanente, Health Net, and Western Health Advantage – have created special units within their organizations to help members enroll in HSA California.

J.P. Morgan: Expense management is the key to helping employees become educated healthcare consumers.  To assist employees, we offer the ability to store receipts online including those expenses paid out of pocket.  Employees can use direct deposit for self-reimbursement, access online bill pay to make payments, as well as download expense details to financial planning sites.

Kaiser Permanente:  Money in the HSA can be used to pay for a variety of qualified medical expenses ranging from routine physicals to prescription drugs. To pay for expenses, the member can simply present their HSA debit card to the provider, and money will be deducted directly from their HSA. However, if the member wants to pay for services out of pocket and submit an HSA reimbursement claim manually, they can.  Kaiser Permanente’s Member Service Unit can support our members with any medical bill question or concern. A member can also write their HSA debit card number on their Kaiser Permanente bill and remit for payment.

SeeChange Health: We help our members understand their share of medical treatment and how they can offset those costs by completing Health Actions designed to help them manage their health. Expenditures from their HSA are handled directly between the member and their account administrator.

Sterling HSA: Sterling reviews the EOB and medical bills for health plan discounts to insure that our accountholders do not spend more for a healthcare service or product than the insurance company would pay. We also alert accountholders when we spot disbursements that do not appear to comply with IRS rules.  A number of our clients come to us for help with payment plans in the event there are insufficient funds to pay a medical bill. This service is especially valuable in this difficult economy. We also partner with Medical Cost Advocate to help our accountholders negotiate medical costs before and after they are incurred.

10. How does the administrator help the accountholder with insurance-related questions?

Aetna: Customer service representatives are available by phone and  through our website.

Cigna: Cigna offers integrated customer service via our myCigna.com website and 24/7/365 toll-free telephone service to respond to questions about the member’s health insurance and the HSA.

Anthem Blue Cross: Anthem provides online resources as well as a customer service support line for all members.  Support numbers are listed on the member’s health insurance card.

Blue Shield: All HDHP-related questions are referred back to Blue Shield.

HealthEquity: Should the member call HealthEquity, our support specialists will be able to help the account holder understand basic health plan information such as: eligibility, claims for reimbursement, co-pays, deductibles, and co-insurance information. HealthEquity can facilitate “warm transfers” to the health plan for detailed issues involving claims, coverage, or other health plan-specific information.

HSA California: Both HSA California and The Bancorp Bank have customer support teams with expert knowledge available by phone or e-mail from 8 a.m. to 5 p.m., Eastern Time, Monday-Friday. (866) 271-2649 or HSAInvestments@TheBancorp.com.

J.P. Morgan:  We help educate employees on how HDHPs and HSAs work together, and even work with employers to provide details on the health plan as needed.  We also have developed partnerships with many of thenation’s largest health plans.

Kaiser Permanente: Our preferred financial administrator for HSAs, Wells Fargo, refers insurance-related calls back to Kaiser Permanente (KP). KP member service representatives are trained to answer any insurance related questions our members may have.  At kp.org, we also have a website for deductible plan members to educate themselves about what to expect pre/during/post visits with our providers, including decision support tools (e.g., preventive services list, sample fee list, interactive treatment fee tool) that may facilitate better understanding of their insurance coverage and optimize the wide range of health-related services offered by KP. Visit kp.org/deductibleplans to find out more.

SeeChange Health: Account administrators refer plan coverage questions to SeeChange Health. Our Customer Service representatives are available by email or phone from 5am-8:30pm.  Additionally, members can access helpful information and tools through MySeeChangeHealth.com.

Sterling HSA: Our customer service representatives are available Monday – Friday from 7 am to 6 pm Pacific. Clients and brokers can reach us toll-free at 800-617-4729 and via e-mail at customer.service@sterlinghsa.com.

UnitedHealth Group: UnitedHealthcare’s Customer Care Professionals are available by phone to respond to all insurance and account-related questions; a number of resources, including calculators and FAQs are also available online at www.myuhc.com.

11. Is the administrator integrated with the health plan?

Aetna: Yes, The administrator provides a diverse fund selection by asset classes supporting a range of investment objectives.

Anthem Blue Cross: Yes, BNY/ Mellon provides consumers with:
• Online Checking Activation Services through Anthem.com/ca
• Interest-bearing checking account
• Anthem-branded MasterCard debit card
• Checkbook
• Consumer receives the HSA debit card, checkbook, etc. after completing the activation process
• Online Monthly HSA Statements (bank statement)
• Annual Tax forms: 1099s (January), 5498s (May)
• Online Investment opportunities through its subsidiary Dreyfus
• New in 2011, Online Bill Pay for the members medical fees

Blue Shield: Blue Shield offers a fully integrated experience through
our partnership with Health Equity. Our new Account Based platform offers a completely integrated healthcare experience for both members and clients.  All accounts are on one platform with integrated enrollment and claims information, and flexible contribution models.  We will also provide clients with an Employer Portal with access in real time to eligibility information, contributions, fee payments, and more.  Clients will also be able to run reports for easy reconciliation.

Cigna: Yes, the HSA is fully integrated with the high deductible health plan.

HealthEquity: HealthEquity’s integration capabilities differentiate us in the HSA marketplace. In addition to integrating with health plans, we currently support single sign-on methodology with 21 different partners.

HSA Bank: No. This makes it hassle-free when a broker moves a group from one carrier to another. Why? They can keep the account with HSA Bank.

HSA California: HSA California is completely integrated with The Bancorp Bank. Eligibility is automatically transferred to The Bancorp Bank, so that account set-up is simplified; employers can set up employee HSAs, fund employee HSAs, and complete other administrative capabilities – all online.

