Health Savings Account Blog

While Blackhawk introduced its HSA plan as an exclusive offering, the company also added a traditional PPO two years ago. But according to the company, only 8% of the employees opted for the PPO plan. "The HSA plan wasn't embraced with open arms when we introduced it," says Susan Burdick, a company rep. "There was a certain amount of employee resistance and fear. Employees were asking, 'Will there be enough money there to meet my family's medical needs when they need it?'" But Burdick says "now that we've lived it, I don't think we could take the feature away."

Bank Contributes 50% Match to Health Savings Accounts

The bank's HSA plan features a $1,500 deductible for individual coverage and $3,000 for family coverage. Once the deductible has been met, employees contribute 10% of the remaining costs up to the out-of-pocket limit of $3,000 for individual and $6,000 for families. The bank also contributes 50% of the dollar amount to each employee's HSA, and it makes the annual contribution on Jan. 1. "We do that for a specific reason," Burdick says. "It reduces peoples' fear that they won't have enough money in their account at the beginning of the year to pay their out-of-pocket costs."

Burdick says that over the four years the plan has been in effect, enrollees have built up average HSA balances of $1,500. She says that this comes close to the average $1,500 to $1,600 that it sees in its custodial Health Savings Accounts.

So far, Blackhawk's medical insurance premiums have not exceeded the 2005 premium renewal rate levels, so employees are still contributing less in 2009 for their medical insurance than they were in 2005. Blackhawk employees contribute a flat premium percentage, based on their annual salary, for their insurance regardless of whether they choose the HSA or PPO plan. Monthly premiums for the CDH plan trend lower than for the PPO.

Blackhawk has made no changes to the plan's design since its introduction, and for a reason. "People must be able to understand their medical plan," Burdick says. "But if you tweak your plan on an annual basis, people become confused and feel that they're losing control." And that, she warns, makes it more difficult for your employees to become your partner in saving health care costs.

For Blackhawk, the critical element for HSA plan success is employee education. "When we introduced the plan, we brought our employees together in small groups of 10 each to talk about the plan and explain in detail how it works, including the tax benefits for employees," Burdick says. The small groups created an atmosphere of intimacy and gave people the opportunity to ask questions and address their concerns. "We also hit the message multiple times over a period of time, chunking the information into small pieces and getting it out in meetings, articles in our newsletter and other venues," she notes.

But the deciding factor, Burdick says, was "having the courage to put pencil to paper" and help people calculate what their expenses would be under the plan. "This is an emotional issue for people," she notes. "Mess with an employee's benefits, and you're messing with his or her family. So you have to remove the emotion from the equation." Burdick explains that once they went through this exercise with their employees, "it was a home run."

Blackhawk works with Health Solutions, a Milwaukee-based wellness program management company, to support its employee wellness program. But the bank has done something that many employers don't do: Employees must take an annual health risk assessment (HRA) to participate in the company's medical plan. The first year was voluntary, Burdick explains. "But starting with year two, it was mandatory, and you also had to discuss your results with a health coach," she says, adding that the rule applies to plan members and their spouses. "We started from the premise that if you don't know what's wrong with you, you can't address and fix it." It also works to strengthen the employee's partnership with his or her physician, which, Burdick observes, is at the heart of a HSA plan.

Burdick admits that the bank experienced more employee resistance to the mandatory HRA than it did to the HSA plan when it was introduced. But the company worked to assure employees that it would be receiving only aggregate HRA results.

Major Emphasis Put on Wellness

Blackhawk also involves its employees in a variety of worksite-based health and wellness initiatives, focusing on the top three health risks — poor nutrition, cancer and lack of fitness — identified through the HRAs. As part of its "Eat Right" initiative, all food vending machines now include healthy choices on the right side of the machines. A company Health Team composed of employees plans events, activities and education around the three health areas. Among positive results to date: a drop over the past four years in the number of employees at risk for poor nutrition, from 91% to 60% ("Not as much as we'd like to see," Burdick says), and an increase in the number of days each week that employees are exercising.

While Blackhawk doesn't tinker with its HSA plan design, the company is ramping up its wellness program. The company is now adding incentives to encourage more employees to take annual physical exams. "We found that only 26% of our employees were doing this," Burdick says. "So now we're putting an extra $100 into the HSA of any employee who takes an annual physical." The company also is focusing on seven basic health habits that are said to be predictors of longevity. Using HRA baseline data, the company is shifting its health and wellness practices toward addressing improvements in the seven areas.

Burdick's takeaway for other employers: "It's all about education, communication and keeping it fresh," she says. "It can't be a once-a-year discussion with your employees." Burdick advises aligning what the company puts out as part of its health and wellness program with what it actually does in the workplace. And she says that you can't roll out a HSA plan with a wellness component without visible support from the top. "It can't be 'yes, top management supports it,' "she says. "They have to support it visibly."