2022 Key Enrollment Trends For High Deductible Health Plans

High deductible health plan (HDHP) enrollees may have a broader selection of health plans and may view pre-deductible coverage for chronic disease prevention care as a deciding factor in health plan selection, a survey from Employee Benefit Research Institute (EBRI) and Greenwald Research found.

EBRI and Greenwald Research surveyed over 2,000 Americans between the ages of 21 and 64 between October 17 and November 20, 2022. Both traditional health plan members and HDHP enrollees responded to the survey.

The survey covered six main topics: open enrollment trends between HDHP enrollees and traditional health plan enrollees, health plan choice, HDHP enrollment, financial wellbeing differences between HDHP and traditional health plan enrollees, use of health savings accounts (HSAs), and pre-deductible coverage in HSA-eligible health plans.

“Open enrollment is the time of year when employees get to evaluate their plan options,” Paul Fronstin, director of health research benefits at EBRI, said in an emailed press release. “Employees should consider the trade-offs between premiums and cost sharing when making health plan decisions.”

Most enrollees were satisfied with the enrollment process, with six out of ten enrollees saying they were extremely or very satisfied and a third saying they were somewhat satisfied.

Almost three-quarters of adults spent less than an hour on their health plan decision (72 percent), the survey uncovered. Around 20 percent of Americans with private coverage had passive enrollment, including 16 percent of HDHP enrollees.

HDHP enrollees tended to leverage their employers’ plan selection tools more readily than employees without an HDHP. Nearly six out of ten HDHP enrollees used their annual employee benefits guides and slightly more than four out of ten leveraged the online portal. In contrast, four out of ten non-HDHP enrollees used the guides and three out of ten used the online portal.

Sixty percent of respondents said that they had a choice in their health plan. Almost three out of ten HDHP enrollees reported having three health plan options. Less than a fifth of the traditional plan enrollees could say the same (17 percent).

Overall, health plan members did not prioritize low premiums. While low premiums were considered important, the provider network, low out-of-pocket spending, prescription drug coverage, and the plan’s overall simplicity were key components that factored into members’ decision-making. HDHP enrollees prioritized low premiums over low out-of-pocket spending.

For HDHP enrollees, chronic disease prevention coverage could significantly influence their health plan selections.

Forty-five percent of HDHP enrollees said that pre-deductible chronic disease prevention coverage influenced their health plan decision. A quarter of traditional plan enrollees were extremely or very likely to switch to an HDHP plan if the plan offered this type of coverage.

Almost four out of ten HDHP enrollees said that their HDHP plans covered chronic disease prevention care while another four out of ten enrollees were unsure if their plans covered these services.

“Those especially with chronic conditions should pay careful attention as we see employers both enhancing and cutting back on health benefits,” Lisa Weber-Raley, chief research officer at Greenwald Research, added in the emailed press release.

Enrollment in HSAs returned to the 2020 record high: 19 percent of employees were enrolled in HSA-eligible plans. Meanwhile, non-HSA-eligible HDHP enrollment dropped to 12 percent.

Traditional health plan employees felt pressure from higher healthcare spending more frequently than their HDHP counterparts. However, more HDHP enrollees reported higher out-of-pocket costs than traditional health plan enrollees, with 46 percent seeing shifts in cost-sharing or premiums in 2022.

Despite the rising prices, 80 percent of enrollees agreed that their finances were stable. Still, 58 percent of respondents said that they had opened an HSA to help cover future costs and nearly the same amount had opened an HSA to save on taxes.

The findings demonstrated HDHP enrollees’ level of involvement in their coverage and the aspects of a health plan that were most attractive to potential enrollees in 2022.