J.P. Morgan: An HSA program from J.P. Morgan can be paired with High Deductible Health Plans from any insurance company. Clients won’t have to switch HSA administrators just because they switch health plans. That makes it easier for brokers to provide new, more cost-effective solutions whenever the situation warrants.

Kaiser Permanente: No, Kaiser Permanente provides the health plan services and Wells Fargo, our preferred financial administrator for HSAs, provides the financial account.

SeeChange Health: No as members are free to select any HSA administrator they choose.

Sterling HSA: We are an independent administrator available to work with all health plans across the nation.  We have the ability to pull EOB information from the carrier for payment on behalf of our accountholders.

UnitedHealth Group: Yes, in 2002, UnitedHealth Group chartered OptumHealthBank to help advance the growing convergence of healthcare and financial services and to give consumers a more integrated experience.

12. Are investment choices limited by the administrator?

Anthem Blue Cross: There are over 20 investment opportunities Through BNY/Mellon’s subsidiary Dreyfus.

Blue Shield: Under the Health Equity program, employees can invest their HSA dollars directly from the website after reaching the $2,000 minimum balance; investments are on the same, single platform.  There are no fees to invest and members can access up to 12 different mutual funds and each fund prospectus.  Tax statements are also available on the website.  Wells Fargo has 13 mutual fund options available for investment options.

Cigna: Cigna offers a customized slate of diversified HSA investment options through JP Morgan Chase as part of our Cigna Choice Fund HSA.

HealthEquity: HealthEquity has selected a standard investment slate of 49 funds across 15 investment categories from which enrollees can choose to invest.

HealthEquity provides a completely integrated investment experience at no additional cost to the member. The Member Portal is an integrated platform with the investments, so employees do not have to log out and log back in to a separate site. Both the cash position and the invested position are reported on the account holder’s same monthly statement. HealthEquity offers a user-friendly investment desktop where employees can review their target and actual holdings. Account holders are allowed to set their target mutual funds directly from the HealthEquity Member Portal.

HSA Bank: No. All investment options are self-directed by the account-holder. There’s no minimum HSA balance to begin investing. And, there’s no default investment based on account balance.

HSA California: The Bancorp Bank offers an extensive investment portfolio, from FDIC-insured savings accounts to more than 7,000 investment options.

J.P. Morgan:  We offer a competitive slate of mutual funds – all with no front-end or back-end loads, as well as no fees for making online trades.

Kaiser Permanente: The Wells Fargo HSA offers both an FDIC-insured interest bearing deposit account plus the option to direct funds into pre-selected investments and mutual funds.  For more information on Wells Fargo Advantage Funds®, visit wellsfargo.com/advantagefunds or call (800) 222-8222.

SeeChange Health: That will vary based on the HSA administrator chosen by the member.

Sterling HSA: Not at all. Our accountholders can choose any IRS qualified investment for their HSA funds, including stocks, bonds, mutual funds, and CDs. We made arrangements with Partnervest Securities LLC to offer investment services at a discounted fee for Sterling accountholders. Partnervest also provides Sterling with monthly account balance information to ensure the outside investment information contained in Sterling HSA account records is current. Partnervest contact information is available on our website at http://www.sterlinghsa.com/products/hsa/investment_services/

13. What forms are needed to submit an HSA case?

Aetna: Aetna’s standard enrollment processes are used. There are separate medical and HSA elections. Eligibility/enrollment options are electronic batch enrollment, paper enrollment, and Web enrollment.

Anthem Blue Cross: An HSA Addendum and Agreement need to be completed. The HSA Addendum captures how the Employer wants to fund their employees’ accounts.  The HSA Addendum is stating you will or will not use our integrated banking option. HSA Agreement must be signed if the Employer chooses our inegrated partner BNY/Mellon.

Blue Shield: There are no extra forms needed; all questions are included in your Blue Shield group installation paperwork.

Cigna: Cigna’s standard processes and forms are used for all Cigna products including the HSA.

HealthEquity: No forms are required. Employers as well as employees
have the ability to set up their accounts online or, if they prefer, download and complete a paper application. Some of our carrier partners offer integrated enrollment, making the setup process even easier.

HSA California: Standard application forms are needed to submit an HSA California case. These forms are available at www.hsacalifornia.com.

J.P. Morgan:  We require employers to complete only one form.  Once received, the HSA program can be established in 7-10 business days.

Kaiser Permanente: We require our standard application and enrollment process plus necessary forms to set up the Wells Fargo HSA. Wells Fargo: A broker must complete the “HSA Broker Supplement – Application for Services” form and an “HSA Employer Application”. You can find copies of the applications at wellsfargo.com/hsa

SeeChange Health: No special forms are required when applying for an HSA-compatible plan.

Sterling HSA: It’s very simple. Just a completed employer group application (for groups) and an individual accountholder application for each accountholder, along with a list bill and employer preferred form of contribution. Online enrollment and forms are available at www.sterlinghsa.com.

UnitedHealth Group: Employers contributing to the HSA account are required to complete an employer discovery document.

14. Do you plan to offer an HSA-eligible plan to your own employees?

Aetna: Aetna Inc. offers several HSA-eligible plans to our employees.

Anthem Blue Cross: All Anthem Blue Cross and WellPoint eligible employees ave the option to choose a Lumenos HSA plan.

Blue Shield: Blue Shield employees have been offered a High Deductible Health Plan and HSA since January 1, 2007.

Cigna: Yes, Cigna has offered employees HRA and HSA plan options since January 2005.

HealthEquity: Yes, HealthEquity’s benefit-eligible employees are enrolled in HSA-qualified plans.

HSA Bank: Absolutely. We offer a couple of HSA-eligible plans for our employees.

HSA California: CHOICE Administrators, the company behind HSA California, CaliforniaChoice, CaliforniaChoice 51+, Kaiser Permanente Choice Solution, Contractor’s Choice, and Choice Builder, currently offers its employees access to HSA-compatible plans.

J.P. Morgan: Thousands of J.P. Morgan employees are enrolled in HSAs.

Kaiser Permanente: We consider our entire portfolio of health plans for our own employees.

SeeChange Health: Yes.

Sterling HSA: We have offered our employees an HSA plan since Sterling was founded in 2004.

UnitedHealth Group: All UnitedHealth Group employees have the option of enrolling in all an HSA or HRA.

15. Are you using a trustee? If so, how long have you been with the trustee?

Aetna: Yes, since May 2004

Anthem Blue Cross: Anthem has partnered with BNY/Mellon FDIC to offer all of your banking needs for your HSA account.

Blue Shield:  Blue Shield has vendor relationships in place today with Wells Fargo (since 2004) and, for our integrated model, Health Equity (new for 2011).  Both vendors are qualified trustee and custodians that administer health savings accounts.

Cigna: JP Morgan Chase has been the trustee for our Cigna Choice Fund HSA product since January 1, 2005.

HealthEquity: HealthEquity is the HSA trustee and has been administering HSA services this way since 2005.

HSA California: Yes. The Bancorp Bank handles HSAs directly; HSA California’s relationship with Bancorp dates back to the start of HSA California, but the bank has been offering services to customers since 2000. The HDHP insurance plans are fully insured products from Health Net, Kaiser Permanente, and Western Health Advantage.

J.P. Morgan: We are the bank and the trustee.

Kaiser Permanente: We first began selling HSA-Qualified Deductible HMO plans with an optional HSA through Wells Fargo in our Colorado, Georgia and Northwest regions in 2005, Mid-Atlantic States in 2006, and California and Ohio in 2007.

SeeChange Health: Members are free to choose their own HSA administrators and, consequently, their own trustees.

Sterling HSA: Sterling does not use a trustee. BNY Mellon Corporation is the custodian of assets of accountholders of health savings accounts administered by Sterling Health Services Inc. and is investment manager of assets in accordance with the Sterling Health Services Inc. Administrative Services Agreement.

UnitedHealth Group: Yes, UnitedHealthcare partners with Optum HealthBank for trustee services. UnitedHealthcare’s parent company, UnitedHealth Group, chartered OptumHealthBank in 2002 to help advance the growing convergence of health care and financial services.

16. What service guarantees do you offer?

Aetna: We do not offer HSA service guarantees.

Anthem Blue Cross: We do not offer performance guarantees in the Small Group market or Individual market.

Blue Shield: In order to ensure our members consistently receive excellent customer service, we have a number of service level agreements in place as part of our relationships with Wells Fargo and Health Equity (e.g., performance agreements for average speed of telephone response).

CIGNA: The standard performance guarantees apply.

HealthEquity: For larger clients, our service guarantee levels are negotiated during the contract phase. We pride ourselves on meeting or exceeding all service guarantee levels.

HSA California: HSA California’s customer service team is committed to outstanding service and 100% customer satisfaction. Our expert staff is available between 8 a.m. and 5:00 p.m., Pacific Time, Monday-Friday, for personal assistance by calling 866-251-4625.

Kaiser Permanente: We do not offer service guarantees to the Individual, Family or Small group markets.

SeeChange Health: We strive to provide excellent service on all of our health plans.

Sterling HSA: Sterling offers a full money-back guarantee of up to 12 months of paid monthly maintenance fees if our accountholders are unhappy with our service for any reason. Sterling was the first HSA administrator to offer such a guarantee and made this commitment when the company was founded in 2004.

UnitedHealth Group: Service guarantees will  vary  based on the scope of the relationship with the customer, but are typically available with respect to administrative service delivered under the plan.

17. What kinds of depositories are desired?

Aetna: Not applicable.

Anthem Blue Cross: There is no minimum balance requirement.

Blue Shield: As members may open their HSAs with the financial institution of their choice, depository guidelines will vary by financial institution.

Cigna: There are no minimum deposit or balance requirements. Contributions to the HSA can be funded through employer facilitated pre-tax payroll contributions (EFT/ACH transactions) or through unscheduled deposits in which participants arrange for an EFT.

HealthEquity: HealthEquity is the custodian; we have depository arrangements in place and have used depositories recommended by our health plan partners.

HSA California: There is no minimum balance requirement to open an HSA, and no minimum deposit requirement for employer groups.

Kaiser Permanente: Our preferred financial administrator for HSAs, Wells Fargo, does not require minimum deposits for employer groups with payroll deduction.  The minimum deposit of $100 is required for individual and family plan members not enrolling through an employer group.

SeeChange Health: This will vary based on the HSA administrator chosen by the member.

Sterling HSA: Sterling accepts cash, checks, and electronic fund transfers through www.sterlinghsa.com in a secure, password protected environment. We recommend an initial deposit of $100 and require a minimum balance of $20 to keep the account open and active.

18. Where is your company headquartered?

Aetna: Hartford, Conn.

Anthem Blue Cross: The headquarters building for Anthem Blue Cross is located at 21555 Oxnard Street, Woodland Hills, CA.

Blue Shield: Blue Shield is headquartered in San Francisco, California.

CIGNA: CIGNA HealthCare is headquartered in Bloomfield, Conn.

HealthEquity: HealthEquity is headquartered in Draper, Utah. HSA Bank: We are headquartered in Sheboygan, Wisconsin. HSA Bank is a division of Webster Bank, N.A. headquartered in Waterbury, Connecticut.

HSA Bank: We are headquartered in Sheboygan, Wisconsin. HSA Bank is adivision of Webster Bank, N.A. headquartered in Waterbury, Connecticut.

HSA California: HSA California is based in Orange, Calif., and does business throughout the state.

J.P. Morgan: We are headquartered in New York City, and have over 6,000 branches and 16,000 no-fee ATMs nationwide.

Kaiser Permanente: Oakland, California.

SeeChange Health: San Francisco, California.

Sterling HSA: We are a California owned company and are headquartered in Oakland, CA. We serve clients nationwide and have sales representatives in the Southwest, Northeast, Midwest, and California.

UnitedHealth Group: Minnetonka, Minn.

19. Please provide the phone number and e-mail that brokers can use to find out more about your plan.

Aetna: 877-249-2472, prompt 6

CIGNA: Please contact your local CIGNA HealthCare sales representative at 888-802-4462.

Anthem Blue Cross: Please reference our online resources or contact the regional sales manager for individual and small group assistance. Large Group representatives should likewise call their group sales manager at the company.

Blue Shield: Brokers can call their Blue Shield sales representative or call Blue Shield Producer Services at (800) 559-5905 or visit Producer Connection at www.blueshieldca.com.

HealthEquity: Brokers who would like more information can contact HealthEquity’s Broker Sales Team at 877-949-6727 or dcoffman@healthequity.com.

HSA Bank: Call David at (949) 374-2853 or email him at ddrzymkowski@hsabank.com. Or, call our Business Relations team at (866) 357-5232 or email businessrelations@hsabank.com. Our HSA experts are dedicated in the support of brokers and your employer groups. We’re here to help you!

HSA California: Brokers can call us at (866) 251-4625 between 8 a.m. and 5 p.m., Pacific Time, Monday-Friday, or e-mail us anytime at sales@hsacalifornia.com. Brokers can also visit us online at www.hsacalifornia.com, where they will find free sales training collateral, brochures, and forms to print and share with clients.

J.P. Morgan: Call Meghan O’Shea at 312.954.6927 or Laura Podraza at 312.954.4016 to get started.  You can also visit us online at www.jpmorgan.com/hsa.

Kaiser Permanente: For questions or information about Kaiser Permanente: BrokerNet Website Address: brokernet.kp.org Individual and Family Broker Sales: 1-800-789-4661, option 6 or 1-800-207-5084 (8:30 a.m. to 5 p.m. PST)
Small Business Broker Sales: 1-800-789-4661 (8:30 a.m. to 5 p.m. PST)
Client Services Unit: 866-752-4737 (8 a.m. to 5 p.m. PST)
For questions about Wells Fargo:
Members can contact the Wells Fargo Health Benefit Services toll free at 1-866-884-7374 from 5 a.m. – 6 p.m. PST / 8 a.m. – 9 p.m. EST, Monday – Friday
Employers/Brokers can contact the Wells Fargo Health Benefit Services toll free at 1-866-449-9929 from 5 a.m. – 6 p.m. PST / 8 a.m. – 9 p.m. EST, Monday – Friday

SeeChange Health: Brokers can call SeeChange Health’s sales support team at 888-237-6650 or email them at Sales@SeeChangeHealth.com. Brokers can also contact their preferred General Agency to learn more about our HSA and other offerings.

Sterling HSA: Brokers can contact any of our sales representatives. Their names, email addresses, phone numbers and territories are available at www.sterlinghsa.com on the Contact Us page. Brokers can also email broker.support@sterlinghsa.com or customer.service@sterlinghsa.com. Our phone number is 800-617-4729 and we’re available from 7 am – 6 pm Pacific. Personal service and account support is a hallmark of Sterling HSA.

UnitedHealth Group: For more information, please visit www.united-healthcare.com.

20. Which market segment (small/mid/large) do you anticipate these plans will best accommodate?

Aetna: All segments.

Anthem Blue Cross: We are seeing interest and adoption in all market segments.

Blue Shield: HSA-eligible plans continue to generate interest from all market segments, including individual and group markets.  Therefore, Blue Shield members enrolled in HSA-eligible plans span across all lines of business, from the individual and small group markets to large employers.

HealthEquity: HealthEquity’s block of business mirrors the national trends – our customers range from individuals to small “mom & pop” shops to Fortune 500 companies. Each of these segments has grown rapidly in the last couple years, and we expect this trend to continue.

HSA California: We believe HSAs are appealing to all market segments; however, HSA California is designed for employers with 2-50 employees.

J.P. Morgan: We believe an HSA program can fit the needs of organizations regardless of their size.  We work with thousands of employers to develop the right solution for their companies.  Our HSA program can be tailored to meet a company’s needs or policies through customized employee educational materials, integration arrangements with their vendors, secure online transmission of information, and other features.

Kaiser Permanente: Our HSA-Qualified deductible HMO, PPO and EPO plans appeal to all market segments, including Individual and Family, Small, Mid and Large

SeeChange Health: HSA-compatible plans have matured greatly in the past several years, becoming popular with all market segments.

Sterling HSA: HDHP/HSAs accommodate all market segments and we serve them all today.

UnitedHealth Group: All segments.

21. What channels have been most effective in selling HSAs?

Aetna: Brokers and general agents, consultants, Aetna sales force

Anthem Blue Cross: Agents and brokers remain our most effective channel for HSA marketing and sales.

Blue Shield: Our HSA-eligible high-deductible health plans are primarily sold via soliciting brokers. To assist brokers in selling our HSA-eligible plans, we’ve provided educational and marketing collateral as valuable resources to ease the plan purchase process.

CIGNA: We have found that the broker/consultant channel has been the most effective.

HealthEquity: HealthEquity has a number of distribution channels. We’ve had a lot of success partnering and integrating with health plans as well as working through brokers and consultants.

HSA Bank: We work with brokers, general agencies, consultants, third party administrators, and carriers.  However, brokers remain our most effective channel in selling HSAs to date.  Results show that over half of our business comes from this channel. As such, we have a strong focus on our broker distribution channel.  We offer brokers easy enrollment options to set up their groups and individuals, revenue-sharing opportunities, a dedicated call center as well as field sales support to help close deals and provide education to groups.

HSA California: All HSA California sales are through licensed independent insurance brokers and authorized general agencies. To make sure brokers understand the unique selling opportunity behind HSA California – that we’re the only small group, fully integrated HSA program with multiple carriers in California – we produce timely communications and brochures that walk them through the program.

J.P. Morgan: We receive new business from all segments of the market.  Typically the most successful programs are those that have strong support from management or the business owners.

Kaiser Permanente: All channels have been successful  in selling HSA programs.

SeeChange Health: As with all health insurance products, the brokers channel is the most effective channel when it comes to helping consumers and employers find the medical plans that best fit their needs. Given that our HSA-compatible plans provide value-based benefits that reward members for taking specified health actions, brokers play an extremely valuable role in ensuring our members receive the maximum benefit from their SeeChange Health

Sterling HSA: We are committed to the broker, agent, and consulant channel.

UnitedHealth Group: UnitedHealthcare’s HSA-qualified plans are sold primarily through brokers and consultants, or directly to individuals purchasing insurance policies on their own.

22.  Which customer segments have been most receptive to HSAs?

Aetna: All customer segments.

Anthem Blue Cross: All customer segments continue to express interest in and adoption of HSAs.

Blue Shield: HSA-eligible plans appeal to all customer segments, from the individual market to small, midsize, and large groups.

CIGNA: We have seen receptivity in all customer segments from the small group segment through National Accounts.

HealthEquity: Customers of all sizes, from individuals to large employers, have been receptive to HSAs. The most recent trend, though, is that employers are realizing that an HSA-compatible plan is a good fit for the majority of their employees and they are making the decision to go total replacement.

HSA Bank:  HSA Bank’s 2011 Consumer Benchmark Survey results indicate no statistically significant difference between HSA participants and non-HSA participants in regards to age, income, or overall health. This debunks the myth that HSAs only benefit the young, wealthy, and healthy.

HSA California: Employers looking to rein in premium increases while at the same time expanding health plan choices to employees have been most receptive. HSA California is also appealing to small-business owners looking to offer medical coverage to employees for the first time, because it is less expensive than traditional coverage and offers unique turnkey savings opportunities.

J.P. Morgan: Typically those customers who believe in controlling medical costs as well as empowering employees to make their own decisions on healthcare.

Kaiser Permanente: We have seen strong growth in all customer segments including the Individual and Family, Small, Mid and Large Group segments.

SeeChange Health: HSAs have evolved beyond being a niche product and have been embraced by all customer segments.

Sterling HSA: Customers who want to contain their healthcare costs and reduce increases continue moving to the HSA market. Areas with high PPO penetration move quickly as well. We believe this trend will continue due to rising health plan premium costs and taxes.

UnitedHealth Group: All segments have been receptive to the HS product.

23. How prone are brokers to support this with reduced commissions on the high deductible health plan side of the equation?

Aetna: We have seen widespread broker support of HSA plans as a viable option for their clients.

Anthem Blue Cross: There is high interest in supporting this product from brokers to date.  We continue to believe brokers will promote the appropriate health plans based on their client’s needs, regardless of commission rate.

Blue Shield: We have received positive broker feedback on our HSA eligible HDHPs, as these plans have proven to be an important option for brokers looking to provide plan benefit designs at more affordable price points for their IFP and group clients.  In addition, HSA-eligible HDHPs are also attractive because of the possible tax and personal saving advantages.

CIGNA: Brokers have been very supportive of these plans.

HealthEquity: Brokers are looking for solutions for their clients. As we move forward, HSA-qualified plans appear to be a better fit than ever, so brokers are recommending them.

HSA California: In today’s economy, the owners of small business are looking to reduce premiums yet still provide quality benefits to employees. HSA California takes HDHPs and HSAs to a new level by not only offering affordable benefits, but packaging three top California health plans in one program; each employee can choose a different health plan – a choice no other program in the state offers. As the market continues to change, we believe brokers will continue to adopt HSA-compatible plans as an applicable solution for many clients.

J.P. Morgan: Brokers who are registered with J.P. Morgan are focused on providing the right solution for their clients, regardless of commission.

Kaiser Permanente:  Brokers are very supportive of these programs when they meet their customers’ business needs.

SeeChange Health: Professional brokers focus on meeting the needs of their clients. We’ve seen no reluctance to sell our value-based, HSA-compatible plans.

Sterling HSA: Brokers who think this is the right thing to do for their clients place them in an HDHP/HSA. Many brokers use the HSA concept as a marketing advantage to grow their book of business.

UnitedHealth Group: Brokers realize that the CDH plans are experiencing rapid adoption and they are doing their best to offer their customers the product that is right for them.

24. Will high-deductible health plans actually reduce utilization?

Aetna: We see continued positive signs of cost control and consumer engagement in studies in HSA and HRA results.

Anthem Blue Cross: When members engage in healthy choices and become active in their medical decisions, utilization is affected.

Blue Shield: While preventive care is covered on all our HSA-eligible HDHPs with low or no co-payment and all Blue Shield members can take advantage of our core wellness programs, it is yet to be determined if HSA-eligible HDHPs reduce utilization.

Cigna: During the past several years, Cigna has compiled empirical data on literally millions of individuals enrolled in our CDHP, HMO and PPO plans based on claims experience that demonstrates that our consumerism products (HRA and HSA), offered as part of a comprehensive package of communication, member education and access to reliable and actionable information, substantially reduce the overall employer medical trend. Moreover, Cigna’s multi-year experience studies of CDHP plans provide evidence demonstrating that our consumer-driven health plans both improve costs and health care quality.

HealthEquity: Properly designed HSA-qualified plans combined with strategic employer funding have proven successful at reducing utilization and, as a result, reducing trend. HealthEquity has a number of case studies showing how some of our larger clients have been successful at saving money with a consumer-directed approach.

HSA Bank:  Our data supports evidence of lower claims which makes sense because consumers shop differently with their own money.  They adopt the usual consumer behaviors. They shop on quality and price and even start to adopt healthier behaviors. However, there is a distinction between HDHPs when paired with an HSA vs. HRA. HRAs do not lower claims because the employer, not the employee, owns the money. Without owning the money, there is a use it-or lose it mentality, just like with FSAs.  In fact, claims for unnecessary visits and procedures can go up, not down…just to use-up the money available. In other words the wide adoption of HRAs with HDHPs has unfortunately voided the HDHPs intended low-utilization premise and actuaries are now pricing HDHPs higher relative to traditional plans to the point that the savings spread has almost disappeared.

HSA California: The goal of an HDHP is to allow employees and and their families to control what they spend on healthcare. It’s still too early to tell whether utilization will actually be reduced by offering plans with higher deductibles.

Kaiser Permanente: We are frequently evaluating the impact on utilization. Based on some small samples assessed, we have seen a drop in utilization with our members in HSA-qualified health plans.  The lower risk factor behind this population segment may be a contributing factor.  Additionally, there are also some small studies that indicate a change in behavior from these members as they become more financially engaged and responsible for their health expense.  Preliminary information shows that some members have pursued alternative options – e.g., emailing their physician. We believe that it is important to have members enrolled in the high deductible health plans to receive care from Kaiser Permanente’s integrated delivery system to ensure engagement extends beyond benefit designs.  Achieving sustainable behavior change also requires evidence based clinical engagement at every care encounter with market leading electronic medical record system.

SeeChange Health: Not only have studies shown that HSA-compatible plans positively impact utilization, but also their relatively lower costs mean more consumers can afford coverage, reducing the number of uninsured Californians.  Additionally, we believe our value-based HSA compatible-plans are uniquely positioned to help employees stay healthier and reduce health care costs for the long term.

Sterling HSA: Our experience suggests that our clients are carefully evaluating cost/treatment alternatives, thereby reducing unnecessary medical utilization. Trends on a national level are below that of traditional health plans.

25. How can vendors make HSAs more effective and attractive for brokers?

Aetna: Make the sales process as simple as possible and give brokers tools that allow them to present these options to employers and employees effectively.

Anthem Blue Cross: Vendors can make HSAs more effective by streamlining and simplifying the enrollment and communication processes.

Blue Shield: Blue Shield has relationships with HSA custodians to promote HSAs and offer consumer education to brokers and employer groups.  For example, vendors can demonstrate for employers how moving from a traditional PPO or HMO product to an HSA-eligible HDHP offers more affordability, which also allows for greater employee coverage.  Our website provides extensive information on this topic: http://www.healthequity.com/BSCemployeeEd

Cigna: By providing information to help brokers understand the consumer advantages of the HSA product, providing products and processes that are easily understood by employers and supporting the member education at enrollment and on an ongoing basis.

HealthEquity: HealthEquity strives to make HSAs attractive to brokers by delivering a complete, integrated solution to their clients and providing 24/7/365 customer service. This improves the member experience and reduces the number of calls the broker receives. HealthEquity also has a Broker Sales Team that can assist with new business and a broker portal where producers can access marketing material; create proposals, and manage their HSA clients.

HSA Bank: They’re selling HSAs.

HSA California: Education is the key. It’s important that brokers are comfortable explaining the concept of an HSA and how it can work to completely satisfy the needs of clients, employees, and families. HSA California and The Bancorp Bank provide a number of educational resources for brokers to help them better explain HSAs to clients. For more information on these materials, brokers can call us anytime at (866) 251-4625.

J.P. Morgan: Producers are selling HSAs more than any other spending account.

Kaiser Permanente: Vendors can make HSAs more effective and attractive by keeping the sales process simple, supporting good communications, supporting installations and bringing effective online tools to the employer and members.

SeeChange Health: Whether talking about HSA-compatible plans or more traditional policies, at SeeChange Health Insurance we’re extremely broker-centric, providing unique products that actually encourages members to see their doctor, strong training and education, and delivering outstanding service to them and their clients.

Sterling HSA: We support the broker channel with sales representatives who handle their needs personally. We also offer HSA training and education. We have online toolkits for brokers and consultants who have registered with Sterling. These include analysis tools, PowerPoint presentations, and other sales material. In addition, we support the broker’s employer clients in a similar fashion. This helps our broker partners better satisfy their clients’ needs.

UnitedHealth Group: Make quoting, set up, and enrollment as simple as possible for the broker. Provide as much broker training as possible. Provide simple communication materials for HR staff and the enrollees. Leverage the experience and materials of your health plan partner, who can offer communications materials and other tools to provide assistance.

26. Will consumers purchase plans for their traditional health plan features and view the HSA account as a perk to cover short-term medical expenses or will the primary purchase decision focus more on long-term financial planning to cover immediate and long term medical expenses and to reduce tax liability?

Aetna: We see both with the latter being more common.

Anthem Blue Cross: The HSA plans offer choices for all members.The member can choose to save the tax-deferred monies or choose to spend the monies to cover their individual or family medical and pharmacy claims.

Blue Shield: Research indicates that consumers appreciate the lower cost of the actual HSA-eligible HDHP as well as the flexibility offered by HSAs, whether used to cover short-term medical expenses or for longer-term financial planning.

HealthEquity: This really depends on the consumer. Some people keep a relatively low balance, funding their account when they anticipate an eligible expense and immediately spending the tax-free dollars. Other people are savers; they use the account to reduce their current tax liability while setting aside funds that can be used for long-term medical expenses.

HSA Bank: We make brokers look good.  Period.  From enrollments to answering difficult questions, we have outstanding customer service dedicated to brokers and their customers.

HSA California: It depends on the individual consumer. Having funds available in an HSA for short-term medical expenses is a great feature. However, the long-term advantages are equally important. The ability to save HSA funds and earn interest tax-free year-after-year, provides the unique value inherent in HSAs. An HSA is a perfect savings vehicle to add to a long-term savings portfolio next to a 401(k), IRA, or any retirement medium.

J.P. Morgan: We maintain a dedicated Broker Service Team that supports all aspects of the sales process for brokers. We work with brokers as an educational resource, supplying detailed information about HSAs and timely updates regarding any pending changes in HSA regulations.

We assist brokers with proposals to clients, providing detailed cost estimates and all the relevant statistical data brokers will need to make a convincing case.

Once your clients are up and running, you can rely on J.P. Morgan’s HSA expertise to ensure the ongoing success of their programs.

The J.P. Morgan name is universally known and trusted in the world of financial services today, so brokers will have the power of a major international brand behind them in their sales efforts. What’s more, HSAs are sold to employees under the Chase brand, the retail counterpart of J.P. Morgan, which also has a very strong reputation for financial stability among consumers. At both the business and consumer levels, working with names like J.P. Morgan and Chase will give people the comfort level they need to entrust their HSA program to you.

Kaiser Permanente:  Consumers purchase Kaiser Permanente HSA – Qualified Deductible HMO plans and open HSAs to cover both immediate and long-term medical expenses, as well as to reduce tax liability.

SeeChange Health: California is a diverse state so it’s not surprising that employers are buying HSA-compatible plans for both reasons.

Sterling HSA: The latter appears to be the case. This is truly a new way to finance the costs related to healthcare. In today’s economic climate, the HSA is a great way to budget for medical, dental and vision expenses as well.

UnitedHealth Group: Based on research from OptumHealthBank released in April 2007, HSA accountholders typically can be categorized into one of three basic patterns of account usage: Spenders, savers and investors. Roughly half of OptumHealthBank 400,000 accountholders are spenders and most of the remaining are Savers. While less than 5 percent of today’s HSA population are Investors, this may someday be the largest group based on early, accelerating balance trajectories. OptumHealthBank Spenders carry balances that hover between $400 and $600, spend 80 percent of contributions on current medical expenses and contribute an average of $133 per month. OptumHealthBank Savers hold a balance of nearly $1,500 on average and spend less than 10 percent of contributions to their account. OptumHealthBank Investors are the most active contributors with the highest total balances and highest expected tax savings, holding over $2,000 in bank balances and, on average, investing another $3,000 in any combination of OptumHealthBank eight highly regarded non-proprietary mutual funds.

27. Do you envision interest in an HSA eligible HMO (low-cost) plan?

Aetna: Yes, since January 2006, Aetna has offered an HMO HSA in some markets.

Anthem Blue Cross: Anthem is reviewing market interest and feasibility of offering an HSA HMO.

Blue Shield: We are reviewing the HMO/HSA market trends and will be introducing new HDHPs that answer the markets needs.

CIGNA: We have not seen significant interest at this time.

HealthEquity: This really depends on the consumer. Some people keep a relatively low balance, funding their account when they anticipate an eligible expense and immediately spending the tax-free dollars. Other people are savers – they use the account to reduce their current tax liability while setting aside funds that can be used for long-term medical expenses.

HSA Bank:  That’s the beauty of an HSA – its flexibility. If a consumer needs to cover qualified medical expenses, they can do so tax-free with their HSA funds.  The consumer also has the option to grow their funds through self-directed investment options with no minimum balance.

HSA California: HSA California currently offers four HSA-eligible HMO plans. Brokers can call 866-251-4625 between 8 a.m. and 5 p.m., Pacific Time, for full benefit plan summaries for all HSA California plans.

Kaiser Permanente: Absolutely.  Since 2005, Kaiser Permanente HSA-Qualified Deductible HMO plans have appealed to all market segments, including individual and Family, Small, mid and Large Groups.

SeeChange Health: We offer only PPO plans, but HSA-eligible HMOs will likely find an audience, although we don’t think it will be nearly as large as HSA-compatible high deductible plans.

Sterling HSA: Several carriers already offer an HMO/HDHP plan or EPO/HDHP plan design.

UnitedHealth Group: Yes.

28. Which geographic areas and consumer demographics are brokers seeing a demand for competitive individual and family plan HSAs?

Aetna: We are not in that market segment, so we cannot respond.

Anthem Blue Cross: Being our HSA plans are consumer centric and come with strong preventive benefits, we are seeing strong demand across all territories and demographics.

Blue Shield: Blue Shield experience indicates that the broker interest in HSAs is statewide.

Cigna:  We offer an array of individual and family plans in California, some of which are HSAs. Cigna is price competitive in this market.

HealthEquity: This is not something that we are asked about very often, but there may be some interest in areas where HMOs are still a popular plan option. The interest level would depend in large part on how these products are priced.

HSA Bank: Yes. And, carriers should not overlook this as an option for California.

HSA California: We’re seeing growing interest throughout the state.

Kaiser Permanente: We are seeing demand across all geographic areas and demographics.

SeeChange Health: We sell exclusively to groups of 2-to-200 employees or more.

Sterling HSA: We know that the early baby boomer is very interested in choosing a HDHP/HSA product. Areas with high PPO concentration and lower pricing are high sales areas. The individual market has been a PPO market for some time and was the first to migrate to the HSA. Some individuals already have a HDHP and now have a tax-advantaged way to pay for medical expenses or save for retirement. We also see strong interest in certain geographic areas where Sterling has recently expanded, including key markets in the Midwest and the Southwest.

UnitedHealth Group: All.

29. What problems, if any, have you encountered with HSA eligible plans?

Aetna: None

Anthem Blue Cross: Many health plans in the California market have had challenges pricing the 100% HSA plans. Anthem made pricing adjustment in 2008 and a pharmacy benefit adjustment in 2009 to reflect the actual utilization we were seeing in these 100% plans.  Anthem small group also introduced new 80% plans in 2009 and the market continues to show an interest in HSA plans in all market sizes.

Blue Shield: We have not encountered any issues specifically pertaining to HSA-eligible plans.

Cigna: We have not encountered problems with the administration of the HSA eligible plans. One of the challenges of introducing these plans is to educate the member on the value of the plan and the tools to become actively engaged in the management and maintenance of their own health care.

HealthEquity: Price is still a huge issue for most employers and individuals considering an HSA-qualified plan. Some health plans have made a commitment to pricing these products appropriately while others have not.

HSA California: We haven’t encountered any problems with our benefit plan designs.

Kaiser Permanente:  When there is excellent communication to the employer and employees we do not encounter problems. It is important to provide education on how the deductible plans and the HSA work together.  Kaiser Permanente and our preferred financial administrator for HSAs, Wells Fargo, have developed extensive training materials and marketing collateral for brokers, employers, employees and individuals.

SeeChange Health: None.

Sterling HSA: Pricing is imperative in an HSA plan.  If the rates are competitive then the plan does not sell well.  However, we have recently seen a differential in the traditional PPO and HDHP/HSA compatible plan that is supporting considerable sales of this product.

UnitedHealth Group: The main challenge with the HSA product is educating the consumer to take financial responsibility when receiving health services. Most consumers are used to dealing with a health insurance company or their bank. The HSA product is more than the sum of its parts; it involves educating the members and encouraging them to ask financial questions when seeking and receiving health services.

30. How has your plan changed from last year?

Anthem Blue Cross: We have enhanced our online support of resources with our banking partners BNY/Mellon (ACS/Mellon), added Rx Copay vs. Coinsurance and a variety of enhanced deductibles for our HSAs. We have also eliminated several 100% HSA plans from our portfolio due to high cost and poor performance.

Blue Shield: Blue Shield is pleased to now offer our clients an unsurpassed Account Based Health Plan (ABHP) in conjunction with our new partner, HealthEquity.  We researched the market extensively before selecting a strategic Account Based Custodial vendor that can service all lines of business.  This is a platform and not a banking system and was designed and developed by HealthEquity.  HealthEquity’s leading technology supports releases and platform enhancements and updates twice a month and has a speed to market, which is unheard of with our competition.  Our new Account Based platform offers a completely integrated healthcare experience for both members and clients.  All accounts are on one platform with integrated enrollment and claims information, and flexible contribution models.  We will also provide our clients with an Employer Portal with access in real time to eligibility information, contributions, fee payments, and more. Clients will also be able to run for easy reconciliation.

Cigna: We have added enhanced decision support tools. One such tool is our Health Risk Assessment. Cigna has entered into a long-term agreement with the University of Michigan providing access to the use of analytics that help consumers and Cigna identify and address health risks and help employers develop worksite health and wellness programs. We also offer online coaching capability that invites immediate, active participation in online behavior change modules, pushing targeted follow-up based on HRA responses.

HealthEquity: HealthEquity recently introduced an option called “Balance Protector,” a low-cost, guaranteed-issue product designed to preserve an account holder’s HSA balance in the event of an accident.

HSA California: In 2011, HSA California added the Ameritas EPO 3000 Dental Plan to our portfolio of offerings. The new EPO is the ideal combination of choice and savings – allowing members to select their own dentist from a network of more than 160,000 trusted professionals, while also assuring them of savings on covered treatment and their plan premium. We also expanded our Cal Perks Employee Discount Program (offered at no cost to enrolled groups) to include an increased variety of discounts, including theme parks, water parks, paintball, sports team tickets, and more. HSA California is strongly positioned to meet all of the requirements set forth by health reform; plans are 100% compliant with health reform-related legislation.

Kaiser Permanente: Aside from compliance with federal Health Care reform, We have no significant changes planned for 2011/2012, but we are always exploring ways to make improvements to meet our customers’ needs. We have expanded member support activities including proactive outreach activities to assist with employee understanding of these programs.

SeeChange Health: We introduced what we believe to be the nation’s first value-based benefit HSA-compatible plans in 2010 at the request of our brokers. (Our HSA-compatible plans lower members’ out-of-pocket exposure when they complete specified actions that help them manage their health). We’re constantly listening to our brokers to improve our products. So in 2011 we began giving employers the option of choosing either a calendar year or plan year deductible period. We also modified our underwriting rules to make it easier for brokers to sell our HSA (and other plans) alongside HMOs. Based on the strong support we’re receiving from brokers and their clients we’re not expecting to make any significant changes in 2012, but we’re always open to input from the brokers we’re privileged to work with.

Sterling HSA: We reduced our HSA set-up fees effective in September 2011. We also offer discounted set-up fees for groups adopting multiple products from Sterling (HSA with HRA, HSA with FSA, COBRA).